My New Bloodwork 4 weeks after starting .25mcg levo

[000ggg]

Hello Everyone,

I had my blood work done and tsh went up.. I'm not sure what T4 is yet, that is never posted online so I have to get the result at my doc this week. What do you think? Is this dose supressing what I have? I did have the test done early in the am fasting, around 11am, not as early as I had hoped because my bg started dropping a lot when I got up and I had to take 4g sugar to treat it and adjust my insulin. That is the earliest I have ever had it done. My ldl has gone down 60 points or so so I wonder if that could be the levo, the prunes I've been eating for osteoporosis and constipation and or the ginko biloba or some combo of these three? My calcium is normal, I'm not sure yet what pth is yet but it doesn't look like a parathyroid issue causing the osteoporosis at this point which is upsetting because then all I would need to do is have a tumor removed with the mini surgery and it would heal that at least.

Here are my results- I will add the T4, pth, vitamin D and folate when I get those.

TSH

2.910 uIU/mL

Date: Feb 12, 2016 11:30 a.m. EST Reference Range:0.270 uIU/mL - 4.200 uIU/mL

2.050 uIU/mL

Date: Oct 26, 2015 06:00 p.m. EDT Reference Range:0.270 uIU/mL - 4.200 uIU/mL

T4

1.46 (.93-1.70) / Feb 12, 2016 11:30 am

1.27 (.93-1.70) / Oct 26, 2015 6pm

Hematocrit

42.5 %

Date: Feb 12, 2016 11:30 a.m. EST Reference Range:37.0 % - 47.0 %

43.0 %

Date: Oct 26, 2015 06:00 p.m. EDT Reference Range:37.0 % - 47.0 %

LDL-cholesterol

94 mg/dL

Date: Feb 12, 2016 11:30 a.m. EST Reference Range:< 130 mg/dL

151 mg/dL (High)

Date: Oct 26, 2015 06:00 p.m. EDT Reference Range:< 130 mg/dL

HDL-cholesterol

108 mg/dL

Date: Feb 12, 2016 11:30 a.m. EST

112 mg/dL

Date: Oct 26, 2015 06:00 p.m. EDT

VLDL-cholesterol

8 mg/dL

Date: Feb 12, 2016 11:30 a.m. EST Reference Range:< 30 mg/dL

7 mg/dL

Date: Oct 26, 2015 06:00 p.m. EDT Reference Range:< 30 mg/dL

Triglyceride

39 mg/dL

Date: Feb 12, 2016 11:30 a.m. EST Reference Range:< 150 mg/dL

37 mg/dL

Date: Oct 26, 2015 06:00 p.m. EDT Reference Range:< 150 mg/dL

Calcium

9.7 mg/dL

Date: Feb 12, 2016 11:30 a.m. EST Reference Range:8.6 mg/dL - 10.2 mg/dL

9.9 mg/dL

Date: Oct 26, 2015 06:00 p.m. EDT Reference Range:8.6 mg/dL - 10.2 mg/dL

10.3 mg/dL (High)

Date: Jun 24, 2015 05:00 p.m. EDT Reference Range:8.6 mg/dL - 10.2 mg/dL

Phosphorous

3.7 ( 2.7-4.5) 2/12/2016 11:30am

Folate

> 20 (7.3-26.1) 2/12/2016 11:30am

WBC

3.42 low ( 4.8-10.8) 2/12/2016 11:30am

3.25 low (4.8-10.8) Oct 26, 2015 06:00 p.m.

[Clutter]

000ggg,TSH has gone up because FT4 has dropped. TSH would likely be higher if you tested early in the morning. As TSH has risen on 25mcg dose should be increased. Blood sugar may rise after a dose increase and should be checked after every Levothyroxine dose adjustment.

Cholesterol should drop when thyroid levels are optimal.

Haematocrit and calcium are within normal ranges.

_______________________________________________________________________________

I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

[000ggg in reply to Clutter]

Thanks Clutter,

Do you think this is due to the low dose supressing what I have already? Or maybe it is due to me getting the test done earlier and my tsh has been higher all along. My father had much higher tsh than me (14) prior to levo and his tsh reduced by half on 25 Mcg. The 25mcg caused a reduction of tsh for him.

I have type 1 diabetes and test bg multiple x per day. So far I haven't noticed much change in my Bg patterns. I don't want hdl to drop. Ldl is the only one I need to drop. I'm pretty sure it was the prunes.

[Clutter in reply to 000ggg]

000ggg, 25mcg isn't suppressing anything. FT4 has dropped which causes TSH to rise because 25mcg is insufficient. If you hadn't taken 25mcg FT4 would be lower and TSH higher.

TSH fluctuates throughout the day and is higher early and lower later in the day. See the graph in this link healthunlocked.com/thyroidu...

