My 6 weeks Blood Work after Hormone Replacement Therapy

[Ali1101]

After about 3 years struggling with hypothyroid symptoms, finally I was diagnosed with hypothyroidism.

Before medications:

TSH: 0.015L (ref. 0.460 - 4.680).

FT4: 18.10 (ref. 10.00-28.00).

FT3: 7.48 (ref. 4.28-8.1).

Antibodies:

Anti TPO <10 (ref. up to 34)

Thyreoglobulin abs 233H (ref. up to 115).

After 6 weeks on 50 mg Levothyroxine:

TSH: 4.690H (ref. 0.460 - 4.680).

FT4: 9.93L (ref. 10.00-28.00).

FT3: 4.17L (ref. 4.28-8.1).

I'm confused, Anyone can explain to me? Right now I'm on 75 mg and waiting for another 6 weeks for next blood work. I still have all symptoms.

[shaws Administrator]

Don't worry too much Ali as it does take a while to get to an optimum dose of levo. You were obviously on a starting dose at 50mcg and wasn't sufficient as your TSH rose. The rise of another 25mcg is correct. You have a blood test every 6 weeks with a rise until you feel well (not until the GP tells you that your TSH is now 'in range' and you still have symptoms). Always take levo first thing with a glass of water and wait about an hour before eating.

When you have a blood test for your thyroid hormones, always have the earliest and fast (take levo after test). Leave about 24 hours between last dose of levo and the blood test and take levo afterwards. Always get a print-out of your results as you have done (with the ranges) for your own records and so that you can post if you have a query.

If GP hasn't test B12, Vit D, iron, ferritin and folate ask for these to be done also as we are usually deficient.

I hope you feel better soon.

[Ali1101 in reply to shaws]

Thanks Shaws, very supportive words but I'm so confused that my TSH was suppressed and T3 T4 were in normal ranges (even I felt hypo thyroid) but once I started levo, TSH rose and T3 T4 dropped!

[Clutter]

Ali1101, Thyroglobulin antibodies are positive for autoimmune thyroid disease (Hashimoto's). Autoimmune disease is widely thought to start in the gut with gluten being a trigger.Many members benefit from adopting 100% gluten-free diet which helps manage Hashimoto's and may reduce antibodies.

thyroiduk.org.uk/tuk/about_...

Your TSH is over range and FT4 and FT3 below range because 50mcg wasn't a sufficient dose. 75mcg will help but it's possible you will require a further increase. Most people will be comfortable with TSH just above, or below, 1.0 with FT4 in the upper quadrant of range and FT3 over half way through range.

thyroiduk.org.uk/tuk/about_...

[Ali1101]

Clutter, thanks for usual help. I so hopeful that an increase in dosage will correct my levels but couldn't understand the blood work before/after!

I tried gluten free diet before, I might try it once again with levo.