Thyroid UK
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Thyroid function test results advice please - raised antibodies?

Serum TSH *22.8 (0.2 - 4.2)

Serum Free T4 12.7 (12 - 22)

Serum Free T3 4.0 (3.1 - 6.8)

Thyroid Peroxidase Antibodies *840.5 (<34)

Thyroglobulin antibodies *>1200 (<115)

Hi

I am new, I am 26 years old and I was diagnosed with hypothyroidism when I was 21. Could someone please advise on my results below. I take 25mcg levothyroxine. Symptoms are

Sweating

Pins and needles in feet and legs

Hair loss

Puffy eyes

Dark circles under eyes

Joint pain

Heavy periods

Stomach getting easily upset/unsettled

Tiredness

Breathlessness

Hard stool

Weight gain

Thanks

14 Replies
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25mcg is a starter dose of levothyroxine. Have you been on higher doses? Your TSH is much too high. You are very undermedicated and need to increase your dose by 25mcg and retest in 6 weeks and increase dose and so on until your TSH reaches around 1. What has your doctor said about these results?

You have elevated thyroid antibodies which means you have autoimmune thyroid disease otherwise known as Hashimotos thyroiditis. You can read more about it on Thyroid UK's main website.

It would be wise to have your vitamin levels tested as being hypothyroid they are probably low.

Ask for tests for

B12

Folate

Ferritin

Vitamin D

People with thyroid disease are often low in these. When you get results post them here. Doctors will often say fine when the results are bumping along the bottom of the range but it doesn't make us feel well. If you post them here people will give good suggestions.

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Thanks been taking 25mcg since August 2017 and was on 150mcg before that. Endo has not said anything

1 like
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WHAT???? Has your doctor abandoned you? of did you abandon him/her? Did you have these tests done privately. As you can see your thyroid is barely producing anything and your pituitary is screaming for more. Autoimmune disease means your body is undergoing something it hates and telling you so. The antibodies are showing that your body is trying to extinguish foreign tissue. We have learned a lot about autoimmune disease and one thing is that gluten resembles thyroid tissue. No one really digests gluten well and leaks through the gut. Was this precipitated by a virus like Epstein Barre or a foodborne illness? There are a lot of triggers and maybe a genetic tendency as well. Even if you replace the hormone your body cannot produce at the moment, you still have the autoimmune disease but you can make some strides with that.

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Thanks endo has abandoned me and test done by him, haven't got Epstein Barr or food poisoning

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stress is a biggy, at causing hypothyroidism, i.e. high cortisol levels, check out DR ray Peat on Progesterone and thyroid , listen to him talk to KMUD radio, with Andrew and Sarah Murray on youtube or listen to him talking to Danny Roddy on youtube as well., Have you had your progesterone checked as well, low progesterone and high oestrogen can cause hypothyroidism, oestrogen blocks the receptor sites of the thyroid carrying hormone. Are you on the pill? If you are get off it as it is full of a synthetic oestrogen, also a low protein diet can use low thyroid, are you a Vegetarian? All the brassicas can cause hypothyroidism as well as all beans and especially soy. Drs are really really bad on hypothyroidism, they know diddly squat, endos are no better, and no T4 supplementation for most women does not work you need to take it with T3 as well. a natural desiccated thyroid product can really help, but you can get a synthetic T3 from your drs, but you need to take very very small amounts, and then build up slowly. I have loads of info is you need it

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Not on pill or vegetarian thanks

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also, oestrogen dominance also causes the increase in antibodies looking like auto immune. Eat a carrot salad everyday with 1 Tablespoon of Apple cider vinegar and a good salt, and a tablespoon of coconut oil, coconut oil helps boost thyroid metabolism. But carrot fibre helps to bind to the excess oestrogen that gets recycle by the liver, check out the forefront heath page on Facebook and read all their articles,

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Have you always been only taking 25mcg?

Or have you had dose reduced recently

You are now extremely under medicated and need an urgent increase in dose. 25mcg dose increase and retesting after 6-8 weeks

This should be repeated in 25mcgs steps, retesting each time after 6-8 weeks until TSH is around one and FT4 towards top of range and FT3 at least half way in range.

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

How long since this test result was done?

You very likely have extremely low vitamin D, Folate, ferritin and B12 as result. Have these been tested, if so can you add the results and ranges

If not done ask GP to test.

Has anyone explained to you that the high thyroid antibodies means you have Hashimoto's (medics tend to call it autoimmune thyroid disease )

With Hashimoto's, especially until it's adequately treated, our gut can be badly affected. Low stomach acid can lead to poor absorption of vitamins. Low vitamin levels stop thyroid hormones working.

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

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

chriskresser.com/the-gluten...

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

drknews.com/changing-your-d...

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, 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)."

You can obtain a copy of the articles from Thyroid UK email dionne.fulcher@thyroidUK.org. print it and highlight question 6 to show your doctor.

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Thanks have been on 25mcg since August 2017 and was taking 150mcg before that and results taken October 2017

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What prompted that huge reduction? You probably need something close to the higher dose.

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TSH 0.03 (0.2 - 4.2)

Free T4 20.4 (12 - 22)

Free T3 4.3 (3.1 - 6.8)

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Marti, the most important result you posted is your free T3 and it is too low by a large margin. You will have symptoms.

I know doctors seem to be afraid of the low value of TSH but that is your pituitary function and after you start taking hormone it will flatten right out because it's not needed. You have got to get back on a higher dose. Were these taken while you were still on 150? I presume that they were.

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This shows you were not on enough.

GP freaked out at low TSH but FT4 was in range and FT3 was too low

With Hashimoto's poor conversion is common

Very likely to have also had low vitamins

You need to learn as much as possible about Hashimoto's and take control

Gluten free diet likely to help

Post your vitamin results if you have them

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Your doctor is a pillock to order such a huge reduction in thyroid meds. More than a 25mcg increase/decrease generally makes us feel ill. It can trigger anxiety too.

TSH 0.03 (0.2 - 4.2) This is low but not significant if FT3 and FT4 are in range - which they are.

Free T4 20.4 (12 - 22) This is fine, it's where it should be and it's in range.

Free T3 4.3 (3.1 - 6.8) This is low but in range so you were not overmedicated.

If anything these results show your FT3 levels are low. This can be for a number of reasons. You could benefit from checking your vitamin levels. If any are less than half way in range with vitamin levels then levothyroxine does not function very well. Some people add T3 but this is becoming very difficult in the UK as the NHS is trying to deprescribe it.

Vitamins all need to be mid-range and vitamin B12 near to the top of the range for us to feel well.

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