I have just joined, could someone please help me to interpret results? I take 50mcg Levo for hypothyroid diagnosed in 2012. Symptoms are breathlessness, sighs, depression, fatigue, muscle weakness, insomnia, constipation, heavy periods, feeling cold. Thank you
Serum TSH 5.2 (0.2 - 4.2)
Serum Free T4 13.1 (12 - 22)
Serum Free T3 4.0 (3.1 - 6.8)
TPO 442 (<34)
TG 288.1 (<115)
I would rather have your Free T3 and T4 a bit higher on the normL range. Your thyroid antibodies are high. You can google what that means. What does your doctor say about that? Since you are on a low dose of T4 and younare still symtomatic i would ask for an increase to say 75. If that doesnt fix things inwould ask to have some T3 added via liothyronine (cytomel) as you may not be converting enough of the T4 to the usable T3 form in your body or your TSH would be lower. It is saying that there is a lot of hormone in your blood but apparently you are not able to ise it. It needs to be lowered by more medicine for unto feel better.
Thanks my doctor hasn't said anything about the thyroid antibodies. Endo is reluctant to increase dose because of my weight and other symptoms which suggests over active thyroid.
Bex4,
Your endo should go back to school. You are very under medicated which is likely to mean your weight will increase and will make any weight loss impossible.
The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 1.0 or lower with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email louise.roberts@thyroiduk.org.uk if you would like a copy of the Pulse article to show your GP and endo.
Thyroid peroxidase and thyroglobulin antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.
Bex4 You are clearly undermedicated. The aim of a Hypo patient is generally for TSH to be 1 or below or wherever it is needed for FT4 and FT3 to be in the upper part of their respective reference ranges.Yoir TSHn is over range and your free Ts have just scraped in at the bottom of theirs.
Dr Toft, past president of the British Thyroid Association and leading endocrinologist states in Pulse Magazine:
"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)."
Your symptoms are due to undermedication. You need an increase of 25mcg then re-test in 6-8 weeks, another increase and re-test after another 6-8 weeks, until you feel well.
Your high antibodies are positive for autoimmune thyroid disease aka Hashimoto's. This is where antibodies attack the thyroid and eventually destroy it. Hashi's isn't treated, it's the resulting hypothyroidism that is.
You can help reduce the antibodies by adopting a strict gluten free diet, many members have found this helps enormously.
Gluten/Thyroid connection - chriskresser.com/the-gluten...
Supplementing with Selenium L-selenomethionine 200mcg daily also helps, as does keeping TSH very low or suppressed.
Hashi's Information:
stopthethyroidmadness.com/h...
stopthethyroidmadness.com/h...
thyroiduk.org.uk/tuk/about_...
What symptoms does your endo say indicate over active thyroid?
Have you had ferritin, folate and Vit D tested? I see from your other post that you're B12 is very low.
Thanks yes I have had ferritin, folate, vitamin D tested as well. Symptoms my endo said indicate over active thyroid - weight loss, insomnia, anxiety, sweating, fine tremor in hands, increased appetite, gritty eyes. Not sure where to post the results since I have started a new thread on B12.
Bex4 Please post the results with the reference ranges.
Tremor is more likely to be caused by your very low B12 level.
Also, because you have Hashi's, your symptoms will fluctuate and can swing from hypo to hyper. I don't think your endo knows much about thyroid disease and is probably a diabetes specialist.
Ok I will put them here.
Ferritin 71 (15 - 150)
Folate 14.7 (4.6 - 18.7)
Total 25 OH vitamin D 33.5 (25 - 50 vitamin D deficiency. Supplementation is indicated)
I am taking 800iu vitamin D3 tablets
Bex4 Ferritin is OK, it needs to be 70 for thyroid hormone to work properly and half way through range is best. I have seen it said that for females then 100-130 is best. You could eat liver once every week to ten days to maintain your level.
Folate is good but still ask on the PA forum about your low B12 and mention your folate level too.
Vit D, as you know, is deficient. Was your 800iu D3 prescribed? It is far too low a dose. You should be having a loading dose of 10,000iu daily for 3-4 weeks then reduce to 5000iu daily then re-test in the Spring. If you've then reached the recommended level of 100-150nmol/L reduce to 5000iu alternate days as a maintenance dose.
When taking Vit D there are important co-factors:
vitamindcouncil.org/about-v...
D3 aids the absorption of calcium from food and K2-MK7 directs it to bones and teeth rather than arteries and soft tissues. D3 and K2 are fat soluble so should be taken with the fattiest meal of the day. Take D3 four hours away from Levo.
Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening and four hours away from Levo.
naturalnews.com/046401_magn...
Thanks yes the vitamin D3 is prescribed. The GP says that's the only dose they prescribe.
Bex4 He is following NICE guidelines, but by taking only 800iu daily means it will take a very long time to increase your level. There's nothing stopping you buying your own if you wish to help yourself.
The more you read on here, the more you will see that so many of are let down by our doctors and we only get well by helping ourselves.
Just to add my endo only wants me tested every 6-8 weeks for every dose change and I have been taking as much as 175mcg Levo with 10mcg T3 added.
Bex4 It's normal for re-testing to be done 6-8 weeks after a dose change as that is how long it takes for the difference to take full effect.
If you were on 175 Levo plus 10 T3 then there is a massive difference from what you are taking now. Was the dose lowered gradually? How did you feel on the higher dose? Why was it lowered so much?
Thanks the dose was lowered by 75mcg Levo and T3 kept the same and then reduced again by another 25mcg because of suppressed TSH. I felt better on the higher dose but it took a long time for me to notice an improvement. Endo told me I should notice a difference straight away.
Bex4 Changes in dose should be done gradually, 25mcg at a time. I think your endo has been playing around because she doesn't really know what to do and she doesn't understand Hashi's fluctuations. You can't notice a difference 'straight away' because it takes 6 weeks for the full effect of a dose change.
I really don't think this endo doing you any favours and is keeping you ill unnecessarily.
The article by Dr Toft that I mentioned further up can be obtained by emailing louise.roberts@thyroiduk.org.uk . You should obtain a copy of it and print it out. Then you should discuss it with your GP or endo and ask for an increase in Levo. Your current results, though dreadful, do show that at the moment you are converting T4 to T3 well, so just an increase in Levo at the moment, just 25mcg then retest in 6-8 weeks, then another increase of 25mcg then another re-test until you are feeling well and your results are where they need to be, or FT4 and FT3 at the upper end of their ranges if that is right for you.
At a later stage we can see how your conversion is and whether you need to ask for T3 to be added again.
If you want to get well then you are going to have to fight for it, gather the information and be assertive enough to not let them keep you on a silly dose where you feel ill and your results are so poor and a TSH out of range.
You also need to address the Hashi's, don't expect any help from your doctors there, they don't know much about it and there's no other treatment other than treating the hypothyroidism. But, being gluten free can help you enormously.
Also, you need to keep your ferritin level up, get your Vit D up to 100-150 and get over to the PA forum for advice about your dreadfully low B12.
If you want to know what B12 deficiency can do, and why it's important to get it sorted, then please check out the first film on this link, you won't really need to watch all of it
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