High TSH and elevated antibodies help please

[Lucky234]

Hi I am new

TPO ANTIBODIES 378 (<34)

TG ANTIBODIES 258.3 (<115)

TSH 7.80 (0.2 - 4.2)

FREE T4 12.7 (12 - 22)

FREE T3 3.0 (3.1 - 6.8)

Diagnosed hypothyroid in 2013

Taking 25mcg levothyroxine

Feel really poorly

Thanks in advance

[SeasideSusie Remembering]

Lucky234 Please tell us more. Surely you've not been on 25mcg Levo since diagnosis with no increase? If you've been on different doses, please tell us what they were and why they were changed.

You are currently very undermedicated and need an increase in your dose. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever is necessary for FT4 and FT3 to be in the upper part of their reference ranges if that is where you feel well, when on Levo only.

[Lucky234 in reply to SeasideSusie]

I have been on more than 25mcg and I am worried about getting over treated results like when I was on higher doses.

[Lucky234]

Aug 2014 on no levothyroxine

TSH 0.02 (0.2 - 4.2)

Free T4 23.8 (12 - 22)

Free T3 6.9 (3.1 - 6.8)

TPO antibodies 278 (<34)

Oct 2014 on 100mcg levothyroxine

TSH 2.56 (0.2 - 4.2)

Free T4 15.1 (3.1 - 6.8)

Free T3 4.0 (3.1 - 6.8)

Jan 2015 on 125mcg levothyroxine

TSH 3.73 (0.2 - 4.2)

Free T4 13.1 (12 - 22)

Free T3 3.8 (3.1 - 6.8)

May 2015 on 150mcg levothyroxine

TSH 5.01 (0.2 - 6.8)

Free T4 28.2 (12 - 22)

Free T3 5.4 (3.1 - 6.8)

TPO antibodies 78.5 (<34)

TG antibodies 287.3 (<115)

Aug 2015 on 175mcg levothyroxine

TSH 1.36 (0.2 - 4.2)

Free T4 19.5 (12 - 22)

Free T3 4.1 (3.1 - 6.8)

Nov 2015 on 75mcg levothyroxine and 10mcg T3

TSH <0.02 (0.2 - 4.2)

Free T4 20.8 (12 - 22)

Free T3 5.6 (3.1 - 6.8)

Dec 2015 on 75mcg levothyroxine and 10mcg T3

TSH <0.02 (0.2 - 4.2)

Free T4 20.5 (3.1 - 6.8)

Free T3 5.1 (3.1 - 6.8)

Jan 2016 on 100mcg levothyroxine and 10mcg T3

TSH 0.08 (0.2 - 4.2)

Free T4 22.7 (12 - 22)

Free T3 4.8 (3.1 - 6.8)

Feb 2016 on 25mcg levothyroxine

TSH 7.10 (0.2 - 4.2)

Free T4 12.9 (12 - 22)

Free T3 4.2 (3.1 - 6.8)

Mar 2016 on 50mcg levothyroxine

TSH 7.25 (0.2 - 4.2)

Free T4 13.3 (12 - 22)

Free T3 4.4 (3.1 - 6.8)

May 2016 on 75mcg levothyroxine and 10mcg T3

TSH 3.89 (0.2 - 4.2)

Free T4 18.6 (12 - 22)

Free T3 5.0 (3.1 - 6.8

Nov 2016 on 100mcg levothyroxine and 10mcg T3

TSH 2.70 (0.2 - 4.2)

Free T4 17.2 (12 - 22)

Free T3 5.1 (3.1 - 6.8)

Jan 2017 on 125mcg levothyroxine and 10mcg T3

TSH 2.55 (0.2 - 4.2)

Free T4 15.9 (12 - 22)

Free T3 4.6 (3.1 - 6.8)

TPO antibodies >1500 (<34)

TG antibodies 301.8 (<115)

May 2017 on 150mcg levothyroxine and 10mcg T3

TSH <0.02 (0.2 - 4.2)

Free T4 23.1 (12 - 22)

Free T3 7.2 (3.1 - 6.8)

[Angel_of_the_North]

You have hashis, so every now and then your throid will dump lots of hormone into teh blood stream regardless of your dose of meds. That will give over range readings and then, after the flare subsides, you'll be more hypo. I'd try 75-100mcg levo and 12.5mcg T3 (or 15) as your results were better on 100 and 10 but your Ft3 was still a bit low in range. Keeping TSH suppressed and going gluten free can help to prevent hashis flares - TSH has been much too high from Feb 2016. May 2017 suggests a flare. The late 2015 results looked pretty good.

[Lucky234 in reply to Angel_of_the_North]

Hi I felt unwell throughout diagnosis and treatment even with good thyroid levels and I don't know why

[SeasideSusie Remembering]

Lucky234 Angel_of_the_North is spot on. 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. 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.

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.

You can read and learn about Hashi's which will help you understand and manage the hypo-hyper-hypo swings

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

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

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

Gut and absorption problems seem to go hand in hand with Hashi's so that may need looking into. SlowDragon has helpful information about that.

It would also be useful to have Vit D, B12, Folate and Ferritin tested, as often here are deficiencies with these nutrients which wont be helping. If you've had them tested, please post results, if not it would be worth asking your GP or doing them privately.

We've seen a lot of posts like yours recently, and frequently the GP or endo is blaming the patient for abusing their medication, telling them it's their fault they have these high results. Obvously, the doctors don't have enough knowledge of Hashi's to understand what's happening, so it's easier to hide their ignorance by blaming the patient.

[Lucky234 in reply to SeasideSusie]

Ok will post results of vitamins and minerals now