On 50mg levothyroxine. Recent test levels are
Tsh level 0.28Tpo 781
Triodothyronine 4.4
Gp has flagged them abnormal.. im due for a appointment but its a couple of weeks away.. can anyone guide me in the meantime please.
Just to add, I'm due ivf treatment soon, so anyone with any insight or help would be appreciated.
welcome to the forum
How long have.you been on just standard starter dose levothyroxine
Which brand
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
For full Thyroid evaluation you need TSH, FT4 and FT3 tested
Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease
About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s.
Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)
20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis
In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
is this how you did your test?
Triodothyronine 4.4
Please add range on this test result (figures in brackets after results)
no Ft4 result?
High TPO antibodies confirms autoimmune hypothyroid disease also called Hashimoto’s
Absolutely essential to test vitamin levels, especially with Hashimoto’s and definitely before considering TTC
Low B12, folate, ferritin and/or vitamin D highly likely
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
Post all about what time of day to test
healthunlocked.com/thyroidu...
Testing options and includes money off codes for private testing
Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins
medichecks.com/products/adv...
Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins
bluehorizonbloodtests.co.uk...
Only do private testing early Monday or Tuesday morning.
Link about thyroid blood tests
thyroiduk.org/testing/thyro...
Link about Hashimoto’s
thyroiduk.org/hypothyroid-b...
Symptoms of hypothyroidism
thyroiduk.org/signs-and-sym...
Tips on how to do DIY finger prick test
support.medichecks.com/hc/e...
Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee
Thank you so much for your replys I really do appreciate it.
These are the only 3 test results I have had back,
Triodothyronine 4.4 (2.4- 6.0)
Tsh 0.28 (0.4- 4.9)
Tpo 781 (0.0- 6.0) recommended brackets
I have been on levothyroxine 50mg (teva brand) for 1 month now, after tsh of 5 ivf consultant wanted it lower hence levothyroxine.
I'm not sure if this test is linked to the above but I also came out positive for ANA, anti nuclear, at 100 titre (dosnt give me a recommended number in brackets for this one.
B12- 635ng/l (187-883)
Folate- 19.6ug/l (3.1 - 20.5)
Tests were done first thing in the morning.
So high thyroid antibodies confirms autoimmune thyroid disease
Once adequately treated you may not need IVF
Autoimmune disease frequently results in difficulty conceiving
Exactly what vitamin supplements are you taking
B12 and folate look good
No vitamin D or iron and ferritin
May i ask what the treatment for autoimmune disease is?
My consultant has me on loads of vitamins and supplements.
Pregnacare conception max which has alot of vitamins at low dose but methylfolate at 400ug
Omega 3 fish oil 600mg
Inositol 100mg the rest are standard doses.
Additional
Vitamin D 4000iu
Vitamin C 500mg
Vitamin E 500iu
B12 1000ug
Dhea 75mg (as I have one ovary, low amh and low quality eggs)
Coq10 400mg (egg quality)
Melatonin 5mg
I will book a vit d and iron test to see what they are in the coming week.
I havent ever had a full thyroid check, only tsh previously, (just a question would levothyroxine effect tpo levels) or would they remain the same with or without levo?
Had bio chemical miscarriages hence why tsh and tpo have been checked this time before another round.
So miscarriage often linked to low iron/ferritin
I havent ever had a full thyroid check, only tsh previously, (just a question would levothyroxine effect tpo levels) or would they remain the same with or without levo?
Levothyroxine won’t affect TPO antibodies
Gluten Free and/or dairy free often slowly reduces TPO antibodies
Important to also test TG antibodies
pubmed.ncbi.nlm.nih.gov/303...
If TG antibodies are also high
As TSH reduces ….as dose levothyroxine is increased then high TG antibodies reduce
I will definitely be getting my iron and ferritin levels checked next. Thank you so much for putting my mind at ease,I have been driving myself mad thinking the levothyroxine has elevated my tpo! (Naive Me) lol I will request my Dr for TG antibodies too.
I will look into going gluten and dairy free for awhile (such a tough journey already and now even tougher)
I appreciate all the help you have given me ❤
Get coeliac blood test via GP BEFORE trialing gluten free diet as per NICE guidelines
Suggest only cutting gluten or dairy initially
Cutting both at same time is hard and if you see benefits you won’t know which is helping
Pregnancy
Before considering TTC thyroid levels need to be stable
verywellhealth.com/infertil...
.
Pregnancy guidelines
NICE guidelines that if hypothyroid or subclinical you should see endocrinologist BEFORE TTC
cks.nice.org.uk/topics/hypo...
