Newbie

[JayJay8]

Hi could I please have my test results interpreted please taking 25mcg levothyroxine and diagnosed 2011. Thanks

TSH 55.00 (0.27 - 4.20)

Free T4 10.1 (12.00 - 22.00)

Free T3 3.3 (3.10 - 6.80)

Thyroid peroxidase antibody 385.3 (<34.00)

[SeasideSusie Remembering]

JayJay8 I am assuming that you've not been on 25mcg Levo only since diagnosis 6 years ago, and that you've had dose changes over this period of time?

If so, can you post some results of when your dose was changed and what dose you were on at the time.

You are currently massively under medicated. 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.

**

If you haven't already been told, your high antibodies mean that you are positive for autoimmune thyroid disease aka Hashimoto's which is where antibodies attack the thyroid and gradually destroy it.

The antibody attacks cause fluctuations in symptoms and test results. If you confirm that you've had dose changes due to test results, I can give more information.

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.

Read and learn about Hashi's because most doctors say antibodies aren't important. On the contrary, you can do much to help yourself.

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

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

Gluten/thyroid connection: chriskresser.com/the-gluten...

[JayJay8 in reply to SeasideSusie]

Thanks for reply I have been on this dose for 6 years.

[SeasideSusie Remembering in reply to JayJay8]

JayJay8

Thanks for reply I have been on this dose for 6 years.

Unbelievable!!!! Your doctor is a idiot and a sadist.

Did he follow the normal protocol for patients when diagnosed with hypothyroidism? Which is

On diagnosis Levo is prescribed. 6 weeks later retest and increase Levo by 25mcg. 6 weeks later retest again and increase Levo by 25mcg. This continues until your symptoms abate and you feel well.

As mentioned above, most of us feel best when TSH is 1 or below and the free Ts in the upper part of their respective ranges.

Please make an urgent appointment with a different GP, take someone with you for moral support and who can speak up for you if necessary.

Make a list of any symptoms you are currently experiencing, and point out your TSH is massively over range, your FT4 is under range with a barely in range FT3. Do not leave without a new prescription for a higher dose. Stage a sit in if necessary!!!!

Once you have your new prescription, make sure that you book a thyroid test for 6 weeks time, then follow the protocol described above until you feel well and your results are in the right place for you.

THEN MAKE AN FORMAL COMPLAINT ABOUT THIS JERK WHO HAS KEPT YOU ON A MINUTE STARTER DOSE FOR 6 YEARS!

When having thyroid tests always book the very first appointment of the morning, fast overnight (water 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 or to avoid a reduction. Don't accept an appointment later than 9am. TSH is highest early morning and lowers during the day and after food. Always do this so that all your test results can be compared accurately.

**

As for Hashi's, be aware that the antibody attacks cause fluctuations in symptoms and test results. When the antibodies attack, the dying cells dump a load of thyroid hormone into the blood and this can cause TSH to become suppressed and Free T4 and Free T3 to be very high or over range. You may get symptoms of being overmedicated (hyper type symptoms) to go along with these results that look as though you are overmedicated. Unless a GP knows about Hashi's and these hyper swings, then they panic and reduce or stop your thyroid meds.

The hyper swings are temporary, and eventually things go back to normal. Test results settle back down and hypo symptoms may return. Thyroid meds should then be adjusted again, increased until you are stable again.

But your first priority is to get an increase in your Levo. I imagine you must be feeling dreadful, and have probably done so all along since diagnosis.

[JayJay8 in reply to SeasideSusie]

Thanks I have symptoms which GP and endo believe are Addisons related - sweats, pins and needles dizziness when standing, weight loss, balance problems, insomnia, low blood pressure, feeling lightheaded. Currently awaiting investigations to be done on symptoms

[SeasideSusie Remembering in reply to JayJay8]

Have you had vitamins and minerals tested -

Vit D

B12

Folate

Ferritin

as some of those symptoms could be due to low levels.

[JayJay8 in reply to SeasideSusie]

Yes

Ferritin 21 (15 - 400)

MCV 78.4 (80 - 98)

MCHC 379 (310 - 350)

MCH 27.9 (28 - 32)

Haemoglobin 118 (115 - 150)

RBC count 4.43 (3.80 - 5.80)

WBC count 7.16 (4.0 - 11.0)

Iron 7.2 (6.0 - 26.0)

Transferrin saturation % 14 (10 - 30)

Folate 3.6 (4.6 - 18.7)

Vitamin B12 201 (190 - 900)

Vitamin D total 35.5 (25 - 50 vitamin D deficiency. Supplementation is indicated)

Taking 800iu vitamin D3 on prescription since 2015.

[SeasideSusie Remembering in reply to JayJay8]

Oh good grief, this gets worse. I am assuming that the only prescribed treatment for any of this is the Vit D?

Ferritin 21 (15 - 400)

It's said that ferritin should be half way through it's range, it needs to be a minimum of 70 for thyroid hormone to work, and I've seen it said for females 100-130 is a good level. The problem here is that your is 'in range' which is all doctors seem to care about. However, it's obviously nowhere near optimal.

MCV 78.4 (80 - 98)

MCHC 379 (310 - 350)

MCH 27.9 (28 - 32)

Haemoglobin 118 (115 - 150)

These suggest iron deficiency anaemia. You should point this out to your (new) GP and ask for the appropriate treatment which should be Ferrous Fumarate 1 tablet 2 or 3 times a day. 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.

**

Folate 3.6 (4.6 - 18.7)

Vitamin B12 201 (190 - 900)

You are folate deficient with very low B12. Check to see if you have any signs of B12 deficiency (I'm guessing you have) and if you have then take your folate, B12, ferritin and iron results over to the Pernicious Anaemia Society forum here on Health Unlocked for further advice healthunlocked.com/pasoc

Folate should be at least half way through it's range and I have read (but not researched so don't have links) that BCSH, UKNEQAS and NICE guidelines recommend:

"In the presence of discordance between test results and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment."

And an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

I wouldn't be surprised if you need testing for Pernicious Anaemia and may need B12 injections. The PA forum will offer guidance.

**

Vitamin D total 35.5 (25 - 50 vitamin D deficiency. Supplementation is indicated) - Taking 800iu vitamin D3 on prescription since 2015.

Has it not occurred to your GP (or you) that two years of supplementing has done very little, if anything, to raise your level?

The recommended level, according to the Vit D Council, is 100-150nmol/L. Unfortunately, your current level is not low enough (below 30) for your GP to prescribe loading doses but that is what you need. I suggest you buy your own D3 softgels like these bodykind.com/product/2463-b... and take 10,000iu daily for 6-8 weeks then reduce to 5000iu daily. Retest 3 months after starting them, privately if necessary with City Assays vitamindtest.org.uk/

Once you've reached the recommended level you'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.

There are important cofactors needed when taking D3

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, 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

naturalnews.com/046401_magn...

Check out the other cofactors too.

[JayJay8 in reply to SeasideSusie]

Yes only thing prescribed is vitamin D, I am going back to GP tonight to ask what he is going to do.

[Nanaedake in reply to JayJay8]

Your GP and Endo have had 6 years since your diagnosis to investigate Addisons disease!! So what tests have they done to rule it out in that time? I would take SeasideSusies advice and ensure your NEW GP treats you for deficiencies.

[JayJay8 in reply to Nanaedake]

Thanks for reply I had tests done but my previous endo and my previous GP have not gotten back to me about them.

[Nanaedake in reply to JayJay8]

And how long ago were the tests? Whatever the results they should have contacted you because if you do have Addisons then you need treatment for that and if you don't then you need proper treatment and increased medication for your very undertreated underactive thyroid!!!