Underactive thyroid

[JUNEO]

I Was diagnosed with under active thyroid 10 years ago age 50, I have struggled with tiredness my go will not change the 50mg dose of levothyroxine. I have just had it re tested and tsh level is 0.97 I am also anemic come back in the same blood tests so starting iron. Any thoughts please

[Jaydee1507 Administrator]

Welcome to the group. If you could complete your profile it helps members understand your thyroid journey so far and be able to advise you better. Click on your image icon to start. Fill out the free text box at the top.

What time of day was your test?

If GP has only tested TSH then thats completely inadequate to see if you are fully replaced. To make a proper assessment we need to see TSH, FT4 & FT3. Often this is only possible by buying a private blood test sadly. Its usually the lab that refuses to test anything other than TSH.

Have you tried asking different GPs for an increase? Asking for a trial increase can often work better. Keep asking and dont give up.

If you are anaemic then that will be contributing to tiredness, also your thyroid hormone wont be able to work well. We need all 4 key vitamins at OPTIMAL levels for thyroid hormones to work properly.

Have you recently or could you ask your GP to test levels of ferritin, folate, B12 & D3? Private tests are available, see link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/testing/priva...

There is also a new company offering walk in& mail order blood tests in London, Kent, Sussex & Surrey areas. Check to see if there is a blood test company near you. onedaytests.com/products/ul...

Only do private tests on a Monday or Tuesday to avoid postal delays.

Be sure to take iron 4 hours away from Levo as it affects absorption. Take iron with orange juice or anything containing vit C to aid absorption.

Do you know if you had positive thyroid antibodies? Many with autoimmune thyroid disease aka Hashimoto's benefit from a gluten free diet. A smaller percentage of those also need to remove dairy from their diet to feel well. These are intolerances and will not show up on any blood test.

Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process).

Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo/T3 just prior to blood draw can show a falsely elevated result and your GP/Endo might change your dose incorrectly as a result.

[JUNEO in reply to Jaydee1507]

Hi thankyou for the reply, I had the blood test at 11am. The following came back as Abnormal liver function, serum tsh, serum ferritin, serum magnesium, b12 folate, urea and electrolytes I received a message from my gp to say I am to start iron tablets for 3 months nothing else. I have had to have these for each of the blood tests since July 2023 as they keep coming back low. Also I had to have a week supply of calcium 4 months ago. I just feel so tired all the time.

[Jaydee1507 Administrator in reply to JUNEO]

Having the test at 9am or earlier where possible can make all the difference as far as TSH level goes and it would have been a little higher. Next blood test try and go for that time slot.

Do you have a copy of your latest vitamin results that you can share with us? You are legally entitled to a printed copy of your results, ask at GP reception. In England you can get the NHS app and ask for permission to see your blood results on that by asking at GP’s reception.

If your thyroid hormone levels are too low then it affects gut function and low vitamin levels are the result of this.

How is your diet? Do you eat red meat?

As well as taking iron tablets, increasing iron rich foods in your diet can really help.

Link with ideas for dietary iron:

dailyiron.net/

Most people here need to supplement B12, folate & D3 continuously to get their level to optimal and maintain it there.

Has GP started you on B12 injections if your B12 level was low?

What about folic acid for low folate?

[JUNEO in reply to Jaydee1507]

Hi I do have the results of the Abnormal results on my app that I wrote earlier if that helps. I've never had any b12 injections he has always given me 6 weeks supply of ferrous sulphate this time I've been given 3 months supply of 200mg ferrous sulphate?

[Jaydee1507 Administrator in reply to JUNEO]

If you can either screenshot the app results and remove any personal information and doctors name or type out the results for B12, folate & D3.

You likely need to be supplementing them all and can buy over the counter supplements.

Try adding in chicken liver pate a few times a week to up your iron intake.

The PPI Esomeprazole will be further reducing your already low stomach acid caused by low thyroid hormones, so despite a good diet you just cant absorb the vitamins.

[JUNEO in reply to Jaydee1507]

I see what your saying thank you I'm just trying to send the results to you I'm not very technical

B12

[Jaydee1507 Administrator in reply to JUNEO]

You will feel a lot less tired once you raise your vitamin levels.

Your B12 level is very low. Do you have symptoms of B12 deficiency? The reference range for B12 is very wide and cut off point too low. theb12society.com/signs-and...

If you do then you should discuss this with your doctor for further tests for Pernicious Anaemia.

If not, then start with a methyl B12 sublingual spray or lozenge for a week, then add a good B complex. Once you run out of the separate B12 just continue with the B complex.

cytoplan.co.uk/vitamin-b12-...

amazon.co.uk/Better-You-Boo...

B complex suggestions: Slightly cheaper options with inactive B6:

amazon.co.uk/Liposomal-Soft...

Contains B6 as P5P an active form:

bigvits.co.uk/thorne-resear...

healf.com/products/basic-b-...

Explanation about the different forms of B6:

helvella.blogspot.com/p/hel...

B complex comparison spreadsheet:

healthunlocked.com/thyroidu...

If GP hasn't tested vit D:

NHS easy postal kit vitamin D test £31 via

vitamindtest.org.uk

[JUNEO in reply to Jaydee1507]

Hi I have been going to my doctors for the last 2 months saying I am exhausted sleeping 12 hours a night and falling asleep during the day. My tongue is so sore pins and needles also cramp in my legs and feet for the last 4 months I said to my gp something isn't right please can you donblood tests as he he said I didn't any

[Jaydee1507 Administrator in reply to JUNEO]

I know its really hard to get the help you need when you're that tired. Is there anyone you can take with you to your appointments?

Has GP accepted that your B12 level is on the low side?

It may just be the combination of PPI use and low stomach acid but do press GP to investigate pernicious anaemia.

Is there any way you can reduce or change your PPI to something that will affect your vitamin absorption less?

GPs get almost no training in nutrition so you will need to lead the way at appointments and be persuasive with your GP.

Sore tongue and pins & needles are likely your low B12.

[JUNEO in reply to Jaydee1507]

To be honest I got a text message saying your iron is a bit low and to take the prescribed medication for 3 months that's all. I am goingvto speak to my husband and make an appointment to speak to the GP I feel that having so many abnormal results 8 in all needs to be looked at. I am going to see about the ppi tablets to I do struggle with acid reflux I will look into pernicious anemia and mention it to. I haven't felt well for a while dizzy and trembling hands and forgetting things the last few months thankyou for your advicd

[JUNEO in reply to Jaydee1507]

I do eat red meat twice a week. I've also been on Esomeprazole for 12 years which I did mention to my gp, I do eat a healthy diet Thankyou