New blood results

[Padster7]

So six weeks ago my blood results were:

Serum free t4 12.0 pmol/L (10.00-26.00pmol/L)

Serum TSH 31.67 mu/L (0.20-5.00mu/L)

Serum folate 9.3 ug/L (4.60-18.70ug/L)

Vitamin B12 355 ng/L (>183.00ng/L)

Today got new results;

Serum free t4. 20.4pmol/L (10.0-26.0)

Serum TSH level 1.52mu/L (0.20-5.00)

Serum folate 17.7ug/L (4.6-18.7)

Vitamin B12 669ng/L (>183)

I am surprised at the progress on 50mcg only for six weeks. I do still feel fatigue and find I have to pace my activity. I am hoping GP will still increase to 75mcg when I see him next week. My test wasn't fasting although I did plan to do this but had to deal with a sudden family crisis so it was late morning when I was organised to get to blood room. Also had antibody tests done but these are not back yet.

Any advice for my GP visit next week would be appreciated.

Padster7

[Clutter]

Wow, what a difference, Padster You've responded very well to 50mcg. Symptoms can lag behind biochemistry by up to a couple of months so hang in there.

It's a shame you didn't manage an early fasting test, TSH would have been higher and you'd probably have had no problem getting a dose increase. Ask for a dose increase anyway, and if GP won't agree 75mcg try to negotiate 50/75mcg alternate days. Read Treatment Options in thyroiduk.org.uk/tuk/about_... and email [e-mail] full Pulse article if you want to show it to your GP.

If you haven't had vitamin D and ferritin tested ask for them. They're often low in hypothyroid patients and will cause fatigue, musculoskeletal pain and low mood simiilar to hypothyroid symptoms.

[Padster7 in reply to Clutter]

I got my missing blood results today and in addition to the ones above it states:

Serum free T3 4.8 pmol/L (3.60-6.40 pmol/L)

Antibodies TPO was highlighted as consistent with autoimmune thyroid disease 401 iu/ml (0.00-59.00iu/mL)

As this wasn't previously measured I don't know if this has gone up or come down. Does this means hashimotos?

I'm thinking my t3 is low in the range so should help my case for an increased dose to 75 mcg.

Thanks for any thoughts x

[Clutter in reply to Padster7]

Padster, positive TPO confirms Hashimoto's. Most UK doctors will call it thyroiditis or chronic thyroiditis. You might want to consider adopting 100% gluten-free diet which may help reduce Hashi flares and antibodies.

chriskresser.com/the-gluten...

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

FT3 is slightly below half way through range but may still be improving as it takes longer to respond to Levothyroxine than TSH and FT4. Most patients are comfortable with TSH just above or below 1.0 so a dose increase may be helpful. If your GP is sticky about 75mcg try and negotiate 50/75mcg alternate days.

Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email [e-mail] for a copy of the Pulse article if it will be useful to show your GP.

[Padster7]

Thanks Clutter. I saw my GP earlier today and he was happy to keep me on 50mcg. I showed him the pulse article and he then agreed to give me a trial at 75mcg saying he would worry about the suppression of TSH. He's given me the tablets in 25mcg so I can alter doses if I feel hyper. He's also referring me to an endocrinologist as he said they would have more expertise in managing any fluctuations in blood results. When we talked about my increased hair loss he said that in auto immune thyroiditis the hair follicles can sometimes turn against themselves!!

He's given me blood form for four weeks time but only TSH and t4 😤

Shall I go straight onto 75mcg tomorrow or try 50/75mcg alternate days? What does anyone think?

Also does anyone know any good endocrinologists at Salford Royal in Manchester??

Many thanks for suggestions x