First set of bloods since starting on Levo

I have a follow up with my Endo next week and would be grateful for any advice on my latest blood results:

CRP 0.60 <5.0 mg/L

*Ferritin 524.8 30 - 400 ug/L

*TSH 3.37 0.27 - 4.20 mIU/L

T4 Total 95.8 64.5 - 142.0 nmol/L

Free T4 16.37 12 - 22 pmol/L

Free T3 4.26 3.1 - 6.8 pmol/L

*Anti-Thyroidperoxidase abs 372.5 <34 kIU/L

Anti-Thyroglobulin Abs 60 <115 kU/L

Vitamin D (25 OH) 68 50 - 175 nmol/L

Vitamin B12 475 250 - 725 pmol/L

Serum Folate >45.400 8.83 - 60.8 nmol/L

D.H.E.A. Sulphate 4.830 umol/L 0.44 - 13.40

Follicle Stim. Hormone 1.6 IU/L 1.50 - 12.40

Luteinising Hormone 2.82 IU/L 1.70 - 8.60

*Testosterone 6.11 nmol/L 7.60 - 31.40

Sex Hormone Binding Glob 31.95 nmol/L 16.00 - 55.00

*Free Androgen Index 19.12 Ratio 24.00 - 104.00

Currently taking 75mg of Levo and 5000iu Vit D daily - seems odd vit D level above has dropped from 98.2 in last 7 weeks?.

Persisting symptoms are low energy levels, painful joints, memory issues, head pressure, difficulty concentrating, brain fog, sleep disturbances and weight gain.

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4 Replies

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  • Hi there

    Your thryoid results indicate you need an increase in your dose so should increase to 100mcgT4. How long did have you been on levo for? Sometimes it can a while to feel better. Your antibodies are positive for autoimmune thyroid so you immune system is attacking your thyroid so is best to get your tsh as low as possible.

    Your ferritin (iron) is quite high - this often happens when your body is removing iron from your blood on purpose to stop it being used - this can be when you have viruses or infections or can be from inflammation from antibody attacks. THe endo might check this out more with blood count and iron panel or retest to see if has reduced.

    The best suggestion I have for any inflammation, autoimmunity and to help lower your antibodies is to try a gluten free diet. Many of us find this helps with symptoms enormously. Has to be 100% and for at least three months to see if will help :-)

  • Porcelt,

    You are undermedicated to have TSH 3.37. 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.

    Thyroid peroxidase 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.

    chriskresser.com/the-gluten...

    thyroiduk.org.uk/tuk/about_...

    VitD is sub optimal. If you are able to get sun on your face and arms several times a week vitD will improve naturally. If not, supplement 5,000iu daily for 6 weeks and then reduce to 1,000iu daily and retest in 3 months.

    B12 and folate are good.

    Ferritin is high which can indicate inflammation somewhere in the body. I would ask your GP to retest in a few months and if it is still high to do a full blood count to rule out infection.

    I can't interpret sex hormones but testosterone and Free Androgen Index are both flagged as below range.

  • Ok, thanks - will increase to 100mg and see how that goes.

    Regarding Vit D it was 18.5 in December 2016 so I took 20,000iu 3 times a week for 8 weeks and have continued with 5,000iu daily after that to increase it. 7 weeks ago it was 98.2 and it is now 68; What would cause the level to fall?

    Also, in last 7 weeks antibodies have increased from 228 to 372.5 and would have expected this to fall once I started taking Levo?

    How do I reduce ferritin? From what I can gather giving blood seems to be a typical solution but as I have raised bilirubin I am not allowed to give blood.

  • Porcelt,

    If vitD dropped while you are supplementing 5,000iu daily you need to increase daily dose.

    Levothyroxine doesn't reduce antibodies. Low TSH helps reduce antibodies and Gluten-free diet as I posted above.

    If ferritin is raised due to inflammation or infection you need to treat the source. Elevated ferritin is not the same as iron over load (haemochromatosis) which may be treated by venous withdrawal which can be donated if the blood is otherwise good or destroyed if not.

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