Private blood tests back- confused about what to do next, back to the GP or go straight to a private doctor?

[OceanSW]

Hello, I have just got my Blue Horizon blood tests back (appreciated the recommendation!) but not sure what’s best. I’m still getting to grips with deciphering the numbers but think my TSH is ‘normal’ but not optimal, free T4 could be higher , free T3 is lowish and Vit D needs improving. Am I best to go to the GP and see if they would be willing to try me on a low dose levothyroxine (or if i’m not converting would this not have a positive effect?) or try to obtain a low dose T4/T3 combination from a private doctor? Or should I keep trying to control with diet and supplements? Currently following the Auto Immune Protocol which is definitely helping but not sure it’s enough..

Very much appreciate any advice!

TOTAL THYROXINE(T4) 82 nmol/L 59 - 154

THYROID STIMULATING HORMONE 3.27 mIU/L 0.27 - 4.2

FREE THYROXINE 14.7 pmol/l 12.0 - 22.0

FREE T3 4.2 pmol/L 3.1 - 6.8

REVERSE T3 17 ng/dL 10 - 24

Thyroglobulin Antibody * 687.0 IU/mL 0-115

Thyroid Peroxidase Antibodies * 181.0 IU/mL 0 - 34

25 OH Vitamin D 54 nmol/L 50 - 200

Folate (serum) 15.0 ug/L > 2.9

FERRITIN 106 ug/L 13 - 150

C Reactive protein 0.7 mg/L <5.0

[Clutter]

OceanSW,

Your NHS GP is not going to diagnose hypothyroidism until TSH is over range of FT4 below range. TSH is high in range but FT4 and FT3 aren't unduly low. You could point your GP to Dr. Toft's comments about the pragmatism of prescribing Levothyroxine in the presence of positive thyroid antibodies in Guidelines for the Use of thyroid Function Tests in thyroiduk.org.uk/tuk/about_... but I don't think you will be successful. Email [e-mail] for a copy of the Pulse article if you want to show it to your GP.

Some, not all, private practitioners will prescribe Levothyroxine when TSH is >3.0 but you will have to pay for private prescriptions and may not get a NHS diagnosis without coming off Levothyroxine until TSH shows as abnormal.

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_...

VitD 54 is insufficient. I would supplement 5,000iu D3 daily for 8 weeks then reduce to 5,000iu alternate days and retest late April. Take vitD 4 hours away from Levothyroxine.

Folate, ferritin and CRP are good. Was B12 tested?

[OceanSW in reply to Clutter]

Thanks very much for taking the time to answer and for your advice. My B12 was slightly elevated so think the supplements must be working there. I’ll try my GP but sounds like I have to just wait and see if things get worse? Or hopefully better with diet changes..thanks again.

[Clutter in reply to OceanSW]

OceanSW,

Try supplementing 100mcg - 200mcg selenium which is good thyroid support. 100% gluten-free may delay progression but I think your thyroid will continue to decline so do monitor by having a follow up thyroid test in 6 months.

[hypercat54 in reply to Clutter]

Clutter your knowledge always amazes me! x

[EmmaJM]

Don’t give up with your GP. Your results are very similar to mine and for 2 years I fought to see different Gp’s and endos.

Eventually I found a sympathetic NHS gp who actually listened to my symptoms and decided to trial thyroxine.

I started on 25mcg and slowly increases to 100mcg and feel so much better for it.

Hope you get the treatment you need xx

[OceanSW in reply to EmmaJM]

Thank you so much Emma! That’s very helpful.

[OceanSW in reply to OceanSW]

Hi Emma, I went back to the GP today and I think she must have sensed I was at my wit's end as she prescribed a low dose of thyroxine. I think it really helped having the support from this forum so thank you! Do you mind me asking how long it took for you to feel an improvement please - and did you have any marked side effects? Thanks again!