My GP did an annual review in November last year . Since then they have dropped my medication twice so now I’m on 75 Levothyroxine. I haven’t been feeling very well since and slowly going down hill .
TSH. T4. T3
3/11/23. 0.03. 22
(0.1-5). (12-23)
8/1/24. 0.04. 18
(0.1-5). (12-23)
24/4/24. 0.56. 15.7
(0.38-5.33). (11.5-22.7)
13/6/24. 0.94
(0.38-5.33)
2/9/24. 0.30. 18. 4.0
(0.27-4.20). (12-22). ( 3.1-6.8)
Last test was blue horizon
2/9/24 Cortisol 521 (73.8-507)
Test done 7.30 am
Magnesium. 0.8. (0.7-1.0)
serum iron 23/6. 14 (9-40)
Serum trans Ferrin. 2.7. (2-3.6)
Transferrin sat index. 21%. (16-40)
Serum ferritin 25/4 29. (15-300)
13/6. 20. (15-300)
I’m going for TSH and hopefully T4 and cortisol bloods tomorrow at 9 .am be doing the no meds and only water before .
with my symptoms I feel under treated but not sure as don’t understand all of it still . I’ve gone gluten free which had helped some my stomach issues . Drs won’t do vitamin test so will get them done private .
Any thoughts will be appreciated as I’m running on empty and can only manage small chores . Before November I was regularly running 20-40 miles a week , working , and allotment . Drs want to give me antidepressants as she thinks I’ve emotional anxiety 🫣
thank you in advance x
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andepande
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I’m on 75mgs of Levothyroxine I was on 100mgs . This is the only medication I take for thyroid. I do have a goitre which has got bigger . I did do test early with only water .
I’m on B12 injection s as got PA I self inject between jabs at Gp.
I’m taking multi vitamins .
I’m also taking amitriptyline 10mg at night .
Have bloods tomorrow and the Gp said if they are ok it’s not hormones 🫣. Not sure I’ll get the T4 as it was added by another gp I saw . I’ll post results I get and will then go and see a private consultant . The one GP isn’t being helpful just wants to put me on anti depressants.
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Thank you for your incredible patience while you have been awaiting the outcome of our ferritin reference range review. We conducted this with Inuvi lab, which has now changed the reference ranges to the following:
Females 18 ≤ age < 40. 30 to 180
Females 40 ≤ age < 50. 30 to 207
Females 50 ≤ age < 60. 30 to 264l
Females Age ≥ 60. 30 to 332
Males 18 ≤ age < 40 30 to 442
Males Age ≥ 40 30 to 518
The lower limits of 30 are by the NICE threshold of <30 for iron deficiency. Our review of Medichecks data has determined the upper limits. This retrospective study used a large dataset of blood test results from 25,425 healthy participants aged 18 to 97 over seven years. This is the most extensive study on ferritin reference ranges, and we hope to achieve journal publication so that these ranges can be applied more widely.
Presumably your hypothyroidism is autoimmune as you have PA which is autoimmune
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)
Essential to test vitamin D, folate, ferritin and B12
Lower vitamin levels more common as we get older
Assuming 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
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
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
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
I keep telling them how I feel but the one Spanish Gp keeps saying I need anti depressants, if my results come back in range she’s saying it’s not hormonal 🤬 .
I know. It's sooo frustrating. I went through similar with my GP lowering Levo to get my TSH in range. I had to beg and argue the point to get my levo dose raised back to where it was. Still feel crap but my T4/T3 conversion is a bit pants - my results even now on 100mcg daily are very similar to yours.GP's seem to want to dish out antidepressants like smarties. Not very fair when there's a physical reason for feeling down and if that was addressed, well, you wouldn't be depressed 🙄
😂😂 that’s the answer too everything, they don’t offer men anti depressants as quickly as they do women . I find looking them in the eyes and saying no thank you. if you will just listen to me you’ll know it started when …… you messed with my meds ( it makes me laugh if I had a problem with symptoms I’d go to the dr . So why if I haven’t been to them are they messing with me ) 🫣
Well we all know that women are neurotic and are always having a fit of the vapours. We also can't be trusted to know what's wrong with us so a little antidepressant will make everything better. 🙄
Seriously, state your case calmly and firmly ask for your previous dose to be reinstated. Call it a trial if that makes your GP more amenable.
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Blood test results 
Increasing TSH with normal T3 levels. 
Am I over medicated?
Results after T3/T4 trial...is this it?
