CURRENT RESULTS AT THE END
Hi.
I've posted before about my girlfriend here. Could really use some help.
She was diagnosed as hypothyroid in June 2016. Her bloods then were as follows:
17/06/2016
TSH basal - 4.43 (0.35 - 4.50)
Free T3 - 2.7 (2.0 - 4.2)
Free T4 - 1.2 (0.8 - 1.7)
Other noteworthy results on the same date:
Vitamin D3: 44.8 (>20ng/ml)
Vitamin B12: 438 (for some reason the range is not on the lab report).
Hb: 12.7 (12.0 - 16)
She was prescribed 50 mcg Levothyroxine Henning (German brand). However she was not compliant. I think she did not take it for large stretches of time, and when she did take it she would do so erratically and when she remembered. It's also a case of poor patient education. She had no idea this was important until I (I'm a doctor) found out about it.
She had gained 9 kg by January 2018. She suffered a significant amount of hair loss, feels bitterly cold even in warm rooms. She started to (and still does) find it impossibly hard to wake up. Sleeps through alarms. But in an hour or so, after a cup or two of coffee, she's back to herself and energetic through the day.
The most devastating thing for her so far has been the weight gain. She's lost a part of herself. She's athletic and was, before all this, 56 kg at about 5 ft 10 inch. Now (this morning) she weighs 67kg. Also, waking up late ruins her day in terms of getting her work done and her exercise in. Exercise makes her feel good.
She let me know in January about the non-compliance. I got on the case. We got bloods done which were as follows:
02/01/2018
TSH basal - 5.05 (0.35 - 4.50)
Free T3 - 3.5 (2.0 - 4.2)
Free T4 - 1.0 (0.8 - 1.7)
Since then, with the help of the forum, thanks SlowDragon and Hidden , she is taking her levo properly (I made a mistake here, I upped it to 75mcg and then a week later, by around January 10, to 100mcg - she has had no side effects all though).
She is also on the following minerals, vitamins since - Vit D, B complex including Folate, Ferrous Fumarate 210 mg twice a day (though this was started only at the start of February). She has tried to stay largely gluten free but it's a challenge. She exercise a fair bit, doing a ton of walking. She is never tired after exercise.
However, she is still symptomatic. She has put on another kilogram.
Since it had been 6 weeks since she properly started medicating I got a Thyroid Ultravit Check done through Medichecks on to be honest it has me baffled. Here are the results:
15/02/2018
THYROID STIMULATING HORMONE 0.482 mIU/L (0.27 - 4.20)
FREE THYROXINE 14.7 pmol/L (12.00 - 22.00)
TOTAL THYROXINE (T4) 99.4 nmol/L (59.00 - 154.00)
FREE T3 5.33 pmol/L (3.10 - 6.80)
THYROGLOBULIN ANTIBODY 27.400 IU/mL (0.00 - 115.00)
THYROID PEROXIDASE ANTIBODIES 28.3 IU/mL (0.00 - 34.00)
ACTIVE B12 65.000 pmol/L (25.10 -165.00)
FOLATE (SERUM) 4.14 ug/L (2.91 - 50.00)
25 OH VITAMIN D 89.50 nmol/L (50.00 - 200.00)
CRP - HIGH SENSITIVITY 0.83 mg/l (0.00 - 5.00)
FERRITIN *9.91 ug/L (13.00 - 150.0)
Here is what I've gathered/ am querying:
1) She seems to be converting well, T3 seems a tad better than the last blood but the T4 is still in the bottom of the range. TSH has dropped a LOT, but this does not seem to be reflected in the actual T4 levels. Can we increase levo to 125 mcg? She doesn't seem to have trouble with it.
2) Does she likely have Hasimoto's? TPO is closer tot he top of the range so I'm thinking yes.
3) Crucially, it seems she is anemic - likely explains things like her tiredness in the mornings, hair loss, though these are hypothyroid symptoms as well. I am thinking of asking her to take the Ferrous Fumarate, 210 mg, 3 times a day instead of twice a day. Then we will check for her thyroid levels again in a couple months along with, perhaps, an anemia profile? I can't get bloods done now and won't see her until early April.
Could you guys let me know what you think? Is there something we can do to help her lose the weight and help her with the hair loss? Is it simply a matter of waiting till T4 goes up and is in the top of the range? Shall I increase Levo? Is T3 likely not needed in her case?
Please help!
Thanks
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