Need help with blood test results please?

[Helliefish]

I went to my GP in March as I had been feeling more and more tired over the last few years as well as other thyroid related symptoms, and have a family history of thyroid issues. GP seemed sceptical, but agreed to test thyroid function and antibodies:

Serum thyroid peroxidase antibody concentration 474 iu/ml (0.0 - 60.0)

Serum TSH level 13.03 mU/L (0.35 - 5.5)

Serum free T4 level 12.6 pmol/L (10.0 - 19.8)

Was told these results were borderline, but would treat with levo anyway. So was prescribed 50mcg of levo for two months, during which I felt much worse, and then retested:

Serum TSH level 13.59 mU/L (0.35 - 5.5)

Serum free T4 level 12.2 pmol/L (10.0 - 19.8)

Spoke to a different GP who recommended that I double my dose of levo to 100mcg, and retest again in 6 weeks, so am now taking that.

Does anyone have any insight into what these results mean? Is it normal to have such high TSH but free T4 in range? And for two months of levo to have had no effect?

Thank you

[SeasideSusie Remembering]

Helliefish - borderline my eye!!! TSH of 13.03, TPO antibodies of 474 screams autoimmune thyroid disease aka Hashimoto's (or autoimmune thyroiditis in doctor speak). Your GP knows diddly squat about hypothyroidism! Well done to the second GP who increased your dose.

When you are retested, patient to patient advice is to book the earliest appointment of the morning, fast overnight (water is allowed) and leave off Levo for 24 hours (take after the blood draw). This gives the highest possible TSH which is needed when looking for an increase in dose or to avoid a reduction.

Retesting and dose increases should take place every 6-8 weeks until you feel well.

Most hypo patients feel best when TSH is 1 or below and FT4 and FT3 in the upper part of their respective reference ranges.

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When taking your Levo, always take it on an empty stomach with a glass of water only, one hour before or two hours after food and drink, and a couple of hours away from other medication and supplements (four hours for iron, D3, magnesium and calcium).

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Regarding your Hashimoto's, this is where antibodies attack the thyroid and gradually destroy it. There is no treatment for Hashi's, it's the resulting Hypothyroidism that is treated. Reducing antibodies can help. Many members find that a strict gluten free diet can help reduce the antibodies. Gluten contains gliadin which is a protein thought to trigger antibody attacks. Read about the gluten/thyroid connection here

chriskresser.com/the-gluten...

Supplementing with selenium L-selenomethionine 200mcg daily and keeping TSH suppressed also can help reduce antibodies.

And these articles will explain about Hashi's:

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

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