These high antibody results confirm autoimmune thyroid disease aka Hashimoto's which is where antibodies attack the thyroid and gradually destroy it.
The antibody attacks can cause fluctuations in symptoms and test results.
The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it is needed for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo only. Add T3 into the mix and TSH may well be suppressed, FT4 can lower and FT3 should be nearer the top of it's range.
You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks. You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.
Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.
These suggest she is undermedicated The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it is needed for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo only. Add T3 into the mix and TSH may well be suppressed, FT4 can lower and FT3 should be nearer the top of it's range.
However, Hashi's can cause gut/absorpion problems and that can mean that the thyroid meds aren't getting absorbed properly. The fact that she is on a fairly high dose of Levo suggests that she may have as absorption problem.
Some of her symptoms can be indicative of low nutrient levels, and again this can cause problems with thyroid hormone not being able to work properly. Does she have test results for
Vit D
B12
Folate
Ferritin (and maybe an iron panel and full blood count)
If so please post them, if not it would be a very good idea to get them tested.
The 3 x iron tablets will be for the iron deficiency anaemia. She should take each iron tablet with 1000mg Vitamin C to aid absorption and help prevent constipaton. Always take iron 4 hours away from thyroid meds and two hours away from other medication and supplements as it will affect absorption.
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Vitamin D total 56.6 nmol/L - 800iu D3
800iu D3 is going to take forever to raise her level. It is hardly a maintenance dose for someone with a reasonable level. I suggest she buys her own D3 softgels like these bodykind.com/product/2463-b... and take 5000iu daily for 3 months then retest. When she's reached the recommended level, which the Vit D Council say is 100-150nmol/L, then she'll need a sensible 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. She can do this with a private fingerprick blood spot test with City Assays vitamindtest.org.uk/
There are important cofactors needed when taking D3
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, D3 four hours away from thyroid meds.
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, four hours away from thyroid meds
As far as her B12 is concerned, has she had 6 x injections over 2 weeks and is she now on one injection every 3 months? That seems to be the norm but doesn't seem to be enough for everyone. What's happening about her folate deficiency, is she prescribed folic acid? You could post on the Pernicious Anaemia Society forum here on Health Unlocked for further advice about this healthunlocked.com/pasoc
If she has been diagnosed with Pernicious Anaemia then I believe she should have the 6 injections over 2 weeks then followed by 3 monthly. The PA forum will advise but the surgery should be arranging further injections. Also, ask the surgery what they intend to do about the folate deficiency.
Welcome to our forum and am sorry your daughter is unwell and it is due to her not being on sufficient thyroid hormones. This is proven because her TSH should be 1 or lower. Many doctors believe once the TSH is anywhere in the 'range' that there job is done. No it isn't.
Both FT4 and FT3 are not high enough. Both should be towards the upper part of the range.
She has an Autoimmune Thyroid Disease called Hashimotos 'hashi' for short'. The antibodies attack the thyroid gland until she is hypothyroid but treatment is the same i.e. levothyroxine.
Her blood tests have always to be done at the very earliest, fasting (she can drink water) and allow a 24 hour gap between last dose of levo and take afterwards. It should be taken on an empty stomach with a full glass of water, usually first thing and wait an hour before eating.
Unfortunately it isn't a quick fix. A blood test should be taken every six weeks with a 25mcg increase in levo until patient feels well and symptoms-free.
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