Results...help please...

[Ollysmum]

Following on from my increase in Levo eight weeks ago...from 125 mcg to 150 mcg, I have a review this week with my doctor. I've had results from bloods.

TSH 0.2 (0.4 - 4.0) (Nov 16 TSH 2.16)

T4 23.9 (10 - 25)

Tissu transglutaminase IGA 1.4 (0 - 7)

Thyroid Peroxidase Antib 56 (0 - 34)

Practice nurse range yesterday to say my Levo is to be reduce back to 125mcg. Said I will discuss with doctor. I'm worried doc will reduce does as I felt lousy on 125 eight weeks ago! Don't exactly feel great at the minute and still tired and lack of energy some days and got ache in stomach right hand side. Liver FT fine. No T3 tested.. apparently lab doesn't do it. I'm thinking of getting it tested privately. Wondered whether doc might leave dose as it is or alternate 125 one day 150 the next. Any thoughts please?

From replies to my previous post it also looks that I have Hashimoto's as tested positive for antibodies but await doctors confirmation when I go. I realise this is treated with Levo but what else can I expect? Should my antibodies be checked regularly? Is it the 'norm' to be referred to an Endo? I'm really not sure. Also from what I have read those with Hashimoto's tend to go gluten free. However, my Tissu transglutaminase has tested negative. Am I missing the point here?

Any answers gratefully accepted.

[Angel_of_the_North]

Your FT4 is in range so,you are not overmedicated. I'd try to ask the doctor to leave dose as is and, if he hasn't read the Roterdam study and tries to scare you with tales of heart failure and osteoporosis, say you'll have a DEXA scan and a heart monitor, but you'd rather take the risk and have the chance of a life than feel lousy on too low a dose of levo.

[Ollysmum in reply to Angel_of_the_North]

Thank you Angelof theNorth for taking the time to reply. Thats sound advice. Feeling better prepared to stand by my guns with my doctor...to keep dose as it is. 😊

[SeasideSusie Remembering]

You don't need to be positive for coeliac disease where Hashimoto's is concerned. Gluten contains gliadin which is a protein that is thought to trigger antibody attacks, so it's nothing to do with coeliac, it's to do with the gliadin and antibodies. So coeliac or not, a strict gluten free diet can help reduce antibodies and many members have found this helps enormously. Also supplementing with Selenium​ L-selenomethionine 200mcg daily and a suppressed TSH helps reduce antibodies.

Once tested positive, antibodies don't need testing again.

Your GP may not have much knowledge of Hashimoto's, they call it autoimmune thyroiditis anyway.

Tell your GP that you don't want your dose reduced because you've taken advice from NHS Choices recommended source of information for thyroid disorders and it's recommended to keep TSH suppressed to help reduce antibodies. If he says you are overmedicated then you can refer to Dr Toft's article in Pulse Online magazine where he stated:

"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)."

You can obtain a copy of the article by emailing [e-mail] , print it out and highlight question 6 to discuss with him. If he still insists on reducing, ask him to prove that you are over medicated by getting FT3 tested.

[Ollysmum in reply to SeasideSusie]

Thanks so much SeasideSusie for your informative reply. That has helped my understanding a lot and I feel more prepared for my visit to the docs. 😊