Can you please help my friend?

[Bluemaxx]

Hello,

Today I am posting on behalf of a friend who also has hashimotos. She has the usual symptoms of tiredness mostly. She takes 125/100 mcg levothyroxine on alternative days and here are her latest blood test results. She used to take 125 mcg per day but the doctor changed the dose. I don't have any previous blood test results.

Any help would be enormously appreciated. Only things tested were:

TSH 0.43 (0.3-4.2)

T4 11.9 (9-23)

Many thanks!

[SeasideSusie Remembering]

Why was the dose reduced?

Are those results from before the dose reduction or on the new lower dose?

As your friend has Hashi's is she strictly gluten free and supplementing with selenium l-selenomethionine 200mcg daily to help reduce the antibodies?

[Bluemaxx in reply to SeasideSusie]

Hi Seaside Susie,

Thanks so much for replying. Those were the results after she had reduced her dose and she has being taking that dose for about a year as her earlier tests showed (according to the doctor) that she was overmedicated. She doesn't have those earlier results.

She has gone mostly gluten free and will start taking the selenium.

I have explained to her about taking further tests of vitamins and T3 and also about the necessity of going completely gluten free.

I am thinking that she could do with adding some T3 but I am not an expert and wouldn't want to tell her that without a second opinion, even though that is what I myself am doing - i.e. self medicating with additional T3.

Thanks again!

[SeasideSusie Remembering in reply to Bluemaxx]

Her FT4 is very low considering her TSH. Her FT3 will doubtless also be low. She needs to get her FT4 up higher for now, she needs an increase. Do you have a copy of Dr Toft's article in Pulse magazine where he says

"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)."

If not then email Dionne at [e-mail] for a copy and highlight question 6 and she should show that her GP and ask for a dose increase.