You are undermedicated to have TSH 3.57 while taking Levothyroxine. FT4 and FT3 are both under halfway through range. A Levothyroxine dose increase will raise FT4 and FT3 and reduce TSH.
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 dionne.fulcher@thyroiduk.org if you would like a copy of the Pulse article to show your GP.
Thyroid peroxidase antibodies 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.
HbA1c is a diabetes test. 43 is over range so I would see your GP to discuss.
CRP is an inflammation marker. 16.8 is high so see your GP to discuss.
Ferritin is optimal halfway through range but there's little chance of iron deficiency with ferritin 161.
Magnesium is mildly over range. I doubt it is significant but you can Google "high magnesium" to check it out.
VitD 83 is in the replete range 75 - 200.
B12 is low and in the grey area where you could be deficient. If you have symptoms in b12deficiency.info/signs-an... you may be deficient and should pop over to healthunlocked.com/pasoc to discuss as they are the experts on B12, folate and PA.
Folate is deficient. Your GP should prescribe 5mg folic acid for 2-3 months. B12 deficiency should be ruled out first. If B12 injections are initiated this should be done 48 hours before you start taking folic acid.
First is the high thyroid antibodies means you have Hashimoto's also called autoimmune thyroid disease
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Your results suggest you are under medicated to have TSH so high. Usually recommended to have dose increased in 25mcg steps until TSH around one and FT4 towards top of range and FT3 at least half way in range
FT4 is too low, as is total T4, both suggest you need higher dose
FT3 is too low, most find it needs to be in top third to feel well. Increasing Levo should increase FT3 as result
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: tukadmin@thyroiduk.org
Your B12 is Insufficient. You should ask GP to test for Pernicious Anaemia. Especially as folate is also very low and below range. They may not agree it's low enough for B12 injections.
If GP won't offer injections then supplementing B12 sublingual lozenges and also a good vitamin B complex often a good idea, one with folate in.
Folic acid supplements should not be started until after first B12 injection or B12 supplements started as improving folate levels before B12 can make B12 deficiency worse.
Vitamin D is slightly low, getting to around 100nmol is good idea, supplement through winter and retest in spring.
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
According to the above - level of HbA1C - you are in the pre-diabetic range - you need to talk to your GP - probably means looking at diet and exercise to get result back down.
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Blue Horizons Blood Results for Thyroid - Please help
Advice on Blue Horizon thyroid blood results please
Blue Horizon Blood Test Results
