Test Results - Increase Levo or consider T3/NDT

[Bella53]

Good morning all - hope that where ever you are the weather isn't causing you too many problems.

After a few months of feeling well on 100mcg Levo, B12, Selenium, Ferrous Fumerate, Vit C as well as being strictly Gluten Free for 6 months I have begun to feel pretty yucky again so have had a blood test through Medicheck (my GP only tests TSH). I have posted them below with also the previous one I had last August for a comparison when I was on 75mcg Levo. I was wondering if an increase in Levo is required or if I should be considering an alternative and would very much appreciate your thoughts.

FEB 2018

TSH 0.496 (0.27 - 4.2)

Free Thyroxine 15.7. ( 12- 22)

Total T4 93.5. (59 - 154)

Free T3 3.55. (3.10 - 6.8)

TGAb 225. (0 - 115)

TPAb >600. (0 - 34)

B12 186. (25.10 - 165)

Folate 10.12 (2.91 - 50)

Ferritin 56.3 (13.0 - 150)

AUGUST 2017

TSH 0.451

Free Thyroxine 18

Total T4 109.0

Free T3 4.74

TGAb 370

TPAb >600

Both tests are through Medichecks so the range is correct for both.

Many thanks in advance for any advice that can be offered.

[SlowDragon Administrator]

Your FT4 is not very high. And FT3 is too low.

You have room to increase Levo by 25mcg. But GP may not agree.

Your folate is quite low. Do you take a good vitamin B complex, one with folate in? If not you might consider supplementing.

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Ferritin is also on low side. Eating liver once a week should help improve levels

What about vitamin D? Been tested or supplementing ?

[Clutter]

Bella53,

FT4 and FT3 are low in range so there is scope to increase Levothyroxine dose to 125mcg as long as your GP doesn't freak at low TSH.

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.

If you decide to selfmedicate you could add some T3 to Levothyroxine 100mcg or you could switch to NDT. NDT has T3 in it so you won't need NDT and T3.

Thyroid peroxidase and thyroglobulin 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_...

Active B12 is high. If you are not supplementing you should see your GP because high B12 can indicate underlying illness.

Folate is optimal halfway through range. Eating leafy green veg and supplementing folic acid or methylfolate for 3-4 months will raise folate.

Ferritin is optimal halfway through range. Eating iron rich food will raise ferritin. Liver once a week is a very good way of increasing iron.

[Bella53]

Thank you for your advice. I have been supplementing Vit B12 so have now stopped this. I am going to increase my dose by a further 25mcg of Levo and get my folate and ferritin up by the methods suggested. Will give this a try and then think about NDT. Really do appreciate your help and support once again. Even though my antibodies are still high I shall remain gluten free.