Daughter's thyroid results

[Adi_J]

I am posting on behalf of my daughter. She is 22, diagnosed hypothyroid about 4 years ago. Her weight is creeping up, she feels cold, ears ringing, tired during the day, periods draining the life out of her. She does mainly eat very well but she craves chocolate due to its sugar content. Her moods and her symptoms are causing us such concern, I think I really need to help her and this is why I signed up today. Advice welcome.

Thanks

TSH 4.7 (0.2 - 4.2)

FT4 14.9 (12 - 22)

FT3 3.2 (3.1 - 6.8)

[shaws Administrator]

Welcome to our forum and your daughter's TSH is too high. It should be 1 or lower but few doctors are aware of this and believe if TSH is somewhere in range the patient is on sufficient. Not true.

All blood tests for thyroid hormones has to be at the very earliest, fasting (she can drink water) and allow a gap of 24 hours between last dose of levo and test and take afterwards. This helps keep the TSH at its highest and prevents doctor adjusting dose. Doctor should take a blood test every six weeks (following the advice) and prescribe an increase until TSH is 1 or below.

The purpose of taking levothyroxine is to relieve all clinical symptoms and your daughter clearly has symptoms.

Both her FT4 and FT3 are too low and should be towards the upper part of the range. She needs an increase in levo.

GP should also check B12, Vit D, iron, ferritin and folate as deficiencies also cause symptoms..

She has to read, learn and ask questions if hypothyroidism is not going to rule her way of living. I will give a list of symptoms and she should tick off the ones she has:-

thyroiduk.org/tuk/about_the...

When we are on the optimum dose we should have no clinical symptoms. That's the aim although doctors and endocrinologists do no seem to be unaware of this as they keep the TSH somewhere in the range. That is o.k. for diagnosing a patient but not when they've been diagnosed.

[Adi_J in reply to shaws]

Thanks for this. She is starting to have enough of feeling unwell but endo is being no help at all. Her results have been going all over the place with no explanation given.

[shaws Administrator in reply to Adi_J]

Most endocrinologists seem to be trained in diabetes rather than dysfunctions of the thyroid gland. They make statements to patients which are not correct and I think they try to cover up their inadequencies.

What your daughter has to do is take her health into her own hands and when she begins to feel a bit better it will become much easier.

Many on this forum source their own thyroid hormones which isn't illegal if it's for our own use. They have recovered their health. I also self-medicate and GP does a yearly blood test. I have no clinical symptoms and that is supposed to be the aim when hypo.

[Clutter]

Adi_J,

Your daughter is undermedicated with TSH over range. She 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 0.2 - 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.

[SlowDragon Administrator]

Ask GP for 25mcg dose increase and bloods retested in 6 weeks

Dose should be increased in 25mcg steps, retesting 6-8 weeks later each time, until TSH is roughly between 0.2-1.0 and FT4 towards top of range and FT3 at least half way in range

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

[e-mail]

Low vitamin levels are extremely common consequence of being under medicated

Typical Low vitamins due to under medication and detailed supplements advice

healthunlocked.com/thyroidu...

Get GP to test her vitamin D, folate, ferritin and B12

Low B12 is linked to tinnitus

Does she have high thyroid antibodies? This gives diagnosis of Hashimoto's also called autoimmune thyroid disease

[Adi_J in reply to SlowDragon]

Thanks she hasn't had antibodies tested at all

[SlowDragon Administrator in reply to Adi_J]

Then insist they are tested

Or get done privately if GP unhelpful

[SlowDragon Administrator in reply to SlowDragon]

If she has Hashimoto’s then likely a strictly gluten free diet will help

Ask GP for coeliac test first

[Adi_J in reply to SlowDragon]

She has had thyroid autoantibodies tested which were positive but not thyroid antibodies

[SlowDragon Administrator in reply to Adi_J]

That’s the right ones

Called TPO antibodies

Read lots of posts on here about gluten free diet

[Angel_of_the_North]

She may actually crave chocolate for its fats and magnesium, not sugar - both things we are often deficient in. She is undermedicated to have such a high TSH, should be under 1. You might want to get a copy of the Dr Toft Pulse article from TUK and show it your GP while asking for a 25mcg increase in dose.