Advice needed with Blood results ,T3

[hyp0thyr01d]

I was diagnosed as hypothyroid in April of last year although i have been unwell for the past 8 years. With a TSH 4.38 T4 11.4 i was prescribed 50m levethyroxyn which the doctor increased to 75 as i wasn't feeling any better. After being referred to an Endo my new bloods have come back TSH 0.54, T4 19.7, Cortisol 235, TPA 10.4 and T3 4.3. Going by these results i should feel great right?? I still have all my previous symptoms and if i stopped taking T4 tomorrow i wouldn't feel any different. I plan to reduce my T4 to 50 and start taking some T3. Can anyone advice where i can get T3 and a good starter dose to take? Also i have heard that it should be taken in stages throughout the day, again advice please? Or if anyone has and others suggestions given my current bloods.

[Mary-intussuception]

Have you had any tests to check nutrients levels yet of:

Vitamin D, Calcium

B12 , Folate

and Ferritin?

If not ask for blood tests asap because you may be deficient in some and need supplements.

Don't understand Cortisol result - and what's TPA?

What did the doctor say about Adrenals?

Do you have Hashimoto's Autoimmune Thyroiditis? Have you had Thyroid Antibodies tested - TPO and Tg?

[sarah7o in reply to Mary-intussuception]

I should have said, Yes I have had nutrients tested and have been supplementing since diagnosis, all apart from Ferritin are now mid to upper range. Cortisol is adrenals as far as i'm aware. TPA is Antibodies which are well within range. Not sure if Hashmoto no antibodies but am i right in saying they aren'y always present? What else could it be other than hashimoto? TPO and Tg not sure what they are?

[Mary-intussuception in reply to sarah7o]

TPO (Thyroid Peroxidase ) and Tg (Thyroglobulin ) are the Thyroid Antibodies tested to confirm /eliminate Hashimoto's Autoimmune Thyroiditis.

You could ask for an Ultrasound scan of your Thyroid.

I'm not sure what TPA is?

Do you take your Levothyroxine on it's own (no other meds) with water 30 - 60 minutes before breakfast? Do you take your supplements several hours later with food?

[sarah7o in reply to Mary-intussuception]

Thyroid peroxidase was 10.4 there is no chance i will get anything else on the NHS- it took a lot of persuasion to get to see endo who has now signed me off. Yes on it's own , no breakfast, supplements later with food.

[Mary-intussuception in reply to sarah7o]

You haven't put the range but I think that's within it. So you haven't been diagnosed with Hashi's. You could ask your GP to send you for the Ultrasound scan. Only 2 things he can say!

[sarah7o in reply to Mary-intussuception]

Well within range. it's 0.0 - 35 is that good ? What would having a scan do? Should i get Tg done. I know if i need anything else it will have to be private. I am now well within range and all my nutrients fall within range too. I am on yearly review under GP and nothing else.

[Mary-intussuception in reply to sarah7o]

I think the scan would show if you had Thyroiditis

[sarah7o in reply to Mary-intussuception]

Do you think it's worth paying to have it done? I'm frustrated that after waiting so long to see endo not everything has been done. I assumed it was hashimoto?

[sarah7o in reply to sarah7o]

I'm not sure i understand. Is it possible that it isn't hashimoto? How can i find this out for certain? What does no antibodies mean in my bloods. Sorry for so many questions. I'm really struggling health wise and not fully understanding things.

[Mary-intussuception in reply to sarah7o]

Have you got your actual Vitamins' and Ferritin results with normal ranges? Also supplements doses you are on?

All I could suggest is to keep going back to GP about the symptoms you ate still having.

I know that raised Thyroid Peroxidase would confirm Hashimoto's but I'm not sure if not raised. You could ask for the scan, I think that would help.

[Mary-intussuception in reply to sarah7o]

Even if you did have Hashimoto's - it's the Hypothyroidism that is treated.

I don't understand why you don't want to stay on your 75mcg dose.

I have no personal experience of T3.

[Mary-intussuception in reply to sarah7o]

Ask your GP to read out the letter from the Endocrinologist. It probably says diagnosis Hypothyroidism. But you did say this in your post?

[Mary-intussuception in reply to sarah7o]

Did the Endo say it was Hashimoto's or were you given the diagnosis of Hypothyroidism?

Have you got any problems with your throat or neck? Tenderness, swallowing problems, lumpiness?

[Nanaedake in reply to Mary-intussuception]

Sometimes TPO is written as TPA = Thyroid Peroxidase Autosomal Antibodies I think??

[sarah7o in reply to Nanaedake]

Yes that's it

[Kalicocat]

What time did you have these tests taken at? Cortisol is very low if taken at 8:00/9:00 a.m.

[sarah7o]

Around 2pm, I didn't realise that it should have been in the morning.

[SlowDragon Administrator]

You have only had TPO antibodies tested, not TG antibodies. NHS don't test TG antibodies unless TPO antibodies are high

Private tests are available

thyroiduk.org.uk/tuk/testin...

Medichecks or Blue Horizon are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

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

Link about antibodies

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

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Some on here have high TG antibodies and low TPO antibodies.

Also apparently about 20% with Hashimoto's don't have raised antibodies ever. So a scan might reveal Hashimoto's

Your FT3 looks low but can't tell with out ranges

do you have the ranges for all these results?

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

please email Dionne:
[e-mail]

Prof Toft - article just published now saying T3 is likely essential for many

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

75mcgs is not a large dose. You could try increasing or as you say, look at adding T3. You probably don't need to reduce Levo.

[sarah7o in reply to SlowDragon]

Very helpful. TSH 0.54, Range 0.3-3.93, T4 19.7 Range 12.3 -20.2 so i should be feeling good but feel the same. T3 4.3 Range 3.7-6.7 which is why i am considering trialling T3. Please could you tell me the befit of confirming Hashimoto - i'm assuming a scan would be costly? Trying to understand everything. And where can i buy T3? Dosage?

[SlowDragon Administrator in reply to sarah7o]

Well most of us with Hashimoto's find strictly gluten free diet helps significantly

Plus low vitamins are more likely

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

Low vitamin levels affect 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

Ask GP for coeliac blood test first

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...

thyroidpharmacist.com/artic...

It's probably worth testing TG antibodies

Not sure about scan if GP won't

You might try gluten free anyway. There are some on here who don't appear to have Hashimoto's yet still found gluten free helps

I am not up to date on where to get T3 without prescription

Suggest you put up new post asking just that

[sarah7o in reply to SlowDragon]

Thank you. I have been gluten free since my diagnosis in April, along with a gut healing followed by a pro biotic proctorial and still feeling very unwell. I think i'm doing all the things i should be diet and supplement wise hence the T3 question. Thank you for your help - ill try another post as suggested.

[Marz in reply to sarah7o]

Your name has changed from the opening post ? - confusing

[sarah7o in reply to Marz]

Yes. I have a Google account that I am posting from now. My first post I singed in some other way but not sure how and can't seem to do it again.

[Stourie]

Is Hyp0thyr01d the same person as sarah70? Puzzled!!

[sarah7o]

Yes I'm the same person. I can't seem to log in again under original post so am using my Google account now, hence the different name. Sorry for confusion.