Help with Hashimoto test results and meds

[Rhinogirl1959]

Hi, my 27 year old son was diagnosed with hypothyroidism 12 months ago and recently hashimotos after 1st endo visit. He started off on 50 levo, and tsh hovered around 1.0, had 1st endo appt in June as antibodies tested high. He'd been self medicating usual vitamins and wanted to check those before seeing endo so had a thyroid+vitamin check via medichecks in May. His tsh was very low and T3 and T4 quite high, medichecks suggested he was overmedicated so dr lowered his dose to 25. We now think it was a Hashi flare and perhaps should have been left on 50 levo. He's just had blood results and his tsh is very high - tsh only tested even though he requested antibodies etc. Dr has sent a message to increase levo to 75. I'm not sure if this increase is too much and he should increase 50 until he speaks to the gp next week.

Results below:

On 50 Levo:

Jan 17 tsh 1.7 (0.2-4.0) (gp)

Feb 17 tsh 1.3 (0.2-4.0) (gp)

Feb 17 serum thyroid peroxidase antibody 419 (<100) (gp)

May 17 tsh 0.01 (0.27-4.20) Medichecks

May 17 free thyroxine 33.47 (12.00-22.00) Medichecks

May 17 total thyroxine (t4) 160.2 (59.00-154.00) Medichecks

May 17 free t3 7.69 (3.10-6.80) Medichecks

May 17 Thyroglobulin antibody 446.00 (0.00-115.00) Medichecks

May Thyroid peroxidase antibodies 554.1 (0.00-34.00) Medichecks

Vitamins are improving due to self-medicating.

On 25 Levo after May results then:

July 17 - tsh 29.3 (0.2-4.0)

His symptoms are mainly fatigue, dizziness and visual disturbance.

Any help would be appreciated.

Thank you.

[shaws Administrator]

Dose shouldn't have been reduced. His dose is now far too low and he needs an increase. Blood tests should be at the very earliest, fasting and a 24 hour gap between last dose and test and be taken afterwards. I think the GP is correct to increase to 75mcg to bring TSH down. If your son feels overmedicated in a couple of days you can reduce dose but I don't think it necessary. Some people start on 100mcg. Some even take one weekly dose of thyroid hormones.

Tests should be done around every six to eight weeks until on optimum (symptom-free) and thereafter yearly unless symptoms appear.

[Rhinogirl1959 in reply to shaws]

Thanks you for reply shaws. I will tell him to start on his 75mcg. We hadn't realised originally that his medichecks results meant he was having a flare until we read some posts on here. He still had symptoms on 50mcg even with his tsh around 1.0 but we are hoping vitamin, zinc and selenium supplements will help eventually.

[shaws Administrator in reply to Rhinogirl1959]

Before blood tests were introduced along with levothyroxine, people who were diagnosed according to their clinical symptoms alone had doses of between 200 and 400mcg daily of NDT. Today doctors are apt to prescribe less going by the TSH only and not the symptoms patients is experiencing.

I hope he feels better soon as less men experience hypo than females.

[SlowDragon Administrator]

So has he had vitamin D, folate, B12 & ferritin levels checked? What is he supplementing?

[Rhinogirl1959]

Yes, he's had all those checked, they were in range but low so he's taking vitamin D3, K2, Magnesium, B12, Folic Acid, Selenium and Zinc. He decided to get private bloods done before his Endo appointment to see what his T3 and T4 is and if supplementing was increasing his vitamin etc levels as the doctor will only do TSH. The results we realise now suggested a Hashi flare so haven't really given us a true picture so we don't know if he's converting well or not.

The Endo has done some hormone tests, testosterone and cortisol amongst them. He's had a copy of the results letter that was sent to the GP but there are no ranges for some of them so he's going to see the GP next week - we suspect his testosterone is low but really not certain.