Help with Results

[Deb59]

Hi, I have just had a private blood test and would like your advise.

I take

125 mcg levothroxine

10 mcg liothyrinine

Results:

Total thyroxine (t4) 115 mmol/l 59-154

TSH 0.74 miU/l 0.27-4.2

FRee thyroxine 12.9 pmol/l. 12.0-22.0

FRee T3 4.00 pmol/L. 3.1-6.8

Thyroid antibodies 1574.0 IU/ml 0-115

Thyroid peroxidase antibodies 208.0. IU/ml. 0-34

VIt b12, Vit D, CRP, folate are all in good range.

Main Symptoms:. Fatigue, brain fog

Do I need to change dosage of thyroxine or T3?

Many thanks in advance 😊

[Clutter]

Deb59,

I think you may be a little undermedicated as both FT4 and FT3 are low in range. It may be helpful to increase Levothyroxine to 150mcg.

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.3 - 1.0 with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. 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 and thyroglobulin 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_...

[Deb59 in reply to Clutter]

Thank You Clutter, I will increase my dose.

[SlowDragon Administrator]

Can you add your vitamin results

As you have Hashimoto's are you on strictly gluten free diet. It's likely essential and especially when on T3

Leaky gut is very very common

Brain fog can be gluten crossing blood brain barrier and causing inflammation

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...

[Deb59]

Many thanks for your reply. SlowDragon

My vit d 113 mmol/L 50-200

Vit b12 1258 pg/ml 197-771 (started a nasal b12 spray as I was hovering around 2-300 with 3 month injection). I will cut down on the spray!

Folate >20 ug/L >2.9

I have PA. And also exocrine pancreatic insufficiency.

I have just started back on gluten free diet.

I was thinking of ordering the private 3 day bowel test to see if I had a leaky gut or any other issues especially as I have EPI?

Thanks for sending the links 😊

[SlowDragon Administrator in reply to Deb59]

Do you also take a good vitamin B complex? Recommended on here to help keep other B vitamins balanced.

With Hashimoto's we can be low in B5 and/or thiamine. B complex apparently keeps them balanced

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

No ferritin test results?

I think leaky gut is almost inevitable

Kefir and probiotics may help

[Deb59]

No I don't take vit b complex, but I will start. I take probiotics. I am waiting for the ferritin result.