Elevated thyroid peroxidase antibodies and feel... - Thyroid UK

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Elevated thyroid peroxidase antibodies and feeling very tired 😴

YogaSwimmer profile image
7 Replies

Hi all,

I am 51 and take 50mg levothyroxine daily and have been since July last year. I was feeling tired and sluggish and my bloods were tested and had TSH above 5. I was put on 50mg last year. I have had a private blood test done last week and the results are in the photo. My TSH is now 3.76 and I have elevated thyroid peroxidase antibodies(I hadn’t been tested for those before). I’m still feeling tired in the mornings and have a GP appointment today.

My questions are:

Do you think I should ask for an increase in my medication?

Do I have Hashimoto’s disease and do the NHS do anything about it?

Thank you for any advice. I’m new on here and I hope I’ve included enough data ☺️

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7 Replies
TiggerMe profile image
TiggerMe

Welcome aboard

Do you think I should ask for an increase in my medication? Yes, 50mcg is a starter/child dose

Do I have Hashimoto’s disease and do the NHS do anything about it? Yes / No

With autoimmune hypo you might find you feel better excluding dairy / gluten from your diet, worth asking for a coeliac test

You could also do with upping your Vit D to above 100, B12 to nearer top of range 🤗

YogaSwimmer profile image
YogaSwimmer in reply to TiggerMe

Thank you TiggerMe.

I have gone gluten free since February and that has eased a lot of other gut symptoms (which has made my insides feel a lot better!). I have also been taking an oral spray of vit D (BetterYou Vit D with K3 three sprays a day) since February too.

I will have a chat with the GP later today and see what she says as feeling this tired is not good in the mornings.

Love the people on here ☺️

TiggerMe profile image
TiggerMe in reply to YogaSwimmer

Add an extra squirt or two to get things optimised... this is handy to work out what to add...

grassrootshealth.net/projec...

Sublingual B12 is also an effective option

Yours results show a need for a dose increase so don't take no for an answer you are looking to get your TSH around 1 🤗

YogaSwimmer profile image
YogaSwimmer in reply to TiggerMe

Great information, thank you. Looks like I need to increase my Vit D by at least 2 squirts and I’ll look at the sublingual B12 too.

SlowDragon profile image
SlowDragonAdministrator

Be aware most U.K. medics only refer to hashimoto’s as autoimmune hypothyroid disease……and will totally ignore the autoimmune aspect

Which brand of levothyroxine are you currently taking

Was test done early morning, ideally before 9am, only drinking water between waking and test and last dose Levo 24 hours before test

Request 25mcg dose increase in Levo to 75mcg

Retest again in another 2-3 months

Well done on gluten free

Also worth trying dairy free eventually

But only make one change at a time or you can’t tell what’s helping

YogaSwimmer profile image
YogaSwimmer in reply to SlowDragon

Hi SlowDragon,

I am taking Teva levothyroxine 50mcg. The doctor today would not increase my dose saying my results were ‘within range’ and would not entertain that the tsh should be nearer 1.

I did my other test as you suggested to get a more accurate reading.

Doctor wanted to test for celiac disease but I’d have to go back to eating gluten for 6-8 weeks before they can test they said.

I am going to try going dairy free too. One thing to change at a time so I know what’s working or not.

They are going to do a full blood test too to see if anything else is going on.

bit frustrating really…

SlowDragon profile image
SlowDragonAdministrator in reply to YogaSwimmer

GP is plain WRONG

Free T4 (fT4) 18 pmol/L (12 - 22) 60.0%

Free T3 (fT3) 4.3 pmol/L (3.1 - 6.8) 32.4%

When adequately treated most people will need Ft3 at least 60% through range, usually Ft4 (Levo) will be higher at 70-80% through range

see different GP or see thyroid specialist endocrinologist

If seeing different GP, take long list of current hypo symptoms

Request “trial” increase in dose Levo to 75mcg daily……or initially 50mcg and 75mcg on alternate days

And if they still refuse say you request referral to endocrinologist

Print these guidelines out and be ready to quote verbatim

Guidelines of dose Levo by weight

approx how much do you weigh in kilo

Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose (typically 1.6mcg levothyroxine per kilo of your weight per day)

pathlabs.rlbuht.nhs.uk/tft_...

Guiding Treatment with Thyroxine:

In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.

The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).

The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.

……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.

The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.

Some people need a bit less than guidelines, some a bit more

TSH should be under 2 as an absolute maximum when on levothyroxine

gponline.com/endocrinology-...

Graph showing median TSH in healthy population is 1-1.5

web.archive.org/web/2004060...

Comprehensive list of references for needing LOW TSH on levothyroxine

healthunlocked.com/thyroidu....

onlinelibrary.wiley.com/doi...

If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).

Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists

Ideally choose an endocrinologist to see privately initially and who also does NHS consultations

thyroiduk.org/contact-us/ge...

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