Help with recent blood test please

[Bagster]

Dear Friends

I was diagnosed last October and my levo dose was increased from 25 to 50 mcg in January. Because my GP doesn't want to see me until july I did a medi checks BT this week. Here are the results

TSH 4.51 (0.27 - 4.20)

Total T4 77.3 (59 - 154)

FT4 14.55 (12 - 22)

FT3 3.69 (3.1 - 6.8)

TgAb 99 (0 - 115)

TpAb 7.12 (0- 34)

In January (before the dose increase)

TSH 5.1

T4 12.88

T3 4.4

AtgAb 123.1

ATpAb 13.1

(All ranges the same - both tests done before 9am in a fasting state and 24 hours after last levo dose)

I can see from the above that I am still under treated, but what is puzzling is that T3 doesn't appear to be shifting at all. Getting worse if anything! Does this mean I am not converting properly and should I be adding in some T3?

Also it appears my antibodies are now within range (I have been gluten free since diagnosis). I'm feeling reassured by this. Does this mean hashimotos is in remission? Ongoing symptoms are dry skin, breathlessness and less energy than I had before diagnosis! The levo doesn't make me feel great to be honest.

I'm going to try for an earlier appt with my GP, but would be really grateful for some wise counsel from you good people.

Thank you

Bags

[SeasideSusie Remembering]

Bagster - with Hashi's, the antibodies will flucuate but the Hashi's wont go into 'remission', you will continue to have antibodies attacking your thyroid until it is eventually destroyed. This is why it's suggested to do everything you can to try and reduce the antibodies and hopefully reduce the antibody attacks and the fluctuations.

Your TSH is still over range, you are undermedicated. You shouldn't wait until July for another GP test. They should be done every 6 - 8 weeks (by your GP) with any necessary increase in dose until you are symptom free.

I would suggest you take these new results to your GP to discuss. If he doesn't like the fact that you've had a private test done you will have to tell him that you feel so unwell that you couldn't wait until July for the surgery to re-test. Point out that your TSH is still over range and that you've taken advice from NHS Choices recommended source of information for thyroid disorders - Thyroid UK - and they have told you that:

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, wrote this 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.

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 GP.

Tell him that you would like an increase in your Levo, continuing testing at 6-8 week intervals with increases in doses until you feel well.

As far as adding T3 is concerned, it is far too early to consider that. You have to be optimally medicated first and then see whether your conversion is good or whether you could do with the addition of T3.

Also, have you had vitamins and minerals checked

Vit D

B12

Folate

Ferritin

All these need to be optimal for thyroid hormone to work.

And are you supplementing with Selenium to help reduce antibodies?

[Greenwall in reply to SeasideSusie]

Hi. How does selenium reduce antibodies?

[SeasideSusie Remembering in reply to Greenwall]

I don't know the science, but supplementing with Selenium, l-selenomethionine, 200mcg daily is supposed to help reduce them.

If you Google, there are links to information. Here's one to start you off, he has more than one article so you can click through and read the others

chriskresser.com/selenium-t...

[Bagster in reply to SeasideSusie]

Many thanks SeasideSusy. I've emailed my GP and asked for a NHS blood test and an appointment within the next two weeks. She has previously prescribed levo without even seeing/speaking to me so I feel well within my rights requesting a face to face appointment.

[Greenwall]

Thanks for your reply SeasideSusie.