Hi,I hope it's not a silly question. Can I still do a TPO test when I'm on levothyroxine or will this effect the results? Only been on medication for a week.
Thanks
Tpo test: Hi,I hope it's not a silly question... - Thyroid UK
Tpo test
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SlowDragonAdministrator
Yes being on levothyroxine won’t affect the results
Best to test BOTH TPO and TG thyroid antibodies alongside thyroid levels plus vitamin levels after 6-8 weeks on current dose levothyroxine
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)
NHS only tests TG antibodies if TPO are high
20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis
Essential to test vitamin D, folate, ferritin and B12
Lower vitamin levels more common when hypo
For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) we must maintain GOOD vitamin levels
What vitamin supplements are you taking
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Testing options and includes money off codes for private testing
Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins
medichecks.com/products/adv...
Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins
bluehorizonbloodtests.co.uk...
Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee
Only do private testing early Monday or Tuesday morning.
Tips on how to do DIY finger prick test
support.medichecks.com/hc/e...
I'm not taking any vitamin supplements at present, I've been prescribed Ferrous Fumarate for anaemia which I take 4 hours or more apart from Levothyroxine. I will order a test. When I asked the doctor if my thyroid can be cause by an autoimmune disease he said" very unlikely " but I would like a bigger picture other than the test the NHS perform.
How much Levo have you started on
Which brand is it?
When I asked the doctor if my thyroid can be cause by an autoimmune disease he said" very unlikely "
Many GP’s are clueless on thyroid issues
50 mg brand name is accord. Does it make a difference to the brand?I have noticed in a short time of taking Levothyroxine that my stomach doesn't like it, I can only describe as bloating, grumbling feeling and bubbly, I'm just going with it for now to see if this subsides.
Developing gut issues is EXTREMELY common, especially initially when only on low starting doses.
Also low vitamin D, folate and B12 common too
Yes brand of Levo makes a lot of difference to many many people
Accord only make 50mcg and 100mcg tablets.
Accord is also boxed as Almus via Boots,
Relatively new ……Hillcross brand ….This is a box, rather than a brand. 50mcg and 100mcg are Accord brand….but beware 25mcg is Teva brand
Wockhardt is very well tolerated, but only available in 25mcg tablets. Some people remain on Wockhardt, taking their daily dose as a number of tablets
Mercury Pharma make 25mcg, 50mcg and 100mcg tablets
Mercury Pharma also boxed as Eltroxin. Both often listed by company name on pharmacy database - Advanz
July 2024
Crescent levothyroxine. Dosages: 12.5, 25, 50, 75, 100
(Not yet known if all approved dosages are or will be available).
Excipients: lactose monohydrate, maize starch, croscarmellose sodium, gelatin and magnesium stearate.
Lactose free brands - currently Vencamil or Teva
Vencamil is lactose free and mannitol free. originally only available as 100mcg only, but 25mcg, 50mcg and 75mcg tablets became available Sept 2024
Prior to March 2023 Vencamil was called Aristo
Vencamil often very well tolerated/best option for many people
How to get Vencamil stocked at your local pharmacy
healthunlocked.com/thyroidu...
Posts discussing Vencamil
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu....
Teva makes 12.5mcg 25mcg, 50mcg, 75mcg and 100mcg
Many patients do NOT get on well with Teva brand of Levothyroxine.
Teva is lactose free, but contains mannitol as a filler instead of lactose, which seems to be possible cause of problems. Mannitol seems to upset many people, it changes gut biome
Helpful post about Teva
healthunlocked.com/thyroidu...
Posts that mention Teva
healthunlocked.com/search/p...
Teva poll
healthunlocked.com/thyroidu...
Helpful post about different brands
healthunlocked.com/thyroidu...
List of different brands available in U.K.
thyroiduk.org/if-you-are-hy...
Once you find a brand that suits you, best to make sure to only get that one at each prescription.
Watch out for brand change when dose is increased or at repeat prescription.
Government guidelines for GP in support of patients if you find it difficult/impossible to change brands
gov.uk/drug-safety-update/l...
If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient.
academic.oup.com/jcem/artic...
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
And here
pharmacymagazine.co.uk/clin...
Discussed here too
healthunlocked.com/thyroidu...
Hi again!Is there anything I can take to reduce the bloating/rumbling in my stomach? I'm taking Levo around 4pm daily (works best for me with work etc) and for the rest of the evening/night my stomach is going wild. I've always had a sensitive stomach and was told by my GP a long time ago that I've got IBS (never tested) A few years ago I cut out a few lactose things like milk, only ever drink lacto free milk. I don't know if I can keep doing this every evening it's so uncomfortable. Do I just keep going with it and wait to see if this settles. Before I was ever prescribed Levo I've had stomach problems but Levo just seems to make it worse.
Try taking your levothyroxine at bedtime
Presumably you are currently only on 50mcg
This is only standard STARTER Dose
Request new prescription for LACTOSE free Levo and get note added to all future prescriptions
Vencamil is lactose free and mannitol free. originally only available as 100mcg only, but 25mcg, 50mcg and 75mcg tablets became available Sept 2024
Prior to March 2023 Vencamil was called Aristo
Vencamil often very well tolerated/best option for many people
How to get Vencamil stocked at your local pharmacy
healthunlocked.com/thyroidu...
Posts discussing Vencamil
SlowDragonAdministrator
what were your iron and ferritin results
Retest full iron panel including ferritin 3-4 times a year if taking iron supplements
Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test
If taking any iron supplements stop 3-5 days before testing
Medichecks iron panel test
medichecks.com/products/iro...
