Help with results please

[Pinksapphire]

Hi I have just joined. I was diagnosed hypo in 2014. My current dose is 125mcg Levo and 10mcg T3. My question is mainly am I undertreated? I still have many hypo symptoms - heavy periods, constipation, muscle aches, joint pain, eczema, tiredness, weak arms and legs, feeling cold. I would like to ask my endo for a raise in meds but I am worried she will not think my symptoms are hypo. Any ideas if they are? Thank you

June 16 (125mcg Levo and 10mcg T3)

Serum TSH level - 3.10 (0.2 - 4.2)

Serum Free T4 level - 16.4 (12 - 22)

Serum Free T3 level - 4.8 (3.1 - 6.8)

April 2016 (100mcg Levo and 10mcg T3)

Serum TSH level - 3.84 (0.2 - 4.2)

Serum Free T4 level - 13.7 (12 - 22)

Serum Free T3 level - 4.2 (3.1 - 6.8)

March 2016 (50mcg Levo, no T3)

*Serum TSH level - 6.10 (0.2 - 4.2)

Serum Free T4 level - 12.9 (12 - 22)

Serum Free T3 level - 4.5 (3.1 - 6.8)

January 2016 (75mcg Levo and 10mcg T3)

*Serum TSH level - 0.09 (0.2 - 4.2)

*Serum Free T4 level - 22.4 (12 - 22)

Serum Free T3 level - 4.7 (3.1 - 6.8)

December 2015 (75mcg Levo and 10mcg T3)

*Serum TSH level - <0.01 (0.2 - 4.2)

Serum Free T4 level - 20.6 (12 - 22)

Serum Free T3 level - 5.4 (3.1 - 6.8)

October 2015 (75mcg Levo and 10mcg T3)

*Serum TSH level - <0.02 (0.2 - 4.2)

Serum Free T4 level - 20.8 (12 - 22)

Serum Free T3 level - 5.6 (3.1 - 6.8)

July 2015 (125mcg Levo)

Serum TSH level - 1.30 (0.2 - 4.2)

Serum Free T4 level - 19.3 (12 - 22)

Serum Free T3 level - 4.2 (3.1 - 6.8)

*TPO antibody level - 375 (<34)

*TG antibody level - 251 (<115)

May 2015 (100mcg Levo)

*Serum TSH level - 6.51 (0.2 - 4.2)

Serum Free T4 level - 13.1 (12 - 22)

Serum Free T3 level - 4.3 (3.1 - 6.8)

March 2015 (75mcg Levo)

Serum TSH level - 3.60 (0.2 - 4.2)

Serum Free T4 level - 13.8 (12 - 22)

Serum Free T3 level - 4.1 (3.1 - 6.8)

January 2015 (50mcg Levo)

Serum TSH level - 2.37 (0.2 - 4.2)

Serum Free T4 level - 15.9 (12 - 22)

Serum Free T3 level - 4.3 (3.1 - 6.8)

November 2014

*Serum TSH level - 20.3 (0.2 - 4.2)

*Serum Free T4 level - 10.2 (12 - 22)

Serum Free T3 level - 4.0 (3.1 - 6.8)

[shaws Administrator]

Taking only your final blood test into consideration - you are not on sufficient thyroid hormones.

It would seem your Endo/doctor is more keen on adjusting your dose to keep your results 'in range' and all that happens is the patient feels much worse.

We have to have sufficient thyroid hormones for our TSH to be around 1 or lower or suppressed. Both FT3 and FT4 should be toward the upper part of the range. Your results fit none of these and it's no wonder you feel awful.

I hope she increases your dose and it has been found that a combination of T4/T3 should be 3 x 1. Go to page 80 and on the left-hand top column you will see the info.

tpauk.com/images/docs/reduc...

[SeasideSusie Remembering]

Yes Pinksapphire you are undertreated but you are going in the right direction and there is room for an increase in your meds. The aim of a treated hypo patient is for the TSH to be 1 or below or where it needs to be for the FT4 and FT3 to be in the upper part of their ranges. However, when T3 is added into the mix the TSH will usually be suppressed and maybe the FT4 lower than when on Levo alone.

There is an article in Pulse Online magazine by Dr Toft, past president of the British Thyroid Association and leading endocrinologist which says

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

If you email [e-mail] she will let you have a copy of the article which you can print out and show your endo.

Also, has your endo said anything about your very high antibody levels. You have positive results for both TPO and TG antibodies which means you have autoimmune hypothyroidism aka Hashimoto's disease. Your endo or GP may not know this but going completely gluten free will help reduce antibody attacks, some people also need to be dairy free. Also supplementing with selenium helps reduce the attacks.

Most hypos are deficient in vitamins and minerals. It would be a good idea to get Vit D, B12, ferritin and folate tested. If these are not optimal, particularly ferritin, then thyroid hormone can't do it's job properly. If you get them tested then make a new post with the results, including reference ranges, and members can suggest supplements to help where there are deficiencies.

[Pinksapphire in reply to SeasideSusie]

Thank you Seasidesusie, no my endo has not told me anything about me having Hashimoto's. She has just said I am TPO and TG antibody positive. I have results for ferritin, vitamin D, vitamin B12 and folate going back years. I have supplemented in the past but this was months ago and I am not sure if I need to be back on supplements at all. Low ferritin was corrected back in April with IV iron. The doctor has said it is likely I will need more, another doctor has said the IV iron was probably just a one-off. All these results will be in another post.

[SeasideSusie Remembering in reply to Pinksapphire]

OK Pinksapphire I will reply on the other post about vits and mins.

[shaws Administrator]

This is an archived site (Dr Lowe died of an accident) and therefore some links within may not work but there is a wealth of info/topics at top of page on how to help ourselves recover.

web.archive.org/web/2010103...

[Pinksapphire]

Hi and thank you, some symptoms have reduced somewhat but in myself I do not feel as well as I have felt times before. My doctor is checking me for coeliac disease and there is a history of MS and heart disease in the family.