Thyroid UK
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Thyroid levels going up and down - now subclinical

Hi I am new

Why would my thyroid levels be going up and down? I understand TSH is highest in the morning so I don't understand why the sudden rise in TSH? Diagnosed hypothyroid in 2012. Bloods taken fasting and leaving off levo for 24 hours. Thanks

Aug 17 (150mcg levo - test done at 9am)

TSH 0.02 (0.2 - 4.2)

Free T4 20.5 (12 - 22)

Free T3 4.1 (3.1 - 6.8)

Oct 17 (50mcg levo - test done at 5.15pm)

TSH 8.2 (0.2 - 4.2)

Free T4 12.9 (12 - 22)

Free T3 3.2 (3.1 - 6.8)

13 Replies
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100mcg levo. is a big drop in dosage and would be a strong reason why the TSH and other levels have changed so dramatically.

An appropriately-medicated hypo patient tends to find that the TSH is <1 as that is typical for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo. Your earlier results look like you were more appropriately medicated then than you are now.

Why was the dosage changed and how do you feel now?

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Dose changed because endo believed me over medicated.

Symptoms list

Pain in finger joints

Flaky nails

Sweating

Constipation

Feeling cold

Pins and needles

Dry skin

Vitiligo

Bruising

Easy bleeding

Heavy periods

Thinning skin

Weight loss

Thanks

Reply

It looks like you need an increase in your dosage again as your latest results indicate that you're under-medicated. Do you have an appointment to discuss your results with either your endocrinologist or GP?

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I have an appointment Monday

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Your TSH was low as it was late afternoon when you had the test. TSH drops throughout the day that's why early a.m. is recommended.

Your Endo is another who knows little and only looks at the TSH. Your TSH was fine. In fact it is from the pituitary gland and it rises when we don't have sufficient thyroid hormones and we're diagnosed as hypo.

Your August results look good to me and I'm not medically qualified but know we feel best when TSH is low and FT4 and FT3 are in the higher part of the range. It is how we 'feel' which is the best judge of doseage.

Reply

Oh dear, yet another endo only looking at TSH

Your August results did not show over medicated, merely a low TSH. In fact your FT3 was low.

If your dose needed reducing, which was unlikely, it should have been tweaked down by 12.5mcg eg 125/150 alternate days

I would guess you now feel terrible

Your significantly under medicated, probably with very low vitamin D, folate, ferritin and B12

Suspect you also have Hashimoto's? Also called autoimmune thyroid disease. Diagnosed by high thyroid antibodies.

If you do then low vitamins even more likely as Hashimoto's is as much a disease of the gut as the thyroid

Post your vitamin results if you have them, including ranges

If not ask GP to do so

Immediate dose increase required, 25mcg max, retest after 6 weeks. More increases in 25mcg steps required, retesting each time. Until TSH is one or less and symptoms improve

If you can't get full thyroid and vitamin testing from GP

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

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers. DIY finger prick test or option to pay extra for private blood draw or

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH and most consistent results

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I think I have Hashimotos.

TPO antibody 304.5 (<34)

TG antibody 376.3 (<115)

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You have,gluten free might help.

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Symptoms list - symptoms are unchanged from August when had supposedly over medicated results

Pain in finger joints

Flaky nails

Sweating

Constipation

Feeling cold

Pins and needles

Dry skin

Vitiligo

Bruising

Easy bleeding

Heavy periods

Thinning skin

Weight loss

Thanks

Reply

Your antibodies are high this is Hashimoto's, (also known as autoimmune thyroid disease). About 90% of hypothyroidism in UK is due to Hashimoto's.

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. When they are too low they stop Thyroid hormones working.

Do you have test results and ranges for these since dose reduced? If not ask that they are done

Changing to a strictly gluten free diet may help reduce symptoms.

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

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

chriskresser.com/the-gluten...

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

Low stomach acid can be an issue

Lots of posts on here about how to improve with Apple cider vinegar or Betaine HCL

thyroidpharmacist.com/artic...

Other things to help heal gut lining

Bone broth

thyroidpharmacist.com/artic...

Probiotics

carolinasthyroidinstitute.c...

You say you have been having weight loss

Many with Hashimoto's tend to put on weight, so medics tend to assume if you are skinny you can't be hypo

But that is NOT true, there are many with Hashimoto's who are extremely skinny and struggle to keep weight on

This underlines that Hashimoto's is a disease that affects our guts and digestion

About 5% are diagnosed (by endoscopy) as actually coeliac, but over 80% are gluten intolerant

But an endocrinologist often has little interest or experience of gut issues. They ignore or don't understand it

But to get better we need to work it out, supplement to improve vitamins, go strictly gluten free and take high enough dose of Levo, usually with a TSH just below one. FT4 near top of range and FT3 at least half way in range

Reply

I was tested for vitamins and minerals and I supplement but levels haven't improved. Also have unresolved iron deficiency. Will post them. Thanks

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So is it possible symptoms are of low vitamins and minerals? Thanks

Reply

We need to fix all aspects.

Replace missing thyroid hormones with Levothyroxine

Improve low vitamins so that thyroid hormones can work

Work out what food intolerances, most usually gluten, and also other things to heal gut like bone broth, probiotics etc

Read as much as possible about Hashimoto's. See links in my earlier reply

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