Results help please

[nicnac03]

Can anyone help please? I have lots of symptoms of an underactive thyroid but my doctor is reluctant to diagnose. He agreed to try me on 25mg of levothyroxine for 2 months but only because my mum also suffers from it. I’ve just had another blood test and my TSH level has increased - does this mean my dose will just be increased or something else?

Before levothyroxine

Serum free T4 level11 pmol/L (9 - 20pmol/L)

Serum TSH level5.18 mU/L (0.35 - 4.94mU/L)

After levothyroxine

Serum free T4 level12 pmol/L (9 - 20pmol/L)

Serum TSH level5.54 mU/L (0.35 - 4.94mU/L)

Thanks

[ITYFIALMCTT]

Yes, you're in need of a greater dosage of levo. You're on a very cautious dose - it's typically at least 50mcg in the absence of advanced age, cardiac or other known issues.

Your TSH is still above the range and your FT4 is low within the range. Is there any chance at all that you might obtain an FT3 level as well as the thyroid antibodies?

An appropriately-medicated hypo patient tends to find that the TSH is suppressed to <1 as that is typical for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo.

Why is your GP reluctant to diagnose you? Do you have any other results to share like thyroid antibodies, plus your vitamin and mineral levels (iron, ferritin, folate, vitamins B12 and D) along with an FBC? If so, can you post them please as it is useful for members to look at them so that they can make helpful comments?

[nicnac03 in reply to ITYFIALMCTT]

Thanks for replying so quickly. I’m not sure why he’s reluctant. The only results I have are below - I was prescribed a 7 week course of vitamin D after these results before the levothyroxine.

Combined total vit D2 + D3 lvl26.4 nmol/L (50 - 220nmol/L)

Serum vitamin B12212 ng/L (187 - 883ng/L)

Total white cell count5.4 10*9/L (4 - 1110*9/L)

Red blood cell (RBC) count4.04 10*12/L (3 - 5.810*12/L)

Haemoglobin estimation123 g/L (115 - 160g/L)

Haematocrit0.38 L/L (0.3 - .5L/L)

Mean corpuscular volume (MCV)95 fL (79 - 99fL)

Mean corpusc. haemoglobin(MCH)30.4 pg (27 - 34.5pg)

Mean corpusc. Hb. conc. (MCHC)320 g/L (316 - 365g/L)

Platelet count290 10*9/L (150 - 45010*9/L)

Neutrophil count2.48 10*9/L (1.7 - 7.510*9/L)

Lymphocyte count2.14 10*9/L (1 - 4.510*9/L)

Monocyte count0.54 10*9/L (0.2 - .810*9/L)

Eosinophil count0.2 10*9/L (0 - .510*9/L)

Basophil count0.03 10*9/L (0 - .110*9/L)

[ITYFIALMCTT]

Combined total vit D2 + D3 lvl26.4 nmol/L (50 - 220nmol/L) Your vitamin D is 1.4 above the typical 'severe deficiency' category and at the bottom of the 'deficiency' category.

What dosage of vitamin D have you been taking as your level is poor enough to justify loading doses to correct it?

Your B12 in near the bottom of its range and I shall refer to SeasideSusie 's excellent advice for that and vitamin D (if she doesn't see the post I'll find her response to someone with similar numbers). I'm a little ?? about the B12 because I can't see either a folate or iron/ferritin result altho' there are Hb and haematocrit results that are within the range. It would be good if humanbean or someone might take a look at these?

As folate, iron, and B12 deficiencies can all overlap with each other, it's useful to see results for all three at the same time before accepting any of the results at their face value. There's a good chance you can improve your iron status by following Seaside Susie's dietary advice for this.

Scroll down to see SS's advice to someone about vitamin D deficiency and see if it resembles the dosage you're taking (you need the same treatment): healthunlocked.com/thyroidu...

We don't know your ferritin level (I wish we did) but you can see SS's generic advice about improving iron levels there.

[nicnac03 in reply to ITYFIALMCTT]

I took 20000 IU once a week for 7 weeks and when that was finished I started the levothyroxine. Thanks again for taking the time to reply, I feel a bit more prepared for my appointment next week.

[MariLiz]

It’s possible that you need your B12 to be treated too. Symptoms of a deficiency are very similar to underactive thyroid, and we often have both issues. Your VitD needs treating, and you need VitK2 to direct the VitD to your bones.

Did your doctor test for antibodies, they will indicate if it is Hashimotos , where the thyroid is an autoimmune disease.

Have a look at the Pernicious Anaemia Society website for a full symptom list for low B12. The symptoms are the same whether the deficiency is PA or caused by poor absorption for any other reason.

Good luck with getting your GP to look at things more closely. He should be increasing your thyroxine after regular blood tests. Always have the tests as early in the morning as possible, don’t eat or take your thyroxine till after the test, and only drink water.

I usually take a bottle of water with me incase I feel thirsty.