Or
monitormyhealth.org.uk/anae...
Look at increasing iron rich foods in diet
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
List of iron rich foods
Links about iron and ferritin
irondisorders.org/too-littl...
davidg170.sg-host.com/wp-co...
Great in-depth article on low ferritin
oatext.com/iron-deficiency-...
drhedberg.com/ferritin-hypo...
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.
Posts discussing Three Arrows as very effective supplement
Great replies from @FallingInReverse
re ferritin and Three arrows
healthunlocked.com/thyroidu......
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Great reply by @fallinginreverse
healthunlocked.com/thyroidu...
Ferrodyn supplement
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Thyroid disease is as much about optimising vitamins as thyroid hormones
healthunlocked.com/thyroidu...
restartmed.com/hypothyroidi...
Post discussing just how long it can take to raise low ferritin
healthunlocked.com/thyroidu...
Iron and thyroid link
healthunlocked.com/thyroidu...
Posts discussing why important to do full iron panel test
healthunlocked.com/thyroidu...
Good iron but low ferritin
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Chicken livers if iron is good, but ferritin low
healthunlocked.com/thyroidu...
Shellfish and Mussels are excellent source of iron
healthline.com/nutrition/he...
Iron deficiency without anaemia
healthunlocked.com/thyroidu...
Ferritin over 100 to alleviate symptoms
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Great research article discussing similar…..ferritin over 100 often necessary
ncbi.nlm.nih.gov/pmc/articl...
Low Iron implicated in hypothyroidism
healthunlocked.com/thyroidu...
I've only had bloods taken at the doctors and he only advised my hemoglobin is low. It actually looks like my bloods for all different things are all over the place at the moment, lots of different things out of range.
Most are fine with standard treatment but it takes months to get to the correct dose level and recover fully. Forum has the say 15% of strugglers and it does get a complicated ... but NHS is poor for us. Do not be scared of Forum, take comfort that if you need help someone will likely know.
Do you have any TSH or T4 blood results?
TPO is needed as a blood test and NHS will do once to show why you are underactive.(Autoimmune)
If AI type your stomach does not get nutrients out of food as well, so we supplement.
It is a lot to take in and you are likely feeling pants.
I wrote down my symptoms every few days, ot helped. And what I needed to sort next. Symptoms are what doctors need to treat but they do just seem to look at blood tests.
Get your 6 to 8 week bloodctest booked. Ask for T4 and T3. Unlikely to get T3.
Folate ferritin vit b12 and D blood tests.
Get gluten celiac tests from doctor too.
I would ignore higher cholesterol, pre diabetes and liver function issues as these things tend to ressolve once your thyroid hormone is flowing again.
I am AI type and cannot tolerate gluten at all. Some have to avoid dairy.
Update... Spoke to the doctor today. Explained all of the symptoms with my stomach and my IBS, bloating, grumbling, pain and discomfort for a long time after taking Levo , requested Lactose free Levo. Doctors answer was"we don't do lactose free Levothyroxine"! "we do liquid levothyroxine which will cost the NHS £80 for 100ml! Couldn't believe what I was hearing really. I said" can we not treat the IBS to see if that helps" so that's he agreed! Finished the telephone conversation 5 mins later received a text message to say that there is a lactose free tablet Tevo that he will be prescribing alongside IBS medication. He was going to tell me to stop the iron tablets but I'd already done that 4 days ago.. Checked my last bloods and said "we wouldn't normally prescribe Levo with your results."I'm behond belief how difficult it is to get what you need out of a doctor these days. How do you guys cope with the constant fight. X
Try the Teva but if that doesnt suit you then ask for Vencamil. GP needs to rewrite the prescription for that.
Iron tablets are notorious for causing upset tummies. You could try what a lot of people take on here which works very well and no side effects.
received a text message to say that there is a lactose free tablet Tevo that he will be prescribing alongside IBS medication.
What is this “IBS medication “
ALL Levo needs to be taken on its own, on empty stomach and then nothing else apart from water for at least an hour after
Many people find it more convenient to take levothyroxine at bedtime or in middle of night
Get weekly pill dispenser so easy to see if you have taken it each day
Mebeverine is the IBS medication prescribed. I'm struggling to find the time in the day to take medications, trying to take everything 4 hours apart from Levo(prefer to take at night before bed) The ferrous fumarate cause stomach upset so only like to take that when I'm at home, also added vitamin D-k2 BetterYou spray and b12 complex.
what are your B12, folate and vitamin D results?
Vitamin D mouth spray can be taken an hour away from Levo
Vitamin D spray and vitamin B complex and separate B12 all best taken in morning after breakfast
Iron at least 2 hours away from other vitamin supplements and 4 hours away from Levo
If you are taking Levo at bedtime, take iron late afternoon
If you don’t get on with Teva
Vencamil is lactose free and mannitol free.
How to get Vencamil stocked at your local pharmacy
healthunlocked.com/thyroidu...
List of different brands available in U.K.
thyroiduk.org/if-you-are-hy...
Once you find a brand that suits you, best to make sure to only get that one at each prescription.
Watch out for brand change when dose is increased or at repeat prescription.
Government guidelines for GP in support of patients if you find it difficult/impossible to change brands
gov.uk/drug-safety-update/l...
If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient.
If symptoms or poor control of thyroid function persist (despite adhering to a specific product), consider prescribing levothyroxine in an oral solution formulation.
academic.oup.com/jcem/artic...
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
And here
pharmacymagazine.co.uk/clin...
Discussed here too
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