Thyroid UK

Feel undermedicated - raised Serum Thyroid Peroxidase Antibody Concentration

Hi I am new, my antibody results for TPO have come back. Serum Thyroid Peroxidase Antibody Concentration 889 IU/mL (<34)

I was diagnosed hypothyroid in 2012 and I take 100mcg Levo. My current symptoms are eyelashes falling out, feeling cold, having a cold and damp feeling to my skin, dry eyes, thyroid swelling in neck, sugar cravings, salt cravings, dizziness, less frequent bowel movements, taking forever to get over colds, weight gain, loss of appetite, constant rumbling in head, muscle cramps and bone aches, memory loss, loss of balance, also pins and needles and sweating upon exertion.

TSH, FT4, FT3 done Friday 22 Dec due to abnormal bloods taken in October showing

TSH 5.6 mIU/L (0.2 - 4.2)

FT4 13.8 pmol/L (12 - 22)

FT3 4.1 pmol/L (3.4 - 6.8)

Any advice welcome.

2 Replies

You are very under medicated and need immediate dose increase of 25mcg.

TSH should be around one and FT4 towards top of range and FT3 at least half way in range

Bloods should be retested after 6-8 weeks. 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

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

Have these been tested? Post results and ranges if you have them. Ask GP to test if not.

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimotos

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

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

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 print it and highlight question 6 to show your doctor.


Ferritin, folate, B12 and D all done 22 December. No news on any of them yet

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