What should I ask?

I've been diagnosed hypo since April. I'm on 100mg of Levo. At my first follow up appointment my Dr was disappointed with the fact that I didn't feel better as my TSH had dropped from 30 to 0.64 (ref 0.35 to 4.7) and free T4 from 5.7 to 19 (ref 7.8 to 21).

I'm negative for Hasimotos

I asked if I could be tested for free T3 which he agreed (he's quite open to discussing it)

So my results have come back today and I'm seeing him next week:

TSH remains at 0.64 (0.35 to 4.7)

Free T4 now 16 (7.8 to 21)

Free T3 4.0 (3.8 to 6)

I don't know if my maths are correct but I make that T4 at 62% and T3 at 9%

Is that where my problem lies?

What should I ask and what information should I take? As I say he's open to discussion, had no problem doing the T3 test etc, so if I can ask the right things I think he's willing to listen...I just don't know what to ask!

4 Replies

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  • Improvement in symptoms can lag behind good test results. You've only been on Levo for 5 months and it's probably a bit early for everything to be perfect yet.

    I would ask for vitamins and minerals to be tested - Vit D, B12, Folate, Ferritin - so that you can see if all are at optimal levels for thyroid hormone to work properly and conversion of T4 to T3 to take place. Ferritin has to be at least 70, preferably half way through it's range.

    I would supplement with selenium l-selenomethionine to aid conversion.

    What were your antibody results? Were both types tested - TPO and TG? NHS tends to only test TPO but you can be negative for that and positive for TG. Both types can cause Hashi's.

  • Thanks. Ferritin wasn't tested this time (I need to get a list to make sure the relevant things are done each time) but was 50.

    Is there somewhere I can get the information to give the dr about what should be tested and optimal levels from this site?

  • I don't think there is anything 'official' that would be acceptable to a GP, and doctors aren't taught nutrition so anywhere within the range is fine as far as they're concerned.

    Possibly the nearest you'll get is to say you've taken advice from NHS Choices recommended source of information about thyroid disease (which is Thyroid UK) and this is their article on The Role of Vitamins and Minerals

    in Thyroid Disease

    thyroiduk.org.uk/tuk/treatm...

    There is plenty of information on the internet, but I'm sure if you showed it to your GP he would say the source is dubious.

  • With Hashimoto's then very many of us find changing to gluten free diet helps. But I was interested to read others without high antibodies have still found gluten free helpful......just an idea

    Assuming vitamin levels are OK

    One other thing is perhaps get DIO2 gene test

    thyroiduk.org.uk/tuk/testin...

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