I know very little about thyroid issues, and I am a bit overwhelmed by the blood test results I have had.
My GP has prescribed 50mcg Levothyroxine and will review this in 4-6 weeks. I have also been referred for a thyroid scan as I have had some swallowing issues. They have also advised me to take a vitamin D supplement.
Serum total 25 - hydroxy vitamin D level 27 nmol/L [50.0-99999.0]
Vitamin D levels of 25 - 50 nmol/L.
B12 / folate level:
Serum vitamin B12 level 383 ng/L [190-910.0]
Serum folate level 5.7ng/mt [3.3-99999.0]
Ferritin:
Serum ferritin level 80.1 ug/L [30.0-400.0]
Full blood count:
Haemoglobin concentration 145 g/L [115-165]
MCV 95.1 fL [80.00-100]
Mean cell haemoglobin level 32.2 Pg [27.0-32.0]
I requested thyroid tests after getting a high cholesterol result. I remembered my mum having cholesterol and thyroid issues in her 60s (she is in her late 80s now and still taking Levothyroxine).
I have been feeling exhausted for the last few months and have had lots of other apparently unrelated symptoms. Rosacea, GERD, joint pain, thinning hair, irritability, depression, memory loss, brain fog..
My manager wants me to take some time off work. I am struggling a bit because I have other health issues being investigated too - joint pain, hearing loss. I am hoping that the symptoms may improve now I am taking Levothyroxine.
Any comments or suggestions anyone has would be welcome. Technically I think my results make me ‘sub clinical’ but I seem to have a lot of symptoms which could be thyroid related. I also have a very high peroxidase antibody result so my GP wax happy to prescribe Levothyroxine.
Hoping to get my thyroid scan done soon as that might shed some further light on the situation.
Thank you!
Rose
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NortherlyRose
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First of all, I would like to say that no, you are not 'sub-clinical', either technically or any other way. You are full-blown hypo. Sub-clinical is just a term that doctors use to avoid diagnosing people. It's bunkum! When you think that someone with no thyroid problems (euthyroid) would have a TSH of around 1, and over 2 means that your thyroid is struggling, and over 3 is hypo, you can see just how hypo you are.
50 levo is a good starter dose, but if I were you, I'd leave the full 6 weeks before retesting because it takes that long at least for the body to adjust.
Your swallowing problems are more than likely due to your thyroid being a bit swollen. That's what happens when you have Hashi's. Can you see any lump in that area? It's usual to have a goitre with Hashi's. But if you don't have a goitre, just high antibodies, the you have Ord's - same thing but without the goitre. I wouldn't worry about it if I were you. I have Ord's: high antibodies, no goitre.
Your doctors are being very lazy boys! Your vit D is very low so they should be prescribing loading doses of vit D, not just telling you to take a supplement! They should also be telling you that when you take vit D, you should also be taking vit K2-MK7 and magnesium, because the three work together.
Your vit B12 and folate are also very low. B12 should be at least over 550, and folate at least in double figures. These should be supplemented too, but I don't want to over-load you with details straight away. Start with the vit D and contact your doctor to tell him you want loading doses. Meanwhile, start take magnesium.
Your ferritin is on the low-side but at the moment, I wouldn't bother too much with that, just make sure you eat plenty of iron-rich foods, with a source of vit C.
If your cholesterol is high, then your FT3 is low. But that's only to be expected given how hypo you are. Don't worry about it.
I have been feeling exhausted for the last few months and have had lots of other apparently unrelated symptoms. Rosacea, GERD, joint pain, thinning hair, irritability, depression, memory loss, brain fog..
GERD is probably due to low stomach acid - a hypo symptom - but the symptoms are the same as for high stomach acid. Try taking some vit C before a meal, that sometimes helps, and will also help with the absorption of iron.
Joint pain is probably due to your low vit D.
Thinning hair can be caused by low T3, or low ferritin.
The rest of the brain symptoms are due to low T3 because the brain needs a lot of T3.
Hearing-loss can also be a hypo symptom.
If you have any other questions, don't hesitate to ask them. There will always be someone here to reply.
I am really lucky that the locum GP I saw agreed to treat me. The GP I saw for my HRT review would have been harder to convince I think.
So much has been happening my head is spinning. They prescribed statins for my high cholesterol before checking Liver & Thyroid function. I read up about this and went back and insisted on more blood tests. So glad I did. I would never have found out about my hypothyroidism otherwise.
I will go back to them regarding supplements. I thought this was what I needed from reading other people’s posts.
Last October I was feeling so unwell and exhausted that my partner wrote to the GP expressing concern. No reply. It was only when blood tests got done for my joint pain that the cholesterol issue emerged, that then led to the thyroid test, but only because I suggested it.
