I am currently experiencing a strong feeling of pressure at the base of my throat and wondered how common that is?
I have had an underactive thyroid diagnosis for around 5 years but feel that I have such little knowledge on it. I have never felt my medication has made any significant improvements to my symptoms. Any advice is welcomed.
My current Levo medication is 75mcg
Recent test results (Nov)
TSH 3.0 mu/L [0.35-4.7]
T4 11 p/mol [7.8-21]
I had taken my Levo prior to testing as I have only recently been made aware of the advice of not taking it
For reference, I paid for blood results in June.
TSH 3.96 mu/L [0.35-4.7]
T4 16.1 p/mol [7.8-21]
T3 3.5 p/mol [3.2-6.8]
TPO antibodies 133 iu/ml
Written by
fishbulb
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Your TSH at over 3 is too high. Most people feel well when their TSH is at or just below 1.
Both FT4 & FT3 are low in range showing you have plenty of room for a 25mcg dose increase. Make appointment with GP and ask for it on a trial basis which often goes down better.
Likely your symptoms are due to being under replaced. Many doctors are frightened of giving us too much Levo so dont give us enough instead.
reception.
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.
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.
Do you do tests as per the protocol recommended here?
Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last T3 dose 8-12 hours before 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.
So as well as being under replaced you have some very low vitamin levels.
You probably need a very long course of iron to raise your ferritin to a good level. What is GP doing about this?
Folate is quite good.
B12 is all but deficient. What is GP doing about this?
Are you vegan or vegetarian? Do you eat red meat?
B12 - 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.
Being on inadequate dose levothyroxine results in low vitamin levels
Low vitamin levels tend to lower TSH, especially low ferritin
ESSENTIAL to maintain GOOD vitamin levels
Vitamin D at least over 80nmol
Serum B12 at least over 500
Folate at top of range
Ferritin at least over 70
Your B12 and ferritin both terrible
Are you vegetarian or vegan
Request “trial” increase in Levo to 100mcg
Retest in 2-3 months
Meanwhile work on improving low vitamin levels
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 somewhere near full replacement dose (typically 1.6mcg levothyroxine per kilo of your weight per day)
Adults usually start with a dose between 50 micrograms and 100 micrograms taken once a day. This may be increased gradually over a few weeks to between 100 micrograms and 200 micrograms taken once a day.
Some people need a bit less than guidelines, some a bit more
TSH should be under 2 as an absolute maximum when on levothyroxine
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).
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 get the pressure in my throat when I have acid reflux. It feels like there is a lump in my throat that won’t clear no matter what. It’s so uncomfortable. I get acid reflux when I am undermedicated and my TSH starts creeping up. TSH above 3 is definitely too high. The others have responded with some great advice so won’t add to it but just wanted to let you know that I get this too.
For what it's worth, I'm hypothyroid too, and had what sounds like a similar uncomfortable pressure at the base of my throat. After giving up cow's milk products, this symptom vanished completely. (Of course we're all different, and this may or may not be of help.)
I've never had pressure, but I've certainly had shooting pains through my Thyroid gland. I have no idea why I get them. Thank God that they're rare. It helps if you can force your doctor to put you on T3 as well as your Levo. Can you not get Synthroid in the UK? One of my doctors, I've had so many, told me that it's the purest of the synthetics. It's more expensive for some reason. T3 is the star of the show making it the most important of the Thyroid hormones. It will regulate your body temperature for certain if you are oversensitive to cold temps., and so much more. Best of luck.
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Diagnosed with Subclinical Hypothyroidism...still having symptoms. Please help.
thyroid and high blood pressure 
Heres my latest blood test - got GP appointment in the morning with the same guy who suggested counselling for my symptoms :(
Help with blood tests, please?
Does anyone take a combination of NDT and Levothyroxine.