IMPORTANT See pages 7&8
btf-thyroid.org/Handlers/Do...
Also here - dose increase in levothyroxine as soon as pregnancy test confirms conception
cuh.nhs.uk/patient-informat...
thyroidpharmacist.com/artic...
Low ferritin, low thyroid levels and miscarriage
preventmiscarriage.com/iron...
Low iron and hypothyroid
endocrineweb.com/news/thyro...
Folate and B12 and Neural tube defects and autism
Autoimmune disease and inflammatory foods
Your antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances.
Most common by far is gluten.
Dairy is second most common.
A trial of strictly gluten free diet is always worth doing
Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential
A strictly gluten free diet helps or is essential due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and may slowly lower TPO antibodies
While still eating high gluten diet ask GP for coeliac blood test first as per NICE Guidelines
nice.org.uk/guidance/ng20/c...
Or buy a test online, about £20
Assuming test is negative you can immediately go on strictly gluten free diet
(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)
Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse
chriskresser.com/the-gluten...
amymyersmd.com/2018/04/3-re...
thyroidpharmacist.com/artic...
drknews.com/changing-your-d...
Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease
pubmed.ncbi.nlm.nih.gov/296...
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
nuclmed.gr/wp/wp-content/up...
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
restartmed.com/hashimotos-g...
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
Similarly few months later consider trying dairy free too.
Approx 50-60% find dairy free beneficial
With loads of vegan dairy alternatives these days it’s not as difficult as in the past
Post discussing gluten
I have been on levothyroxine 50mg (teva brand) for 1 month now, after tsh of 5
You have tested too soon
Bloods should be tested minimum 6-8 weeks after each dose change in Levo
Teva brand levothyroxine upsets many people
Many people find Levothyroxine brands are not interchangeable.
Most easily available (and often most easily tolerated) are Mercury Pharma or Accord
Mercury Pharma make 25mcg, 50mcg and 100mcg tablets
Mercury Pharma also boxed as Eltroxin. Both often listed by company name on pharmacy database - Advanz
Accord only make 50mcg and 100mcg tablets. Accord is also boxed as Almus via Boots,
Wockhardt is very well tolerated, but only available in 25mcg tablets. Some people remain on Wockhardt, taking their daily dose as a number of tablets
Lactose free brands - currently Teva or Vencamil only
Teva makes 25mcg, 50mcg, 75mcg and 100mcg
Many patients do NOT get on well with Teva brand of Levothyroxine.
Teva is lactose free. But Teva contains mannitol as a filler instead of lactose, which seems to be possible cause of problems. Mannitol seems to upset many people, it changes gut biome
Teva is the only brand that makes 75mcg tablet.
So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half
But for some people (usually if lactose intolerant, Teva is by far the best option)
Vencamil (currently 100mcg only) is lactose free and mannitol free. 25mcg and 50mcg tablets hopefully available from summer 2024
March 2023 - Aristo now called Vencamil
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Helpful post about different brands
healthunlocked.com/thyroidu...
List of different brands available in U.K.
thyroiduk.org/if-you-are-hy...
Posts that mention Teva
healthunlocked.com/search/p...
Teva poll
healthunlocked.com/thyroidu...
Once you find a brand that suits you, best to make sure to only get that one at each prescription.
Watch out for brand change when dose is increased or at repeat prescription.
Government guidelines for GP in support of patients if you find it difficult/impossible to change brands
gov.uk/drug-safety-update/l...
If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient.
academic.oup.com/jcem/artic...
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
And here
pharmacymagazine.co.uk/clin...
Discussed here too
healthunlocked.com/thyroidu...
Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
verywellhealth.com/best-tim...
markvanderpump.co.uk/blog/p...
markvanderpump.co.uk/blog/p...
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
hi- I have just been given this brand for 75 mg as can’t take Teva.
Thanks for that.
See my new post here: healthunlocked.com/thyroidu...
What are the side effects of taking the teva brand? So I know what to keep a look out for. Iv almost finished my teva ones so will change my next batch. Apart from head aches I havent really noticed any symptoms
When I was on Teva all my original symptoms of an under active thyroid came back at once. I didn’t make the link at first, changed back and was fine. Since then I have read lots of Teva horror stories. Sometimes a battle to find other brands as often out of stock.
If you have side effects/adverse reactions or other problems:
🟨 Making Yellow Card Reports 🟨
Headache is common hypothyroid symptom
Teva - reactions wide and various
Some people love it. Others can’t tolerate at all
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