[000ggg in reply to Clutter]

Thanks. ok. I guess that means my tsh has been higher than suspected since I always tested later in the day and I need more... I still don't understand why my father's tsh, he was much more hypo with tsh of 14, responded to 25mcg though and mine didn't. He is on 50 mcg now but he is having blood pressure problems with the levo raising his blood pressure.

Someone here mentioned that too low a dose of levo can suppress your own natural production and cause tsh to go higher.

I'm not sure if I'm misreading that graph but it looks like tsh peaks at 12 midnight, not 9 am? At least for whoever that graph was done for.

[Clutter in reply to 000ggg]

000ggg, you're reading the graph right but as phlebotomy depts don't open at midnight 7.30am-8.30am is likely to be the earliest you can get a blood draw.

[000ggg in reply to Clutter]

Thanks Clutter,

Well oddly enough, my tsh went up but my t4 didn't go down.... according to endo..I still have to check the records if I have them because t4 isn't online while tsh is. He has increased my dose to 50mcg now.

I had an echo of the thyroid also which showed graininess which he said is typical of Hashimotos.

My pth was high 69.1 (65), calcium was high normal 9.7(10.1) and vitamin D is low 28 (30). He said he thinks I have secondary hyperparathyroidism. I have faxed my labs to the Norman Parathyroid Center but they have only received the recent one so far. I will call them Monday to see if they received the others. I just wonder if this will turn out to be primary hyperPT because their vitamin D pro app said on the graphs I'm at the low end of likely to have that but the suggestions said I probably have deficient/insufficient vitamin D- I'm not sure what would cause that? Does everyone with low D also have high PTH? I have to read a lot more about this.

As far as I know I don't have any of the secondary hyperPT causes like kidney failure etc. I tested negative for celiac but the last time I had stopped eating gluten so that test may not be accurate. I think I maybe I should get a sastimibi scan of the PT. I will ask my endo about that and see if anyone does that here. If the next pth and calcium are both high that would confirm that.

I will add these other results above too: t4= 1.46 (.93-1.70) I will look for the last t4 result in my records because I can't find it here in my early post. Folate was >20 (7.3-26.1) phosphorous was 3.7(2.7-4.5).

I also discussed t4 to t3 conversion maybe not working and he said we will see what the next blood work shows- are there specific tests for that?

[Clutter in reply to 000ggg]

000ggg, many people have low vitD, have you been prescribed D3?

It's high or high-normal calcium and high PTH which indicates hyperparathyroidism. Primary hyperparathyroidism is usually caused by a benign parathyroid tumour.

patient.co.uk/health/hyperp...

hyperparathyroid.org.uk/

You may find 100% gluten-free diet helpful in reducing Hashimoto's symptoms and antibodies.

chriskresser.com/the-gluten...

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

T4 1.46 is good, just shy of the top 75% of range, and Folate 20 is good.

It's low TSH, high FT4 and low FT3 which indicate poor conversion. High TSH indicates undermedication. Increasing dose to 50mcg should improve FT4 and FT3 and bring down TSH.

_____________________________________________

I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

[000ggg in reply to Clutter]

Thanks Clutter,

Yes as I explained above I'm aware of what shows primary hyperPT. I've had one high calcium and no PTH with that one. As well as one high normal PTH & high normal ionized calcium. And now a high PTH and high normal calcium with low D. According to the vitamin D pro app from the Norman PT center I'm still at the low end of likely to have primary not secondary. Which they say is rare. (Secondary) They said low D will usually cause middle or low normal calcium if it's secondary not high normal.

What I'm wondering is if everyone with low vitamin D also has high PTH? Most people may not get PTH tested. I guess my next tests may rule out or confirm what is going on. I'm still a it concerned about supplementing D if it does turn out to be primary though. And I wonder why my vitamin D went down when I increased it. Doc said to go to 6000 iu daily from 4000. I've also never had low out of range vitamin D so in my case I wonder what's causing it. That makes sense about the t4/tsh. I feel more tired now on 50 MCg, so does my father. I'm wondering why?

[Clutter in reply to 000ggg]

000ggg, no, having low vitD doesn't mean one has high PTH. My PTH and calcium weren't tested when I was vitD deficient. I think PTH isn't likely to be tested unless calcium is high or low.

[000ggg in reply to Clutter]

That was why mine is being tested so high PTH now confirms something is going on with the PT glands too. Everyone here thought my t3 was low although not out of range so I wonder if I will need that too? I will ask to get that tested again. But if tsh is higher now it seems I don't need it maybe.

I forgot to say I have been eating gluten-free for almost 4 years now and it has made no difference or stopped what is happening to my thyroid glands. It has helped my blood sugar control though.

[Clutter in reply to 000ggg]

000ggg, TSH rises when FT4 and/or FT3 drop.

[000ggg in reply to Clutter]

I should have FT3 tested again.