Question on dosage

[Michelleac]

Newbie here I had my thyroxine 150mcg reduced based on

TSH 1.60 range 0.2 - 4.2

FT4 15.9 range 12 - 22

FT3 3.0 range 3.1 - 6.8

Is this right

Diagnosed hypo 2012

Thanks

[Anthea55]

You should have had your thyroxine increased, not reduced.

Once you are on thyroid treatment the aim is to get TSH to 1 or below, rather than getting it into the range which is only useful for people who are not on treatment.

Your free T3 is below range which means that you must be very tired.

Have you had vitamins and minerals tested? Have your antibodies been tested?

[Michelleac in reply to Anthea55]

TPO antibodies 278 less than 34

TG antibodies 355.3 less than 115

[SlowDragon Administrator]

Absolutely not. It needs increasing

Your FT4 is too low and FT3 is BELOW range

You probably have very low vitamin levels upsetting things as result of being under medicated

Have you got recent tests for vitamin D, folate, ferritin and B12.

Do you have Hashimoto's also called autoimmune thyroid disease diagnosed by high thyroid antibodies?

Typical posts

Low vitamins due to under medication with detailed supplements advice from SeasideSusie

healthunlocked.com/thyroidu...

Low vitamins causing low TSH

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

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...

But essential to get vitamins optimal and Levo dose higher first

If you have high antibodies then strictly gluten free diet likely essential

[Michelleac in reply to SlowDragon]

TPO antibodies 278 less than 34

TG antibodies 355.3 less than 115

[SlowDragon Administrator in reply to Michelleac]

No that means your antibodies are high

TPO is 278

Anything over 34 is high

TG is 355

Anything over 115 is high

You definitely have Hashimoto’s also called autoimmune thyroid disease

Over 90% with primary hypothyroid cause is autoimmune

Will add links shortly about gluten free diet and why it helps

[SlowDragon Administrator in reply to Michelleac]

Essential to test vitamin D, folate, ferritin and B12.

Always get actual results and ranges.

Post results when you have them, members can advise

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...

Typical post with Low vitamins due to under medication and detailed supplements advice from SeasideSusie

healthunlocked.com/thyroidu...

[Angel_of_the_North]

No. No reason there to reduce dose. In fact a 25mcg increase should have happened as most people do best when free T4 is in the top quarter of the range and TSH is under 1. Your free t3 is under range so you need more T4 to convert or the addition of some T3 (preferred). Your doctor doesn't know what s/he is doing.