TSH 46.8 mIU/L (0.2 - 4.2)
FREE T4 10.2 pmol/L (12 - 22)
FREE T3 3.1 pmol/L (3.1 - 6.8)
Taking 200mcg levo and diagnosed 2011 with hypothyroidism thank you
TSH 46.8 mIU/L (0.2 - 4.2)
FREE T4 10.2 pmol/L (12 - 22)
FREE T3 3.1 pmol/L (3.1 - 6.8)
Taking 200mcg levo and diagnosed 2011 with hypothyroidism thank you
Ellie2425,
Were previous tests in normal range? Have you been prescribed a new medicine recently? Did you take biotin supplement or B Complex supplement prior to your blood test?
Previous results
TSH 1.77 mIU/L (0.2 - 4.2)
FREE T4 15.5 pmol/L (12 - 22)
FREE T3 4.2 pmol/L (3.1 - 6.8)
Have you had the following tested
Thyroid antibodies - TPO (thyroid peroxidase) and TG (thyroglobulin)
Vit D
B12
Folate
Ferritin
Hi yes
THYROID PEROXIDASE ANTIBODIES 257.3 IU/mL (<34)
THYROGLOBULIN ANTIBODIES 369.5 IU/mL (<115)
FERRITIN 69 ug/L (30 - 400)
FOLATE 2.6 ug/L (2.5 - 19.5)
VITAMIN B12 238 pg/L (190 - 900)
TOTAL 25 OH VITAMIN D 67.3 nmol/L
(<25 Severe vitamin D deficiency. Patient may require pharmacological preparations
25 - 50 vitamin D deficiency. Supplementation is indicated
50 - 75 vitamin D may be suboptimal, and long-term may lead to clinical effects. Advise on safe sun exposure and diet. Supplementation may be indicated
>75 adequate vitamin D)
Taking the following
3000iu vitamin D from 800iu prescribed to me
210mg ferrous fumarate 1x a day
5mg folic acid 1x a day
Ellie2425
THYROID PEROXIDASE ANTIBODIES 257.3 IU/mL (<34)
THYROGLOBULIN ANTIBODIES 369.5 IU/mL (<115)
This is part of the problem. 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. You can go from hypo to hyper to hypo again. Your current results makes it look like you are massively undermedicated. You don't say what your dose was when the January test was done, but if on the same dose you can see how the antibodies have caused such a difference in your results.
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.
stopthethyroidmadness.com/h...
stopthethyroidmadness.com/h...
hypothyroidmom.com/hashimot...
thyroiduk.org.uk/tuk/about_...
Gluten/thyroid connection: chriskresser.com/the-gluten...
Hashi's can cause gut and absorption problems, SlowDragon has links and information about that.
**
FERRITIN 69 ug/L (30 - 400) 210mg ferrous fumarate 1x a day
You are taking the correct amount of FF. Ferritin is said to be recommended to be half way through it's range, I've also seen it said that for females it should be 100-130, and it needs to be a minimum of 70 for thyroid hormone to work.
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 2.6 ug/L (2.5 - 19.5)
VITAMIN B12 238 pg/L (190 - 900)
5mg folic acid 1x a day
Your B12 is far too low. Do you have any signs of B12 deficiency b12deficiency.info/signs-an... Be aware that taking folic acid can mask any signs so you may need to think back. If you do have signs of deficiency, please post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc
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."
**
TOTAL 25 OH VITAMIN D 67.3 nmol/L - 3000iu vitamin D from 800iu prescribed to me
You're doing the right thing taking 3000iu D3 daily. The recommended level, according to the Vit D Council, is 100-150nmol/L. When you've reached this 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. You can do this with a private fingerprick blood spot test with City Assays vitamindtest.org.uk/
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.
Hi I was taking 200mcg levothyroxine at the time
So the massive difference in the two sets of results are due to the antibodies.
We frequently see hyper swings when a member has a Hashi's 'flare' which shows as suppressed TSH and over range (sometimes massively over range) FT4 and FT3.
With a hyper swing, when the antibodies attack the thyroid the dying cells dump a load of hormone into the blood which results in the low TSH/high free Ts. A reduction in Levo would normally be made until the temporary hyper swing is over, then dose adjustment would be made again when hypo type symptoms returned.
Your previous results show normal-ish levels and your latest results show a massive hypo swing.
You are taking a fairly high dose of Levo and one would expect an increase in Levo to deal with this but what has your GP said about this result? What is he going to do about it? I dare say he doesn't understand anything about Hashi's and antibody attacks causing these swings, most of them don't. And because most endos are diabetes specialists, most of them have little knowledge of how to treat these swings either.
