Thyroid UK
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Need help understanding my results please...newbie

Hi all I am new to the site. I have joined because I have no understanding of my thyroid disease.

I was diagnosed as underactive in June 2005. Over the years my meds have increased and up till August 2017 I was taking 175mcg levo. A recent blood test showed I was thyrotoxic so I was told to reduce to 150 for 6-8 weeks and I have the new blood work.

My results are

FT4 14.8 (12 - 22)

TSH 6.7 (0.27 - 4.2)

Anti Thyroid Peroxidase antibodies 278.5 (<34)

Do I have autoimmune thyroid or something else?

Thanks

10 Replies
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Welcome to the forum, Starsal.

What were your results when you were told you were thyrotoxic on 175mcg?

You are undermedicated now on 150mcg to have TSH so high and should request a dose increase.

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_...

Thyroid peroxidase 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_...

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Thank you the results that were thyrotoxic are

TSH 0.03 (0.2 - 4.2)

FT4 21.3 (12 - 22)

FT3 4.5 (3.1 - 6.8)

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What makes you think you are Thyrotoxic ? Did you feel toxic ? Your results look good and you are only over medicated when the FT3 is over range.

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GP said I was, I did not feel toxic

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Your GP was going by the TSH above - they rarely consider the FT3 which is the most important result. I would go back to the dose where you felt well :-) You can see how lowering your dose has affected your TSH - you are now very Hypo ....

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These results do not show you were over medicated. They show LOW FT3.

You are a poor converter. Possibly due to low vitamin levels

You are now very under medicated on 150mch

Have you had vitamin D, folate, ferritin and B12 tested?

Post results and ranges and say what if any supplements you are taking

Your antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's

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

Persistent low vitamins with supplements suggests coeliac disease or gluten intolerance

gluten.org/resources/health...

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...

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 at


tukadmin@thyroiduk.org

Professor Toft recent article saying, T3 may be necessary for many

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

With Hashimoto's we must get vitamins optimal FIRST, plus dose of Levo increased enough to lower TSH to around one and FT4 towards top of range

Gluten free diet helps or is essential for many

If after these steps, FT3 remains low then, like many with Hashimoto's, you may need the addition of small dose of T3

Ask Dionne for list of recommended thyroid specialists, some are T3 friendly

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Starsal,

They're not thyrotoxic. TSH is suppressed but FT4 and FT3 are within range so you weren't overmedicated. A lot of doctors don't like TSH suppressed and that's probably why dose was reduced. Your GP would do better to ignore low TSH as long as FT3 remains within range.

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.

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Welcome to the forum and glad you are asking questions. Sadly many doctors don't know the answers and if the results you have posted show you are toxic then I fear your GP hasn't much of a clue.

There is a lot to learn and the best place to start is the info on the athyroid U.K. site-they administer this forum. Should out if anything you don't understand and help is at hand. Don't try to take it in all at once but look at things like how to take your medicine and things not to do and gradually your knowledge will build up. I learnt a lot by reading on hear and as I got my head around it I tried to work out what advice I would given and then look at the replies to see if I was on the right track. So glad you have asked for help and always remember that others will help when asked. It took me ages when I was first diagnosed to get my head around TSH rising makes us feel worse!

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Perhaps you should join Thyroid UK charity and begin to learn about your illness.

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Thanks I am sorry I haven't learned about it

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