Blood Results

[Tristy]

I've just received blood test results below and would be grateful for any comments please.

Vitamin B12 - 1167 (197 - 771)

Folate - 12.9 > 2.9

Ferritin - 131 (13-150)

TOTAL THYROXINE(T4) - 71 (59 - 154)

TSH - 0.8 (0.27 - 4.2)

FREE THYROXINE 14.6 (12.0 - 22.0)

FREE T3 - 3.5 (3.1 - 6.8)

Vit D - 72 (50-200)

Thyroglobulin Antibody - 651 (0-115)

Thyroid Peroxidase Antibodies - 97.1 (0-34)

I am on 125mcg Levothyroxine with last dose increase 04/09/17. I generally feel a lot better but still have some days where I don't feel so good. Do I need an increase of levothyroxine?

[Clutter]

Tristy,

You could ask for an increase to raise FT4 and FT3 but GP may be wary as an increase may suppress TSH. 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.

Thyroid peroxidase antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Levothyroxine treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.

chriskresser.com/the-gluten...

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

Ferritin, B12 and folate are good.

VitD is almost replete (75) and most people are comfortable around 100-150 so you could supplement 2,000iu daily until March and then retest. Take vitD 4 hours away from Levothyroxine.

[Tristy in reply to Clutter]

Thanks Clutter. I find it quite strange that the results of the T3 and T4 are quite a lot lower than the last blood test which was:

T4 20.0 (11.0-26.0)

T3 4.8 (3.5-6.8)

I was expecting it to go up, not down. I'm feeling a lot better so I'm not too worried.

I think my Endo will agree to an increase. An increase shouldn't make me over-medicated should it?

[Clutter in reply to Tristy]

Tristy,

Thyroid function declines over time so you will periodically require dose increases. FT4 and FT3 are considerably lower now. I don't think there's any likelihood of 25mcg increase causing overmedication.

[SlowDragon Administrator]

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, lowest FT4 and most consistent results

Is this how this test was done?

Vitamin D is on low side. How much do you supplement and do you also take magnesium

i see from other posts you are strictly gluten free.

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 [e-mail]. print it and highlight question 6 to show your doctor.

Prof Toft - brilliant article just published about how inadequate current treatment is

rcpe.ac.uk/sites/default/fi...

[Tristy in reply to SlowDragon]

Thanks SlowDragon, yes the test was done at 8.50am, fasting overnight and no levo within 24 hours.

Re Vit D - I've been taking 5000mcg daily for the last 3 months and 1000mcg daily previous to that since April so I'm not sure why it's lower than it was at my last results in Sept (when I was only taking 1000mcg) and it was 80. I also take Magnesium 400mg daily.

Also the T3 and T4 are lower in these results (quite a lot lower) they were T4 20.0 (11.0-26.0)

T3 4.8 (3.5-6.8)

at the beginning of September.

I've used Dr Toft's article before when I've needed a dose increase and will use it again. Just not sure why the T3 and T4 are so much lower.

[SlowDragon Administrator in reply to Tristy]

Well I take 6000iu daily as mouth spray and sit out in Sun as much as possible, still struggle to keep vitamin D levels up.

Gastroenterologist advised several winter sunshine holidays every year!!!

Mouth spray by Better You avoids poor gut function.

Vitamin D is not a vitamin at all but a pre-steroid hormone apparently

As you have improved your vitamin D intake it may have improved your ability to utilise thyroid hormones

Or as Clutter says, over time thyroid function decreases further and then we just need dose increase

[Tristy]

Thanks SlowDragon, I think I'll try the Mouth spray. There's not much risk of taking too much at the moment is there?