Hypothyroid - Hashimoto

[Eskaayy]

hello

I am new joiner to this forum. It is only by accident that I came to know about this and I am so much hooked and so valuable info that everyone is sharing and helping each. It is a blessing.

Out of my routine blood check, NHS GP did my blood test (14.02.23) and learnt about my thyroid reading came:

TSH 5.34 (range 0.27 - 4.20mlU/L), fT4 - 11.4 (range 12-22).

GP did another test 04.04.23:

- TSH 4.36, fT4 11.2.

Another test was done 22.06.23: TSH 4.08, fT4 10.1, TPO Ab - 280 iU/mL (range 0 - 34).

GP informed me I have got Autoimmune - Hashimoto. I was put on Levothyroxine 50mcg.

Thyroid test 25.08.23: TSH 0.09. No fT4. This is when Levothyroxine was prescribed.

Thyroid test 05.02.24: TSH 2.54. No fT4 was done this time. I don't know what triggered TSH jump from 0.09 to 2.54.

GP didn't do fT3, folate, B12, Ferritin, vit D.

Prior to Levothyroxine, I was taking B100 (slow release) but GP advised to stop as it contained Biotine and Iron. I used to take Zinc (50mcg) twice a week but now taking daily. I also take B12 (1000iU) every day.

I am planning to test my fT3, folate, B12, Ferritin, Vit D based on suggestions from the experienced contributors here.

I am having mostly gluten-free diet. I do intermittent fasting (16:8). For 5 years I was vegan but started dairy now mainly yogurt, cottage cheese and reduced fat cheese to keep my fat levels.

I am a vegeterian and pre-diabetic (HBA1c 43 mmol/molHb (range 27 - 47). I have cut down my carb intake and increased Protein and Fats (healthy).

Based on the above, any guidance will be highly appreciated.

[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.

Your TSH might have gone low due to hashimoto's causing swinging levels. In the early stages of the disease numbers can change quite a bit due to the autoimmune attacks on the thyroid.

If your most recent TSH test was over 2 then you are ready for the next dose increase. Most people feel well when their TSH is at or just under 1.

Some GPs can be very conservative treating hypo believing that too much will harm us so instead they dont give us enough which also makes us ill.

GPs get no training in nutrition so probably best to disregard anything they say about supplements.

As a vegetarian your diet will be low in iron & B12 so its essential to check your levels of ferritin, folate, B12 & D3.

When hypo we get low stomach acid which means we cannot absorb vitamins well from our food, regardless of a great diet. For thyroid hormone to work well we need OPTIMAL levels of vitamins.

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.

When making dietary changes its important when eliminating gluten that you are strictly gluten free, not just most of the time, otherwise it wont work.

Intermittent fasting can help some hypo people BUT it can lower your conversion rate of T4 to T3 and also reduce your TSH. Best to be aware of that. Reducing carbs can also reduce your conversion rate too.

Next steps are to get Levo dose increase & test key vitamin levels. Start a new post once you have the result.

It's ideal if you can always get the same brand of levo at every prescription. You can do this by getting GP to write the brand you prefer in the first line of the prescription. Many people find that different brands are not interchangeable.

Always take Levo on an empty stomach an hour away from food or caffeine containing drinks & other meds. Many people find taking it at bedtime works well for them.

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.

[Eskaayy in reply to Jaydee1507]

Jaydee1507 - thank you for your prompt response -very detailed and informative. Will do suggested tests in a new post. You mentioned that conversion rate from T4 to T3 will reduce while doing Intermittent fasting, which will reduce TSH, isn't that good though?

Ok noted about reducing carbs can also reduce your conversion rate too - which I understand is not good, right? As I am pre-diabetic hence I am cutting down my carbs (currently 130g/day), would that affect conversion rate also?

[Jaydee1507 Administrator in reply to Eskaayy]

Its difficult when theres a clash in your medical needs with diabetes benefitting from IF and hypo not so much. See how you go but be aware that your conversion rate might be affected by the diet.