Underactive thyroid : Hi.could anyone please tell... - Thyroid UK

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Underactive thyroid

Pheonix51 profile image
9 Replies

Hi.could anyone please tell me when the doctor says my results are in normal range.

What can I do to improve so that they are in the top end of normal or don't I need too.Do I need to take T3.

My results are as follows.

Tsh range 0.27 to 4.20 mine is 1.43

Free thyroxine range is 12 to 22...mine is 15.49

T4 Range 59 to 154....mine is 80.7

Free T3 Range 3.10 to 6.80.....mine is 4.9

Reverse T3 Range 10 to 24....mine is 21

Reverse T3 ratio range 15.01 to 75...mine is 15.19

Thanks for reading

Wayne

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Pheonix51
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shaws profile image
shawsAdministrator

You could do with an increase of 25mcg at least. To lower TSH and raise T4 and FT3.

SeasideSusie profile image
SeasideSusieRemembering

Pheonix51

I see from your other posts that you are not diagnosed.

You need to optimise your vitamins and minerals. From a previous post of yours:

Vitamin D 39.93 low -this needs to be within the recommended range of 100-150nmol/L (range according to the Vit D Council)

Supplement with D3 5000iu daily for 3-4 months then retest. When you've reached the recommended level reduce to a maintenance dose which may be 2000iu daily, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. Vit D can be tested with City Assays vitamindtest.org.uk/index.html

When taking D3 there are important cofactors needed vitamindcouncil.org/about-v...

D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems.

D3 and K2 are fat soluble so should be taken with the fattiest meal of the day.

Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening naturalnews.com/046401_magn...

Check out the other cofactors too.

**

Folate (serum) 2.26 low (2.91-50) - needs to be at least half way through it's range

B12 301.2 (140-724) - anything below 500 can cause neurological problems and top of range is best

Do you have any signs of B12 Deficiency b12deficiency.info/signs-an...

You are folate deficient and your GP should do something about that so speak to him.

If you have any signs of B12 Deficiency then post on the Pernicious Anaemia Society forum here on Health Unlocked for further advice healthunlocked.com/pasoc

If no signs of B12 Deficiency then you could supplement with sublingual methylcobalamin lozenges 5000mcg daily and when the bottle is finished buy some 1000mcg dose as maintenance.

When taking B12 we also need a good B Complex to balance ALL the B vitamins. Buy one with methylfolate rather than folic acid.

**

Ferritin 718.1 high - your GP should be looking into this.

**

TGAB 104.900

TPOAB 44.43

These high antibodies confirm autoimmune thyroid disease aka Hashimoto's which is where antibodies attack the thyroid and gradually destroy it. As your TSH, FT4 and FT3 are well within range, and not showing evidence of Hypothyroidism, I imagine you are in the early stages of Hashi's.

From ThyroidUK's main website > Hypothyroidism

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

"If thyroid antibodies are found, then you may have Hashimoto's disease. If there are thyroid antibodies but the other thyroid tests are normal, there is evidence that treatment will stop full blown hypothyroidism from occurring.

Dr A Toft, consultant physician and endocrinologist at the Royal Infirmary of Edinburgh, has recently written in Pulse Magazine, "The combination of a normal serum T4 and raised serum TSH is known as subclinical hypothyroidism. If measured, serum T3 will also be normal. Repeat the thyroid function tests in two or three months in case the abnormality represents a resolving thyroiditis.2 But if it persists then antibodies to thyroid peroxidase should be measured.

If these are positive – indicative of underlying autoimmune thyroid disease – the patient should be considered to have the mildest form of hypothyroidism.

In the absence of symptoms some would simply recommend annual thyroid function tests until serum TSH is over 10mU/l or symptoms such as tiredness and weight gain develop. But a more pragmatic approach is to recognise that the thyroid failure is likely to become worse and try to nip things in the bud rather than risk loss to follow-up."

Dr Toft is past president of the British Thyroid Association and leading endocrinologist. You can obtain a copy of the Pulse article by emailing louise.roberts@thyroiduk.org.uk and show this part to your GP.

You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin which is a protein thought to trigger antibody attacks. Supplementing with selenium L-selenomethionine 200mcg daily can also help reduce antibodies.

chriskresser.com/the-gluten...

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

**

Your reverse T3 and ratio are fine.

