Thyroid results

[AbbieC]

Taking 50mcg levothyroxine diagnosed 2013 thank you

TSH 3.87 (0.2 - 4.2)

Free T4 15.1 (12 - 22)

Free T3 3.0 (3.1 - 6.8)

[Clutter]

AbbieC,

If you've been taking 50mcg longer than 6 weeks you are undermedicated to have TSH 3.87 and FT3 below range and you should request a dose increase.

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.2 - 1.0 with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email [e-mail] if you would like a copy of the Pulse article to show your GP.

[AbbieC in reply to Clutter]

Have been taking 50mcg for 8 weeks and diagnosed 2013 was on 150mcg levothyroxine and 10mcg T3 before that

[Clutter in reply to AbbieC]

AbbieC,

Well whoever reduced dose to 50mcg should be shot. If you were overmedicated on 150mcg + 10mcg T3 Levothyroxine dose should have reduced in 25-50mcg dose increments until levels were in range.

[AbbieC in reply to Clutter]

Hi levels were always in range only TSH was below range and dose was reduced in 50mcg increments to raise TSH

[Clutter in reply to AbbieC]

AbbieC,

Still an idiot. TSH below range does not mean you are over medicated as long as TSH is within range. Read Dr. Toft's comments in the link I posted above.

[SeasideSusie Remembering]

AbbieC Oh boy, how can they be normal? Your FreeT3 is below range, your TSH is very near the top and your FT4 is quite low.

How long have you been diagnosed?

Were you started on 50mcg Levo?

The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges. You need an increase of 25mcg Levo immediate, then retesting after 6 weeks, maybe another 25mcg increase and another retest 6 weeks later, and so on until you feel well.

To support your request for an increase in meds - From ThyroidUK's main website - thyroiduk.org.uk/tuk/about_... > Treatment Options:

According to the BMA's booklet, "Understanding Thyroid Disorders", many people do not feel well unless their levels are at the bottom of the TSH range or below and at the top of the FT4 range or a little above.

Booklet written by Dr Anthony Toft, past president of the British Thyroid Association and leading endocrinologist. It is published by the British Medical Association for patients. Available from pharmacies and Amazon for about £4.95. It might be worth buying, highlighting the relevant section to show your GP in support of an increase in Levo.

Also -

Dr Toft states in Pulse Magazine, "The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l. In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l. This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

Email [e-mail] for a copy, print it and highlight question 6 to show your GP in support of an increase in Levo.

[AbbieC in reply to SeasideSusie]

Diagnosed 2013 and started on 25mcg levothyroxine but was taking 150mcg levothyroxine and 10mcg T3 before these results and felt well on this

[SeasideSusie Remembering in reply to AbbieC]

Have you had thyroid antibodies tested?

Why has your dose been changed?

Did you go straight from 150mcg Levo/10mcg T3 down to 50mcg Levo in one go? If so that's crazy.

[AbbieC in reply to SeasideSusie]

Yes thyroid peroxidase antibodies 375 (<34) and thyroglobulin antibodies 256.3 (<115) dose was gradually reduced but thyroid hormones remained in range the whole time

[SeasideSusie Remembering in reply to AbbieC]

That's where your problem is. 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.

As the antibodies wax and wane, you can swing from hypo to hyper and back to hypo again. During the hyper swing you might experience hyper type symptoms and your test results might indicate over medication. These swings are temporary and things will settle down again. Dose adjustments can be made if necessary, but readjustment should be made when things settle down.

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.

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

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

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

So if your thyroid hormones remained within range, what was the reason for reducing your meds and removing T3?

[AbbieC in reply to SeasideSusie]

Below range TSH

[SeasideSusie Remembering in reply to AbbieC]

And what are the actual results? What were FT4 and FT3?

[AbbieC in reply to SeasideSusie]

(150mcg levothyroxine and 10mcg T3

TSH 0.08 (0.2 - 4.2)

Free T4 20.6 (12 - 22)

Free T3 5.6 (3.1 - 6.8)

(100mcg levothyroxine and 10mcg T3)

TSH 0.02 (0.2 - 4.2)

Free T4 20.3 (12 - 22)

Free T3 5.3 (3.1 - 6.8)

[SeasideSusie Remembering in reply to AbbieC]

There was nothing wrong with either of those results. Even on 150 Levo/10 T3 they were fine. Both FT4 and FT3 are well within range. Your doctor panicked at the below range TSH but TSH is only good for diagnosis. When taking thyroid hormone it's of no use, the most important result is FT3, that's the one that tells you if you're overmedicated.

TSH isn't a thyroid hormone, it's a pituitary hormone. The pituitary looks to see if there is enough thyroid hormone, if not then it sends a signal to the thyroid to produce some - that signal is TSH (Thyroid Stimulating Hormone) and the TSH will be high. If you are taking synthetic thyroid hormone then the pituitary detects there is enough so it doesn't need to send the signal, hence TSH will be low.

Simple stuff but GPs and endos seem to not understand this and make patients suffer because of it.

[SlowDragon Administrator]

I see your vitamin results on other post are absolutely dire

Hashimoto's very often affects the gut, leading to low stomach acid, low vitamin levels and leaky gut.

Low vitamins that affect thyroid are vitamin D, folate, ferritin and B12.

If they are too low they stop Thyroid hormones working.

As you have Hashimoto's then in part because you are under medicated your gut function will have got worse, leaky gut leading to hidden food intolerances may be causing issues, most common by far is gluten.

Changing to a strictly gluten free diet may help reduce symptoms. Very, very many of us here find it really helps and can slowly lower antibodies.

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

amymyersmd.com/2017/02/3-im...

chriskresser.com/why-changi...

scdlifestyle.com/2014/08/th...

You need a new endo

Email Louise at Thyroid Uk for list of recommended thyroid specialists

[e-mail]