Thyroid UK

A little help understanding my thyroid disease??

Hi all....im new on this forum. I have joined because I literally have no clue about my thyroid disease. I was diagnosed as underactive in Sept 2003. I only found out as I was having trouble conceiving my 2nd child...had blood test done and the day I found out I was underactive is same day I found out I was pregnant. Over the years my meds have increased and up till December 2017 I was taking 175mcg levothyroxine. A recent blood test showed I was on verge of going overactive, so my GP TOLD me to alternate 175 one day and 150 the next and to do this for 8 weeks. I work in a hospital and got my most recent bloods while in work.

My results are :

Free thyroxine 16.5 (12 - 22)

TSH 0.66 (0.27 - 4.2)

Antithyroid Peroxidase ab 52 (<34)

Do i actually have autoimmune thyroid??

Many thanks

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"Do i actually have autoimmune thyroid??"

You may have but you've not given the reference ranges for any of your tests. As ranges vary from lab to lab they can only be interpreted if you give the range your own lab used.

We most often see TPO antibodies with a result >34 as positive and <34 negative. So if yours is the same then you are positive for autoimmune thyroid disease.

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Sorry....told you I was clueless lol. I'll give you them again

Free thyroxine 16.5 pmol/L (12 - 22)

TSH 0.66 mlU/L (0.27 - 4.2)

Antithyroid Peroxidase 52 (<34)

Is this what I needed to say??

Thank you 😊

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:)

Yes, that's right.

So you are positive for autoimmune thyroid disease aka Hashimoto's.

Are those results the ones when your GP said to reduce your dose, or are they after the reduction?

If they were the results that prompted the reduction then there is absolutely no way with those results that you are anywhere near going overactive. Your TSH is well within range and your FT4 is actually very low in range. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it is needed for FT4 and FT3 to be in the upper part of their respective reference ranges if that is where you feel well.

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No these are the results after alternating my meds for 8 weeks. I need to make an appointment with my GP to give him these results & to find out what I am to do now regarding my meds.

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Do you know the results which prompted the reduction?

How do you feel now? Do you feel well enough to stay on your current dose? If not you should ask for it to be increased, there's plenty of room.

If you want to ask for an increase, this should help support your request, from thyroiduk.org.uk/tuk/about_... > Treatment Options

"Dr Toft 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)."

Dr Toft is past president of the British Thyroid Association and leading endocrinologist. You can obtain a copy of the article by emailing Dionne at tukadmin@thyroiduk.org highlight question 6 to show your GP.

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I feel not too bad. My memory is shot to bits tho. Also having irregular periods....was thinking it was either my thyroid or I'm starting early menopause....im 41 in April lol. I really look after my weight as I put weight on soooo easy. I regularly exercise to try n keep it in check.

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All blood tests for thyroid hormones have to be at the very earliest possible, fasting (you can drink water) and allow a gap of 24 hours from your last dose of levothyroxine and the test and take afterwards. This helps keep the TSH at its highest as doctors are apt to adjust dose according to the TSH which reduces throughout the day. Also levothyroxine should be taken (usually when we get up) with one full glass of water as sometimes tablet can stick in the throat.

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I started taking mine at night. I take omeprazole 20mg in the morning..along with 200 sertraline. I take quetiapine 150 at night. Should I change back to taking it in the morning?? I

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No, you can keep to your night time dose as long as you've last eaten about 2 1/2 hours before as food can interfere with the uptake of thyroid hormones. If having a blood test next a.m. Miss this night dose and take after blood test and also at night dose as usual.

I note you have been prescribed omeprazole too. Usually we hypo members get gut problems and we need Acid in our stomach as it enables food to be digested. However, because the symptoms of high and low acid are so similar doctors are apt to prescribe something to lower acid, i.e. omeprazole.

You can put up a new post asking about omerprazole and if its beneneficial when hypothyroid.

Quite a few on the forum take Betaine with pepsin tablets, or Apple Cider Vinegar mixed with juice or water after or during meals.

I also understand you are taking an anti-depressant and (I am not medically qualified) if we aren't converting levothyroxine (T4) to sufficient liothyronine (T3) it could be due to our low T3. It would be good if your doctor, when your next test is due to test Free T4 and Free T3. Both of these results can inform whether or not you can convert levothyroxine (T4) into sufficient liothyronine (T3). T3 is the only active thyroid hormone and it is required in all of our T3 receptor cells. T4 is an inactive hormone.

This is another link which might be helpful: Excerpt:

So we are dealing with a subset of very depressed people who do not respond to the tricyclics. They don't seem to be hypothyroid by physical symptoms or the lab tests of the time, but a certain percentage would respond to augmentation with active thyroid hormone. In addition, "accelerating" the tricyclics (which, like most antidepressants, take several weeks to kick in) with a dose of T3 up front (isolated to 2-4 weeks, then discontinued) seemed to work too. There are fewer studies of augmentation with SSRIs, but these are also short and the results are less definitive.

Why would T3 help? What does T3 do in the central nervous system? Well, a lot. The thyroid has fingers in almost every physiological pie, after all. And T3 not only may act as a direct neurotransmitter, but it also seems to increase the efficiency of serotonin signaling, much like a modern SSRI. T3 also enhances neurogenesis in the central nervous system and could also enhance noradrenergic signaling. The conversion from T4 to T3 occurs all over the body, but in the central nervous system it uses different active genes than in the periphery and occurs within the cells. These differences could explain my own clinical observations--that T3 augmentation seems to work best in folks already diagnosed hypothyroid that are on T4 monotherapy. And the literature (such as it is) seems to support my observation (1).

evolutionarypsychiatry.blog...

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Thank you very much. I wish thyoid disease was easier to understand. Thanks again

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I have never fully understood all these results....diagnosed hypothyroid and just kept getting my bloods done every 6 months and doing what doctor said lol.

Is autoimmune thyroid a different diagnosis that hypothyroid then???

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Hashimoto's is the most common cause of Hypothyroidism. Hashi's is where antibodies attack the thyroid and gradually destroy it. There is no separate treatment for Hashi's, it's the Hypothyroidism that is treated.

You can help reduce the antibodies by adopting a strict gluten free diet and supplementing with selenium L-selenomethionine 200mcg daily.

Most doctors dismiss antibodies as being of no importance and don't realise how the patient is affected. The antibody attacks cause fluctuations in symptoms and test results. Read, learn and help yourself where the Hashi's is concerned.

chriskresser.com/the-gluten...

hypothyroidmom.com/hashimot...

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

Hashi's and gut/absorption problems tend to go hand in hand and very often low nutrient levels or deficiencies are the result. You should ask for Vit D, B12, Folate and Ferritin to be tested.

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Thank you so much. You have been so helpful. Xx 😊

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You're welcome :)

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