I dread to think how many people are having their symptoms dismissed and going without diagnosis and treatment as a result.
Thank you again for replying and for your helpful advice.
An awful lot of people are going undiagnosed because it is their policy to diagnose as few people as possible. They do not like diagnosing and treating thyroid. They know next to nothing about it - and nothing at all about nutrients! We have to stay on our toes as much as possible, and double check everything they tell us.
I had the same experience with perimenopause - had to educate myself and rely on advice from peers. Really appreciate your support with this latest challenge.
Doesn't seem worth going to the doctor for anything, these days. They just don't want to do their jobs anymore. God knows what they do do all day, but it's difficult enough to get an appointment. And telephone appointments are just a cop-out.
My GP’s notes say I had Thyroid function tests in 2023 but the results aren’t accessible via the NHS App.
Ironically one of my previous jobs was working on a research study relating to health checks - I’ve been asking for one for the last five years ago but kept getting told “no!”
I can take my dog to the vet and get a nose to tail check in one visit, but my GP insists on one issue per appointment, and it’s generally a different nurse or doctor I see each time so they don’t build up a good picture unless they delve into the notes, which are often inadequate or inaccurate.
At least when the GP phoned about my thyroid test results he had the grace to say “you were right!”.
If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.
I dread to think how many people are having their symptoms dismissed and going without diagnosis and treatment as a result.
Thousands upon thousands of people
Well done you on pushing for further testing and getting levothyroxine prescribed
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
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).
Thank you for this brilliantly comprehensive medication. I am going to make myself a Gantt chart so I can keep track of what to do when (once a project manager always a project manager!)
You can click the “more” button under your post and edit if you need to : )
also…
All those “apparently unrelated symptoms” are all likely related! I’ve had most of them and all got better with Levothyroxine. It does take a little time, but you’re on your way!
Welcome to the world of GP Thyroid ignorance and ineptitude! But here on this forum you will find, I believe, the help you need to navigate + swat aside GP ignorance. Educate yourself, get private blood tests for TSH, T4 +T3 - the NHS GPs rarely test T3 as they don't know it's the most important thyroid hormone! My GP said it was irrelevant!!😮 This blood test gives a much better picture of yr thyroid health - and I was ignorant for decades! Here is my go to place for education and support! Trust your journey improves, along with your health - and I'm sure it will!!
You will need further 25mcg dose increases over coming months
When starting …….only add or change one thing at a time
So getting started on levothyroxine is the first and most important thing at moment
Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
These need improving…..After vitamin D and magnesium
So 10-14 days after adding magnesium look at starting a separate B12+
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement
A week or so later add a separate vitamin B Complex
Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.
If Vegetarian or vegan likely to need ongoing separate B12 few times a week
Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose and may need 2 per day and/or may need separate methyl folate couple times a week
Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) Thorne can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12 if last test result serum B12 was below 500 or active B12 (private test) under 70
It's a lot at first but it gets easier (and as the levo kicks in, and probably after a few increases, the brain fog gets better which helps a lot too!). I'd recommend to have a reread or two in a few days, and I expect you like notes and a list, like me! Welcome to the forum, it is indeed a lifeline for lots of us; and best of luck now you're on the road to recovery 😊
Comprehensive from Greygoose as always. Found those reminders useful myself. Thanks Greygoose. All I can add to that is make sure you leave at least a 2 hour window from when you take thyroxine before eating or drinking including any iron supplements you may use. If you don't dose will be compromised. Greygoose knows the detail.
NortherlyRose I found this community 5 years after my initial diagnosis. (I also had raised cholesterol)Once I understood the importance of Vitamins the effects that fillers in levo tablets can have and the importance of full thyroid testing of T4 and T3 my health began to improve.
Eventually thanks to this site I also discovered I was a poor converter of T4to T3 and now also take some T3, Liothyronine.
It’s over 12 years since I joined and I am still learning.
Hope you begin to feel some improvement, it won,t be quick and the road to good health can be up and down.
What helped me most was a gluten free diet and later lactose free, avoiding meds such as Teva( the acacia filler was really not good for me) taking vitamins as per advice here. My cholesterol numbers came down, tinnitus stopped and kidney function GFR moved back into normal range.
Regular testing, I use Medichecks, there are other companies,was key to keeping an eye on levels and helped me to advocate for T3, Liothyronine to improve my health further.
There is always someone on here who can help you. Good luck on your thyroid journey. Crimple
I'm glad you found this community I for one have found the support & information shared invaluable in managing my hypothyroidism. Good luck on your journey too.
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