I was diagnosed with Hashimoto's in 1986 and was taking 150mcg Levothyroxine for many years. Upped to 175mcg about ten years ago after routine thyroid test. For the last few months symptoms have appeared eg fatigue, breathless on exertion, swollen tongue with sore tip, blurry vision, memory loss, backache etc. so was sent for ECG (which was normal except for 'sinus bradycardia') and blood tests.
Blood results:
Anti TPO Ab 18 (0.00-34.00)
Serum iron 24 (5.80-34.50)
Serum transferrin 2.9 (2.02-3.36)
Transferrin saturation index 33.1 (20.00-55.00)%
Serum free T3 4.4 (3.10-6.80)
Serum free T4 19.5 (12.00-22.00)
Serum TSH 0.04 (0.27-4.20)
Serum ferritin 152.4 (13.00-150.00)
Serum folate <2.0 (3.90 - 26.80)H
Serum B12 412 (197.00-771.00)
Serum Vitamin D 21.7 (50.00-120.00)
Serum CRP 2 (0.00-5.00)
HbA1c level 37 (20.00-41.00)
GP has given prescription for folic acid and Vitamin D tablets.
Written by
randomlil
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Your B12 is also on low side. Many of us also take a vitamin B complex, one with folate in rather than folic acid, and if you have any low B12 symptoms you might also add a daily sublingual B12 lozenge
Your FT3 is on the low side. The conversion may have been affected by low vitamins and improve once vitamins are optimal
Suggest retesting in 2-3 months
If FT3 remains low and you feel unwell then you either need dose increase in Levo or addition of small dose of T3
TPO antibodies are low, suggest you don't have Hashimoto's
Have you ever had TG antibodies tested?
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
Also request list of recommended thyroid specialists, some are T3 friendly
Professor Toft recent article saying, T3 may be necessary for many
Also as you were originally diagnosed with Hashimoto's are you on strictly gluten free diet?
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
Thank you SlowDragon for your reply. The Vitamin D3 capsules are 3,200 IU and I've to take one daily for 12 weeks then reduce to lower dose as maintenance. The folic acid are 5mg and one a day.
I have a phone appointment with my GP in ten days time to discuss thyroid levels as the printout from the lab has an exclamation mark next to the Thyroid function test and says 'Abnormal - contact patient'.
I have never been on gluten-free but also never tested for this. My mother had Hashi's and my grandfather Pernicious Anaemia.
I am very overweight although exercise regularly and two years ago cut out sugar and reduced portion sizes and managed to lose just over two stones in about nine months. I was fine and didn't have any hyper symptoms but my annual blood test showed FT4 over range (can't remember by how much) and my levo reduced to 150. Follow-up after 6 weeks showed TSH still below range and FT4 still slightly high so reduced again to 125. After a few weeks I was like a slug, depressed and almost falling asleep at work and hair falling out in clumps. It became a joke that if I asked who wanted tea or coffee, they would either get the wrong drink or I would put the kettle on and forget to make any at all. I was so forgetful I became worried that if I set off in the car I'd forget where I was going and end up driving round in circles, LOL.
GP is worried that if my TSH is suppressed I might get heart problems or osteoporosis, but I only feel well on 175. I'm going to try to lose weight again as I have put it all back on, but ask for a test sooner this time.
Prof Toft recent article in my reply above says exactly that, often we need high FT4 and suppressed TSH in order to have high enough FT3
Your FT3 is currently likely to be too low for you are under 5
Other option is to add small addition of T3, but due to extortionate cost charged to NHS it's now extremely difficult to get prescribed on NHS. Though some of us manage it.
Private prescription would enable buying cheap T3 from France or Germany
But would investigate possible B12 issues first
Perhaps ask advice on PAS about lowish B12, family history and the fact you have low folate and GP has prescribed folic acid. (Correcting low folate without addressing low B12 can make low B12 worse)
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Advice on blood test result please
Blood tests results advice please... 
Blood test results - advice please
Edited to show results in text: Blood results advice please
Blood test results - advice please.