Are you under an endo? If not I would ask for an urgent referral to one who specialises in thyroid. If you email louise.roberts@thyroiduk.org she has a list of thyroid friendly endos but you would need to see who is in your area and then ask for feedback from members as you don't meant to see one who is useless regarding Hashi's.
Hi I received a letter from my endo saying I should be taking 200mcg of levothyroxine and he has questioned my compliance. The GP has said because the endo is dealing with my medication he is not getting involved with adjusting my dose.
We frequently hear of Endos/doctors questioning the patient's compliance, and even accusing them of abusing their medication (usually when they're in a hyper phase). This is because they don't understand the nature of Hashi's and the fluctuations it causes.
If you were taking the same dose of Levo when both tests were done, and you were compliant with regularly taking your Levo, then you can see yourself how the results are massively different not due to your Levo but due to a Hashi's hypo phase.
You need an endo who specialises in thyroid and who has full understanding of Hashi's.
Your results currently show undermedication as the aim of a treated hypo patient 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 that is where you feel well. How do you actually feel?
Did you check the signs of B12 Deficiency?
Hi I was taking the same amount of levo when both tests were done and I have been taking it every day.
Symptoms I have are
Difficulty swallowing
Weight loss
Hair loss
Anxiety
Depression
Fatigue
Insomnia
Heavy periods
Muscle weakness
Muscle spasms
Pins and needles
Dry skin
Loss of appetite
Irregular periods
Puffy eyes
Puffy face
I have had a look at the signs of B12 deficiency and most of them I have.
"I was taking the same amount of levo when both tests were done and I have been taking it every day."
Then there doesn't seem to be any other explanation than a Hashi's swing and you are going through a very hypo phase.
**
"I have had a look at the signs of B12 deficiency and most of them I have."
You now need to take advice from the PA forum. Further investigation may be required, you may need to stop the folic acid until they've been done - check that with them.
**
Some of your symptoms seem to be due to Hypo, some due to low nutrients. I have already mentioned the recommended levels for ferritin and Vit D above. Folate should be at least half way through it's range and we say on this forum that B12 should be no lower than 500 to avoid neurological problems, and that top of range is best.
List of B12 deficiency symptoms
Tinnitus
Tremor
Paresthesia - numbness, tingling and pain
Confusion / disorientation
Weakness of legs, arms, trunk
Impaired vibration - position sense
Abnormal reflexes
Unsteady or abnormal gait / falls
Ataxia (Neurological disorder affecting balance, coordination and speech)
Balance problems
Difficulty walking
Dizziness
Restless legs
Visual disturbances
Forgetfulness, memory loss
Dementia / intellectual deterioration
Paralysis
Impaired fine motor coordination
Muscular spasticity
Bladder or bowel incontinence
Impaired pain perception
Nocturnal cramping
Disturbance in taste and smell
Confusion/disorientation
Psychosis
Hallucinations
Memory loss
Delusion
Depression
Suicidal ideation
Mania
Anxiety
Paranoia
Irritability
Apathy
Personality changes
Violent/aggressive behaviour
Schizophrenic symptoms
Sleep disturbances
Insomnia
Changes in taste, smell, vision, and sensory/motor function which can be mistaken for psychiatric problems
Anaemia
Macrocytosis (large red blood cells)
Hyper segmented neutrophils
Generalised weakness, fatigue
Breathlessness
Pallor / jaundice
Chronic fatigue
Vascular Problems
Orthostatic hypotension
Postural hypotension (low blood pressure when standing, which can cause fainting and falls)
Postural orthostatic tachycardia
palpitations
Occlusive vascular disorder
Transient ischemic attacks (TIAs, or 'mini stroke')
Female
Infertility
Recurrent miscarriage
Abnormal PAP smears
Intrauterine growth retardation
Loss of appetite/weight loss or anorexia
Epigastric pain (poor digestion, bloated feeling after eating small or normal sized meals
IBS - Irritable bowel syndrome
Constipation
GERD - Gastric reflux disease - ulcers / mouth ulcers
Giardiasis
Pancreatitis
Decreased stomach acid
Gastropareisis
SIBO Small intestinal bacterial overgrowth
Dry cracked corners of the mouth
Premature greying
Glossitis - swollen / sore tongue, geographic tongue
Fainting/light headedness
Osteoporosis
Fractures
Increased susceptibility to infections
Poor wound healing
Malnutrition
Skin hyper pigmentation and hypo pigmentation