All results advice please

Hi

I am new. Here are results for everything that has been tested for. I take 50mcg Levo for hypothyroid diagnosed in 2012. Endo has been chopping and changing my dose a lot. I do not feel brilliant. Thank you.

Serum TSH - 4.50 (0.2 - 4.2)

Serum free T4 - 14.2 (12 - 22)

Serum free T3 - 3.4 (3.1 - 6.80

Thyroid peroxidase antibodies - 351 (<34)

Thyroglobulin antibodies - 844.3 (<115)

Serum ferritin - 13 (15 - 150)

Serum folate - 2.21 (2.50 - 19.50)

Serum vitamin B12 - 137 (180 - 900)

Total 25 OH vitamin D - 20.5 (<25 severe vitamin D deficiency. Patient may require pharmacological preparations)

2 Replies

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  • Sorry to hear you're unwell. You are wildly undertreated. Your tsh should be much lower, around/under 1.

    Your vit d is extremely low, which makes you severely deficient, you will need a loading dose to get started on improving that: imperialendo.com/for-doctor...

    Your b12, ferritin and folate are all below the lowest end of the range.

    Improvements in the above may help you feel a bit better but really you need a higher dose of meds. May I ask why/how is endo chopping and changing?

    Are you taking your meds away from anything but water?

  • As you have Hashimoto's then you may find adopting 100% gluten free diet can really help reduce symptoms, and lower antibodies too. Selenium supplements can help improve conversion of T4 to T3

    You do not need to have ANY obvious gut issues, to still have poor nutrient absorption or low stomach acid or gluten intolerance.

    You will see, time and time again on here lots of information and advice about importance of good levels of B12, folate, ferritin and vitamin D, low stomach acid, leaky gut and gluten connection to autoimmune Hashimoto's

    chriskresser.com/the-gluten...

    thyroidpharmacist.com

    chriskresser.com/the-thyroi...

    hypothyroidmom.com/92-of-ha...

    Levo must be taken on an empty stomach and then nothing apart from water for at least an hour after. Many take on waking, but taking at bedtime may be more convenient and recent research suggests it may also be more effective. (Must be at least two hours after eating)

    verywell.com/should-i-take-...

    archinte.jamanetwork.com/ar...

    Long research article - final conclusion paragraph below

    "In conclusion, bedtime intake of levothyroxine in our study significantly improved thyroid hormone levels. This may be explained by better gastrointestinal bioavailability at night or by less uptake interference by food or medications. As shown in this study, bedtime administration is more convenient for many patients. Clinicians should inform their patients about the possibility of taking levothyroxine at bedtime. A prolonged period of bedtime levothyroxine therapy may be required for a change in quality of life to occur."

    Dr Toft is a past president of the British Thyroid Association and leading endocrinologist, and this is what he wrote in a Pulse Online magazine article:

    "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.

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