Thyroid results

[helen_m]

Hi - I was finally given levothyroxine in January (after 5 years of being monitored!) - a starter dose of 25mcg. I've got slightly more energy than I had but not much and a trip to the shops tires me out. Hoping its going to improve.

My January 2015 results (on the basis of the antibody test they started giving me levo)

TSH 9.35 (0.35 - 5.00 U)

Free T4 11.8 (9.0 - 21.0 U)

No T3

Thyroid Perox. ABs 905.3 (<<6.0 U)

Today I called for blood test results to be told they were OK (!) but to make a doctor's appointment.

Results: TSH 5.07 ( 0.35 - 5.00 U)

Free T4 13.2 (9.0 - 21.0 U)

I'd asked for Free T3 but they'd not done that one despite it being asked for by the nurse.

It says on my results - - suggests poor compliance or inadequate dose

What does this mean - and any suggestions for what to be saying to the doctor next week?

Many thanks

Helen

[Clutter]

Helen_m, 25mcg is a very low dose. 50-75mcg is usually prescribed for patients under 50 without heart disease. Your latest TSH 5.07 with low FT4 13.2 means you are underdosed and need an increase. Lab rarely test FT3 unless TSH is suppressed <0.04 because low FT3 is usually the reason TSH is high. When the pituitary gland detects low circulating thyroid hormone it produces TSH to stimulate the thyroid gland to produce more.

It can take several months to become optimally dosed and and a few weeks after that for symptoms to resolve. Most people are comfortable with TSH just above or below 1.0. Read Dr. Toft's comments about dosing and levels to Pulse Online in the link below.

thyroiduk.org.uk/tuk/ab...

Your high thyroid antibodies mean you have autoimmune thyroid disease (Hashimoto's). Autoimmune diseases are thought to start in the gut and many, but not all, Hashi patients benefit from a gluten free diet finding it helps reduce antibodies and reduces flare ups.

thyroiduk.org.uk/tuk/ab...

Take your thyroid medication with a full glass of water on an empty stomach for maximum absorption, one hour before or two hours after food and drink, two hours away from other medication and supplements and four hours away from vitamin D3, calcium, iron and oestrogen.

Ask your GP to test ferritin, vitamin D, B12 and folate as hypothyroid patients are often deficient/low and these deficiencies can cause musculoskeletal pain, fatigue and low mood similar to hypothyroid symptoms. Post your results with the lab ref ranges (the figures in brackets after your results) in a new question and members will advise whether supplementation is required.

[humanbean in reply to Clutter]

With reference to Clutter's comment above :

" 50-75mcg is usually prescribed for patients under 50 without heart disease."

I think that should be re-worded to say :

" 50-75mcg is usually prescribed as a starting dose for patients under 50 without heart disease."

I'm not totally sure on this, but I think a normal dose once levels have become optimal is somewhere between 100mcg and 175mcg per day.

[Clutter in reply to humanbean]

HB, yes I did mean starting dose. Optimal dose is however much is required, usually between 50mcg-200mcg, but much higher for some.

[helen_m in reply to Clutter]

Thankyou Clutter

I've been wheat-free almost a year - and mostly gluten -free. I'll try harder as I feel better with no gluten. Am reducing sugar too. I didn't know that about the D3 though - I am vitamin D deficient so take a daily D3 capsule - will make sure to take it far away from the levothyroxine. I sometimes am folate deficient too. I think when I go to the doctor's next week, I'll ask to get these retested - thanks

[Clutter in reply to helen_m]

helen_m, HB is right I meant 50-75mcg is the usual starting dose.

If you are sensitive or intolerant of gluten the tiniest amount will upset your digestive system. Try being completely gluten-free for 8-12 weeks to see if there is improvement. If not, reintroduce gluten, check for adverse reactions and if there are none reintroduce it, there's no point in restricting diet if there is no benefit.