**

With FT4 of 15.49 and FT3 of 4.9 your T4 to T3 conversion ratio is good at 3.16 : 1 Good conversion takes place when the ratio is 4:1 or less. You don't need T3. What you do need is your GP to take Dr Toft's advice and start you on Levo to 'nip things in the bud'.

Pheonix51 profile image
Pheonix51 in reply toSeasideSusie

Thanks for your reply..I am on LevoThyroxine 75mcg.the doctor gave me folic acid tablets for three months and then I have to get another blood test done. I am also on vitamin D3 1000mui a day.I had a full iron blood count taken and the doctor wants to see me on Tuesday to talk about the results. Would having my selium and iodine levels be useful to know.thanks for reading wayne

SeasideSusie profile image
SeasideSusieRemembering in reply toPheonix51

Phoenix51

I am on LevoThyroxine 75mcg

Sorry, I had a quick look through your previous posts and missed that. In that case you are undermedicated with your current results. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges.

See Treatment Options thyroiduk.org.uk/tuk/about_... which state

According to the BMA's booklet, "Understanding Thyroid Disorders", many people do not feel well unless their levels are at the bottom of the TSH range or below and at the top of the FT4 range or a little above.

Dr Anthony Toft wrote the booklet, he is past president of the British Thyroid Association and leading endocrinologist. The booklet is available from local pharmacies and Amazon for about £4.95.

Also -

Dr Toft states in Pulse Magazine, "The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

If you would like a copy of the Pulse article, email louise.roberts@thyroiduk.org.uk print it and highlight question 6 to show your GP.

**

I am also on vitamin D3 1000mui a day.

You already know this isn't enough for your level of Vit D and a suggestion has been made for how much you should be taking.

**

the doctor gave me folic acid tablets for three months

That should take care of the folate deficiency. Did you check for signs of B12 deficiency and have you got any? Be aware that supplementing folate can mask signs of deficiency so you may have to think back. Post on the PA forum if you have signs of deficiency, and suggestions have been made above if you haven't.

**

I had a full iron blood count taken and the doctor wants to see me on Tuesday to talk about the results

Hopefully you don't have iron deficiency anaemia because the usual treatment is Ferrous Fumarate tablets 2 or 3 times a day, and that would raise your ferritin. Make sure you discuss your high ferritin with your GP.

**

Would having my selium and iodine levels be useful to know

Yes it would be useful. Selenium supplements will help with Hashi's but you don't want to overdo it if your level is high already. Iodine has to be tested before supplementing but supplementing is a bad idea for Hashi's anyway.

Pheonix51 profile image
Pheonix51 in reply toSeasideSusie

Sorry my B12 was normal

SeasideSusie profile image
SeasideSusieRemembering in reply toPheonix51

Sorry my B12 was normal

What do you class as normal?

In a previous post of yours you said

B12 301.2 (140-724)

and I replied above saying anything below 500 can cause neurological problems and top of range is best. I suggested you check for signs of B12 deficiency and if you had any post on the PA forum, and if you didn't have any then you need to supplement to get your level up.

Pheonix51 profile image
Pheonix51

The doctor said as long as my Tsh was in normal range then nothing can be done.should I start taking the vitamins you mentioned or wait to see doctor on Tuesday which I think will be a waste of time talking to him about my vitamins.thanks wayne

SeasideSusie profile image
SeasideSusieRemembering in reply toPheonix51

Then you should point out to your doctor what Dr Toft has written in his article. Just being in range isn't enough, it's where in range you feel well and Dr Toft has made this clear. You need to read, learn, provide good evidence to your GP. We have all had to start helping ourselves because most doctors don't know enough.

It will be a waste of time talking to your GP about vitamins, they aren't taught nutrition and like everything else if the result is in range when tested that's enough for them. They know nothing about what a good or optimal level is. So again, patient to patient experience helps us.

It's up to you whether you discuss it with your GP and whether you start taking them. When you do begin supplementing, start with one only, take for a week or two and if no adverse reaction then add in the second one, wait another week or two and again if no reaction add in the next one. The reason to add them individually like this is if you do have any kind of adverse reaction you will know what caused it.

Pheonix51 profile image
Pheonix51 in reply toSeasideSusie

Ok thankyou very much for your useful help and advice.kind regards wayne

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