Hashimtoto's Thyroid.

[SantaMonica2002]

Hello.  I was diagnosed with Hashimotos just before Christmas (by a pure fluke) as I happened to mention to my DR about my hair loss (it's a long story), but a lot of the symptoms I put down to the menopause, and that I have MS.  The DR started me off on 50mg of Levo, the results came back after waiting the 6-8 weeks, and so he upped it to 75mg.  Now my question is, should I have taken my Levo before the blood draw or not, my DR said yes I should, but the Lab told me no I shouldn't.  What should I do, or who should I believe?... a lot of "should" eh?  any help very much appreciated.  Thank you.

[shaws Administrator]

You believe what's recommended on this forum as we've all 'been there - done that'.

The test should be the earliest possible, and don't eat before it although you can drink water. You should also allow 24 hours between your last dose of levo and the test and take it afterwards. This allows the TSH to remain at its highest as food etc can interfere with the results and TSH also drops throughout the day. Is the GP aware of the 24 hour cycle of the TSH. Probably not.

[SantaMonica2002 in reply to shaws]

How does it interfere with the results?  My TSH is the same, but F3 has dropped, and the F4 has barely risen.

[shaws Administrator in reply to SantaMonica2002]

Do you have your blood test around the same time every time?

[SantaMonica2002 in reply to shaws]

Yes I do, first thing in the morning when the lab is open at 7am.  I have just put a call in to his secretary, who has literally come back to me and said that I MUST take the Levo at my normal time (5am), and then go for my blood draw.  I'm wiped out (as I'm sure you know the feeling), last night I was in bed by 6pm, and slept for 11 hours straight.  I feel like a barely walking zombie :(.........should I post my test results?

[Marz in reply to SantaMonica2002]

Yes please post your results with ranges for people to comment.  Have you had your B12 tested ?  Was connecting this to your MS if your B12 and VitD are low.

grassrootshealth.net

The above website have been doing research into the connection of Low VitD and MS.

Also when B12 is on the floor it can become neurological condition - rather than a vitamin deficiency.

b12deficiency.info/signs-an...

Scroll down in the above link to see the neurological symptoms.  Also have Ferritin and Folate tested as your fatigue could be linked to low iron/ferritin/folate/B12 .  I would also add the FT3 into the mix - results need to be quite high in the range.

If you were otherwise diagnosed - please accept my apologies for jumping in with both feet.  Just needed to pass on the information just in case.

[Marz in reply to Marz]

Sorry - forgot to mention I am not a medic - just a fellow Hashi's girl with B12 issues....

Didn't use the Edit button as it rarely works for me and I keep losing replies !!

[SantaMonica2002 in reply to Marz]

No problem, thanks for jumping in.  All my vitamins are in the ranges.  now these are my test results.

27/1/2016

TSH 1,10 (0.27 - 4.20)

F3 4.5 (3.1-6.8)

F4 12.8 (12-22)

These results above were when I was on 50mg of Levo with Levo taken beforehand. The next panel is now on 75mg with the lab ranges the same taken yesterday with Levo:-

TSH 1.01

F3 4.2

F4 14.6

Does this make any sense?

[Marz in reply to SantaMonica2002]

Yes they make sense in as much as the TSH has reduced slightly and most people feel better with a TSH of 1 or under.  Also your FT4 has improved slightly but the FT3 has reduced - but only very slightly.  The FT3 is not the most accurate test and there can be a swing either way I have read.

Maybe you have a conversion issue - which is why I asked about your Ferritin - Folate - B12 - VitD.  They need to be OPTIMAL rather then just in range for the thyroid hormones to work efficiently and for you to feel well.

Having been on this forum for a few years I have learned that being in range with Vits and Minerals is NOT enough - it is where you are in the range that is important.  Is your B12 around 1000 ?

You are still on quite a low dose of Levo - so perhaps there is room for an increase.  What other medication do you take ?  What supplements ?

Did you find the links useful I posted above ?

[SantaMonica2002 in reply to Marz]

Yes I did indeed thank you.  My Vit B12 is 987, lab range (191-663) Folate 15,8 (6,0) which looking at my results from when I was diagnosed is normal. I don't take any minerals or supplements, I eat a healthy diet, and where I live Vit D is from the sunshine, so the DR didn't test me for that.

This is all very confusing isn't it?...newly dx, and I don't know who is correct the DR or the Lab.

[Marz in reply to SantaMonica2002]

Yes I too live in the sun - and my VitD was very low !  Both hubby and I have Hashimotos and both had low VitD.  It could be worth having it tested.  Yes your B12 is impressive.  So the Ferritin is involved in conversion so it may be worth having that tested along with the D.

I wouldn't worry about who is right or wrong - go with your gut feeling .  If you want to increase your dose then you need the TSH as high as possible - so that would mean an early morning fasting test.  If that is not the case then do whatever you want  !

Fasting or not is not the only thing people have varying opinions on when it comes to the Thyroid and that includes the medical profession.  Best to steer your own boat !

[SantaMonica2002 in reply to Marz]

I went this morning for another test, this one I did without taking the levo.  I will ask my DR on Tuesday for me to be tested  on the Vit D, and also the Ferritin.

The test results will be ready later today.  Why has my TSH dropped like that?

I'm still in the learning process you see.

Steer you own boat, you got that right!

[Marz in reply to SantaMonica2002]

It hasn't dropped that much.  The TSH is a Pituitary hormone and responds to a feedback from the circulating thyroid hormones in the blood.  So depending on that - then the TSH responds accordingly.  Hence when taking T3 only the TSH can be suppressed or low.  The Pituitary Gland senses adequate supply of Active Thyroid hormone.  It could be you just had a tad more hormone circulating in the last test.  It is ONLY a guide - the test that is !  Lots of influences in addition to the one I have mentioned.

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

The above link takes you to the main website of Thyroid UK - everything you need to know about the thyroid !

[SantaMonica2002]

Sitting here scratching my head now.  DR says yes, Lab says no.  What do I do? should I pay and have another test done first thing in the morning without the Levo, just to see???

[SlowDragon Administrator]

My endo is an eminent thyroid specialist - he told me very plainly Do NOT take Levo in the 24 hours before a blood test. Take it straight after. 

I also find taking Levo at bedtime (at his suggestion) has improved my uptake. 

When ever you take Levo, it needs to be on empty stomach, (no food for ideally 2 hours before) and do not eat or drink (other than water) for at least an hour after.