Blood Test Results

[romyhorse]

Hi! I've been on 50mg levothyroxine for several years since I was diagnosed as hypothyroid. I have since been diagnosed with Hashimotos. My latest blood results are as follows:

27/06/17

TSH 9.76 (0.55-4.78)

FT4 14 (10-25)

FT3 3.7 (3.1-6.8)

After complaining to my doctor that the levothyroxine hasn't helped me and I have been getting worse she increased my dose to 75mg and I have to go back to get my bloods checked again at the middle of August. What shocked me most was that my previous TSH results were 7, 5 and 11 and they have never done anything about it! They just told me my results were fine and to keep on taking my 50mg dose of levothyroxine! If anyone can give me any advice on these results and tell me what questions I should be asking my doctor that would be great, I'm tired of being tired all the time!

[Inana]

It could be the Levo is not right for you or you are taking too little levo.

Judging by your test results, you are not converting T4 to T3 much. Also, 50mcg is the dose they usually start you on, so most likely, you are not taking enough Levo. However... If you are not converting T4 to T3, but are taking Levo, then it would be interesting to check your rT3 results, because if you are converting T4 to rT3 instead of T3, that will make you feel sicker. This would mean that you probably need T3 and not T4, but, not much can be said because your dose of Levo is very low in the first place. In conclusion, you could be dealing with 1. T4 not converting to T3, and converting to rT3, or you are under-medicated and because you are not being medicated properly, you are just getting worse and worse over time.

Ask your doctor to take the following blood tests:

Free T4

Free T3

Reverse T3

TSH

Vitamin D

B12

Folate

Ferritin

Iodine

Thyroid peroxidase antibody (TPO)

Thyroglobulin antibody (TGAb)

After this, you can have a better perspective on how to go forward because if your vitamins and minerals are also low, which is usually the case, taking Levo will make you feel unwell because you need Ferritin, Iodine etc to help the medication do its job.

I hope you can find assistance from more experienced people around here.

[romyhorse in reply to Inana]

Thank you Inana. I have had vitamin D, B12, folate and ferritin tested. Vitamin D results aren't back as they have to go to a different lab, but the rest are low. Once I get my vitamin D results back I will make an appointment with my GP to address these. I will ask about rT3 test as well. I'm hoping that if I can get my nutrient levels up and the correct dose of levothyroxine that will help. I've already been told that my results won't change my treatment (which I am assuming means she won't prescribe T3!)

[Inana in reply to romyhorse]

Well, then, if your Ferritin, Folate, B12 are low, then it really doesn't make a difference because without these vitamins and minerals being adequate in your system, there will be no conversion of T4 to T3 going on. So, start with fixing your minerals and Vitamins first. That will take you at least 4 months if you're aggressive about your doses.

Then, and only then, can you know if T4 is working or not. You can not say now. There just isn't enough of the good old nutrients to help your medication work, so that is probably why you are feeling sicker.

When your nutrients are fixed, and you still feel terrible, then you can say that T4 is not working, and even then, and only then can you know if you need T3.

Unfortunately, there is not much that can be fixed if your Ferritin, Folate, Vitamin Bs, Magnesium (and even Iodine) are low.

[romyhorse in reply to Inana]

Thanks, I've already been taking supplements for all of these and vit D for nearly 9 months but only over the counter strength, so hopefully my doctor will prescribe me higher strength vitamins. I have explained to her why they need to be in the high part of the range so hopefully I won't have a problem getting this fixed.

[Inana in reply to romyhorse]

Good Luck. We're all on the same funky boat here, trying to get better. I hope it happens soon for you.

[SlowDragon Administrator]

50mcg is normally a starting dose. You almost cert should have had an increase years ago

Moving forward, you will need a new blood test after 6 weeks at this dose. All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after

As you have Hashimoto's you are quite likely to have low vitamin D, folate, B12 and or folate. Suggest you go back to GP and ask that these tests be added to the thyroid ones for 6 week test

Many of us with Hashimoto's also find changing to gluten free diet reduces symptoms and may slowly lower antibodies over time too

Obviously you are going to have to manage your own condition, your doctor has not served you well. Many don't realise when on Levo we need TSH in lower part of the range, but your GP hasn't even managed your thyroid so that your tests were even in range.

Keep good records of your test results, making a note of how you feel at the time too.

Read as much as you can about Hashimoto's, a good place to start us Thyroid UK website, home of thus support group.

The Thyroid Pharmacist website for masses of info about Hashimoto's and her video series the Thyroid Secret on you tube is good too

Never take any iodine with Hashimoto's, and best to avoid multivitamins but especially any with iodide in

[romyhorse in reply to SlowDragon]

Thanks SlowDragon. My vitamin levels are low, just got the results this afternoon, so going to start with addressing those. I have explained to my doctor why my vitamin levels need to be high and why my TSH needs to be low and I think she was receptive to this but she's obviously never dealt with anyone with Hashimoto's before. I have started a gluten free diet this week and hopefully that will help too. I am disappointed my high TSH wasn't addressed previously but I'm hoping my doctor will take on board what I am telling her.

[SlowDragon Administrator in reply to romyhorse]

Doctors often don't understand importance of vitamins and even if they do they can be tied by following guidelines