Partner's test results

[Ad1977]

I am newly registered and have come here on behalf of my partner. She is 31 and was diagnosed with under active thyroid in 2011. She is currently taking 175mcg of levothyroxine and she is not feeling any better as she is constipated, tired and has heavy periods. Should she need an increase despite normal bloods?

Thanks in advance.

Serum TSH 2.53 (0.2 - 4.2)

Serum Free T4 15.5 (12 - 22)

Serum Free T3 3.2 (3.1 - 6.8)

[Clutter]

Welcome to the forum, Ad1977.

Your partner is a little undermedicated and should request a dose increase. 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 [e-mail] if you would like a copy of the Pulse article to show your GP.

She might try a gluten-free diet for 3 or 4 weeks to see whether it improves her digestion and constipation.

Heavy periods can be due to low iron. Ask her GP to check ferritin, vitamin D, B12 and folate which are all often low/deficient in thyroid patients and can present symptoms similar to hypothyroid symptoms.

[Ad1977 in reply to Clutter]

Thanks for reply, GP thinks her constipation is because of her diet and not drinking enough water so has given her 2 boxes of laxatives. Levels of vitamins and minerals arent good despite supplementing.

[humanbean]

Constipation is a common symptom of untreated or under-treated hypothyroidism. Your partner's thyroid test results show under-medication to me.

Serum Free T4 15.5 (12 - 22) ** 35% of the way through the reference range **

Serum Free T3 3.2 (3.1 - 6.8) ** 3% of the way through the reference range **

Most people who are hypothyroid and are being treated for it feel best when Free T4 and Free T3 are in the upper half of the range, and some need them to be in the upper third or even the upper quarter of the range to feel well. Where someone feels well is an individual thing, but I haven't come across a single person who feels best with Free T4 and Free T3 in the lower half of the range or right at the bottom of the range.

To get an idea of what TSH looks like for healthy people with no history of thyroid disease, take a look at this graph :

web.archive.org/web/2004060...

If you read the blurb you can see that the median result for TSH was 1.50 and the mode was 1.25, both being substantially lower than your partner's result.

The data for the graph was gleaned from this research paper :

eje-online.org/content/143/...

My favourite part of that paper is the right hand half of Table 3 which shows the median TSH for each gender in different age groups. So, for example, in healthy women with no history of thyroid disease, aged 40 - 49 (for example), the median TSH was 1.40.

People with hypothyroidism generally feel best with a TSH lower than that of healthy people, so should aim for a TSH of 1 or under, so your partner definitely needs more medication.

If your partner has been supplementing but her nutrient levels aren't improving you should post her blood test results for vitamins and minerals and also let us know what she has been supplementing. It could be she needs a different type of supplement or the dose is insufficient to raise levels.