Newbie, endo wants me to reduce dose: TPO... - Thyroid UK

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Newbie, endo wants me to reduce dose

LaraB profile image
11 Replies

TPO ANTIBODIES 339 (<34)

TG ANTIBODIES >2000 (<115)

TSH 0.03 (0.2 - 4.2)

FREE T4 21.1 (12 - 22)

FREE T3 3.7 (3.1 - 6.8)

Is this a good idea even though I have continuing hypo symptoms diagnosed 2013 taking 175mcg levothyroxine thankyou

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LaraB profile image
LaraB
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11 Replies
SlowDragon profile image
SlowDragonAdministrator

No your FT3 is already far too low

You have Hashimotos- high antibodies

Very likely to have low vitamin D, folate, ferritin and B12

Have you had these tested? Post results and ratify you have them

Thyroid tests should be done as early as possible in morning and fasting and don’t take any Levo in the 24 hours prior to test

This gives highest TSH and lowest FT4

Is this how you did test?

LaraB profile image
LaraB in reply to SlowDragon

I wasn't made aware my thyroid was being checked and I didn't take levothyroxine for 24 hours prior to test and I fasted my thyroid wasn't due to be checked and the endo still wants to reduce but thyroid is usually done fasting and early morning and with me stopping levothyroxine for 24 hours prior to test

Clutter profile image
Clutter

LaraB,

I suspect it is your suppressed TSH which is bothering your endo and that's why you've been asked to reduce dose. You aren't overmedicated because FT4 and FT3 are within range and FT3 is actually low in range.

Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email dionne.fulcher@thyroiduk.org if you would like a copy of the Pulse article to show your GP.

LaraB profile image
LaraB

FERRITIN 47 (30 - 400) Confirmed iron deficient

FOLATE 1.2 (2.5 - 19.5) Folic acid stopped until B12 injections started

VITAMIN B12 298 (190 - 900)

VITAMIN D 28.8 (25 - 50 DEFICIENT) Given cholecalciferol 800iu 6 years ago

SlowDragon profile image
SlowDragonAdministrator in reply to LaraB

See SeasideSusie detailed vitamin advice replies

Will reply further in morning

Chippysue profile image
Chippysue in reply to LaraB

do you know what your Vit D is now? 800iu is not enough, I take 10,000iu per day. Ideally your level would be 100

LaraB profile image
LaraB in reply to Chippysue

VITAMIN D TOTAL 21.1

Chippysue profile image
Chippysue in reply to LaraB

21.1 !!! and a Doctor has seen this? any dr who thinks it’s ok should be struck off!

You need more than 10,000 iu per day until your level is 100!

Vit d is crucial !!

Chippysue profile image
Chippysue

it's looking like you would benefit from adding t3 or ndt

SlowDragon profile image
SlowDragonAdministrator

Here's a reply from SeasideSusie to similar levels

healthunlocked.com/thyroidu...

Has any medic explained that your high antibodies mean you have Hashimoto's?

Hashimoto's affects the gut and lowers stomach acid, causing low vitamins

Low vitamin levels stop Thyroid hormone 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...

To get well very many of us need to be strictly gluten free, supplement like mad to get vitamins better and take a constant and good level of Levo.

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.

If, after doing all this your FT3 remains low then look at finding T3 friendly endo. Many with Hashimoto's need addition of small dose of T3. But all three other steps need doing first

Email Thyroid UK for list of recommended thyroid specialists dionne.fulcher@thyroidUK.org

See Box 1. Some possible causes of persistent symptoms in euthyroid patients on L-T4

onlinelibrary.wiley.com/doi...

Reginacrz profile image
Reginacrz

I mainly wanted to comment on the issue with your antibodies. I haven't read the other comments.

However, most people feel better when they have better T4 to T3 conversion for FT3 above 5. Basic explanation is that, T3 is the active thyroid hormone for all our cellular processes. Taking more, and more, levothyroxine (T4) will not increase the conversion to T3. Google how to improve T4 to T3 conversion. There are lots of factors affecting it, like nutritional deficiencies, lifestyle, and stress.

I don't see that lowering your levothyroxine is the solution. None of your results are out of range. My endo keeps my TSH suppressed because when the thyroid is stimulated to work the antibodies get worse.

In regards to your antibody levels, they can cause symptoms too. And, I have recently come to discover that we can stop what's causing them through our diet. And, we can recover normal thyroid function if we do it early enough.

There's a documentary series starting tomorrow called 'Autoimmune Secrets '.

autoimmunesecrets.com/?orid...

I am definitely watching it.

I have had Hashimoto's thyroiditis for 16 years. My thyroid may be too completely destroyed from the years of antibody attack. Irregardless, I have been gradually changing my diet for the last year and lots of debilitating symptoms have started going away. Especially in recent years, I had started have symptoms of rheumatoid arthritis which has stopped.

Though, no signs of needing to come off my meds yet. I still take a combination of NDT (for a bit of T3) and levothyroxine.

I also highly recommend any book written by Izabella Wentz. She writes the best books on healing the thyroid and she has a website/blog.

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