Advice on results please.

[Pippinapple]

Recently confirmed Hypo could someone please shed light on the results of last 3 bloods and any advice please. Started on 25 mg after January's results, due to see Dr next week for review.

June 2014

Serum TSH 2.90 mu/L (0.35 - 3.50)

January 2014

Serum TSH 3.71 mu/L (0.35 - 3.50)

Free T4 14 pmol/L (8 - 21)

Thyroid Peroxidaise Antibodies 424.8 ku/L (0.0 - 34.0)

December 2013

Serum TSH 3.81 mu/L (0.35 - 3.50)

Free T4 12.9 pmol/L (7.5 - 21.1)

B12 389 pg/mL - cannot read the range as over-typed

folate 3.9 ng/mL (2.7 - 17.5)

Many thanks

[Clutter]

Pippinapple, your TSH is still too high and your FT4 too low. TSH ideally will be just above or below 1.0 and FT4 will be in the top 75% of range. T4 is an inactive pre-hormone which converts to the active hormone T3. Low FT4 generally means low FT3.

Unless you are over 60 or have a heart condition your GP should have started you on the full replacement dose of 75mcg/100mcg. You ought to have had a follow up blood test 6 weeks after starting Levothyroxine not left languishing on a paltry 25mcg for 6 months. Make sure to have a follow up blood test 6/8 weeks after every increase/decrease in medication.

Positive thyroid peroxidase antibodies means you have autoimmune thyroid disease (Hashimoto's). Gluten-free diet can help lower antibodies.

Your B12 and folate are low and supplementing with methylcobalamin spray or sublingual lozenges and methylfolate will be beneficial. b12deficiency.info/what-to-...

Ask your GP to test vitamin D and ferritin. These are often low or deficient in Hashimoto's patients and vitD needs to be high in range with ferritin 70-90 to ensure good absorption of thyroid medication.

vitamindcouncil.org/vitamin...

[Pippinapple in reply to Clutter]

Thank you Clutter. You have confirmed my belief that TSH is still too high despite falling into the ‘normal’ (!) range which is one of the reasons I have requested an appointment with my GP. I too was surprised at the low dosage and length of time I have remained on this. No, I am early 50’s and have no known heart condition although at the same time as diagnosing hypo it was discovered I have osteopenia so wondered if this might be a reason? I attempted to be retested earlier but this was declined.

I had gleaned myself that peroxidase antibodies meant Hashimoto’s and again thank you for clarifying as this was not advised to me – was told I had antibodies which confirmed I had an underactive thyroid. Am I right in thinking this is why I believe I have hyper symptoms sometimes too with a hypo-hyper swing? Would this affect my dosage i.e. smaller dose when I feel I am having a hyper swing (assuming I can persuade the GP to increase the dosage and get myself settled a bit).

Have been increasingly extremely dizzy recently which I am going to raise with the GP – could this be due to B12 deficiency or to hypo (as it’s a symptom) or even both? I will look into supplementing if GP does nothing.

Have always struggled with low ferritin levels (although from last test was told ‘normal’) and have often been prescribed iron/folic acid tablets. I was investigated for coeliac disease some years ago which came back clear and investigation as to why ferritin levels kept crashing ceased. Early indication of hypothyroidism? I now take Vid D supplement in winter months because of Osteopenia.

I am finding it all very confusing - being a ‘bear of very little brain’ so thank you for spelling it out for me so clearly.

[Clutter in reply to Pippinapple]

Pippin, yes the hypo/hyper swings will be caused by Hashimoto's. As your thyroid sputters into life you feel hyper and then it goes back to sleep and you feel hypo. Optimal dosing can reduce the frequency and intensity of lymphocyte attacks on your thyroid but it will eventually be destroyed. Dizziness can be due to under medication &/or B12 deficiency.

cks.nice.org.uk/hypothyroid...

[Pippinapple in reply to Clutter]

Thanks again. Very helpful reading.

[stockman27]

Your TSH is low meaning you could probably up the dose to 50 MCR per day but see what your dr says, your antibodies don't look right and that may be evidence of something else there..

John C

[Pippinapple in reply to stockman27]

Thank you John, as stated to Clutter I am going to try to get the dosage increased when I see the Dr. You say antibodies might be evidence of something else. Like what?

[stockman27]

Hi Pippinapple.

I am an engineer not a dr, so you had best see somebody who knows about this. Its just your antibodies are not showing right in your bloods and a clinician needs to look at this. I can understand your concern why not make an appointment at your GP and ask them what they make of your blood tests.

John