Hashimotos

[VXL02]

Hi I have Hashimotos and I currently take 175mcg levo and 5mcg t3. Any idea if I need an increase? Here are a list of my symptoms

Constipation
Puffy feet and ankles
Reynauds
Fertility issues
Heavy periods
Difficult swallowing
Fatigue
Breathlessness upon walking/exercise
Goitre
Dry skin
Eyebrow loss
Eyelash loss
Easy weight gain
Bone pain
Joint stiffness
Hair loss
Cold intolerance
Cramps

Thank you

TSH - 4.06 mIU/L (0.27 - 4.20)
Free T4 - 12.9 pmol/L (12.0 - 22.0)
Free T3 - 3.4 pmol/L (3.1 - 6.8)
TPO antibody - 308 (<34)
TG antibody - 257.3 (<115)

[gimel]

You are very welcome.  From your latest results, your D and ferritin are adequate.  B12 is best when in the very upper end of its range, so it would be good to supplement for that to raise your level into the 800 level.  

Do you think there is any possibility of getting your doctor to treat clinically, as described, if you gave him a copy of the full paper linked above?  If not, then if you will give us your location, perhaps we might know of a doctor in your area that has been recommended by other thyroid patients.

[gimel]

Good grief, what is the doctor waiting for?  Of course you need increases in your med dosages.  The most important indicator of thyroid status is symptoms.  You have a lot of symptoms related to being hypothyroid.  In addition your Free T4 should be at least at the middle of the range.  Yours is at only 9% of its range.  Your Free T3 should be in the upper part of the range, and adjusted as needed to relieve symptoms.  Your Free T3 is only at 8% of its range, which is far too low for most people.  

A good thyroid doctor will  treat a hypothyroid patient clinically by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, without being influenced by resultant TSH levels.  I expect that your doctor has medicated you only enough to get your TSH within range.  That doesn't work.  Our bodies evolved with the expectation of a continuous low flow of thyroid hormone.  When taking significant doses of thyroid med, the hypothalamus/pituitary system reacts by reducing TSH levels.  Dosages adequate to relieve hypo symptoms frequently suppress TSH below range.  That does not automatically mean hyperthyroidism, unless there are hyper symptoms due to excessive levels of Free T4 and Free T3.  

You can read about this in the following link.  I highly recommend reading at least the first two pages.   For info about suppression of TSH, take a look at recommendation no. 10 on page 13.  

http://www.thyroiduk.org.uk/tuk/TUK_PDFs/diagnosis_and_treatment_of_hypothyroidism_issue_1.pdf

Hypo patients are also frequently too low in the ranges for Vitamin D, B12 and ferritin.  D should be at least 50, B12 in the upper part of its range, and ferritin should be at least 70.  You need to get those tested and supplemented as needed to optimize.  You also need to get your doctor to agree to treat clinically, as described, or else find another doctor that will do so.  

[VXL02]

Hi Gimel and thanks for your reply and advice. I have had vitamins and minerals tested, also take Fluoextine (depression) and Diazepam (muscle spasms)

Total 25 OH vitamin D - 53.6nmol/L (50 - 75 suboptimal)
Vitamin B12 - 461 pg/L (180 - 900) from 612 pg/L (180 - 900) so has dropped even though I have been supplementing B12.
Ferritin - 84 ng/L (15 - 150)