I had the medichecks blood test results 21 March . These are them
ENDOCRINOLOGYThyroid FunctionTHYROID STIMULATING HORMONE 0.85 mIU/L 0.27 - 4.20 FREE THYROXINE 17.8 pmol/L 12.00 - 22.00 TOTAL THYROXINE(T4) 86.6 nmol/L 59.00 - 154.00 FREE T3 *3.03 pmol/L 3.10 - 6.80 THYROGLOBULIN ANTIBODY 12.100 IU/mL 0.00 - 115.00 THYROID PEROXIDASE ANTIBODIES*47.5 IU/mL 0.00 - 34.00
If anyone can give advice, much appreciated?
So your high (but not very high) TPO antibodies at 47 confirm you have Hashimoto's
Your FT3 is below range (suspect you feel horrible)
Your FT4 is reasonable
TT4 could be higher, suggests room for increase in Levo
Great pity you did not have vitamin D, folate, ferritin and B12 tested too. Or has GP done them? If not ask that they do
You need dose increase in Levothyroxine to try to increase FT3. Your GP likely to refuse as TSH is low
Likely your vitamins are low
How much Levothyroxine are you taking?
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
Professor Toft recent article saying, T3 may be necessary for many otherwise we need high FT4 and suppressed TSH in order to have high enough FT3
rcpe.ac.uk/sites/default/fi...
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 gut connection is very poorly understood
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
Ideally ask GP for coeliac blood test first and to test vitamins
thyroidpharmacist.com/artic...
thyroidpharmacist.com/artic...
amymyersmd.com/2017/02/3-im...
chriskresser.com/the-gluten...
scdlifestyle.com/2014/08/th...
drknews.com/changing-your-d...
thyroidpharmacist.com/artic...
Thanks SlowDragon
This is what the Medichecks Dr responded with my results
Thyroid Check Plus21 Mar 2018
Here, I am reporting a Thyroid Check Plus.
From your medical history, I can see that you take levothyroxine for hypothyroidism.
Your thyroid stimulating hormone and thyroxine levels are in the normal range suggesting that your levothyroxine dose is correct.
However, your T3 is still low. This can occur despite normal thyroid stimulating hormone and may suggest you need your medication altered. I recommend that you see your GP with these results.
Your thyroglobulin antibodies are normal.
Your thyroid peroxidase antibodies are raised indicating a possible autoimmune basis for your thyroid dysfunction.
Dr Emil Hodzovic
MBBCh
Refer to GP : We recommend that you make an appointment with your GP to discuss your Thyroid Check Plus results in more detail.
I am back at my doctors on Monday for their blood tests
Then you need to insist on dose being increased back up, you are under medicated. Vitamins need to be tested and thyroid retested again in 6 weeks after dose increase
All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results
Research into fasting or non fasting tests
ncbi.nlm.nih.gov/pmc/articl...
Always only test 6-8 weeks after any dose change
Thank you SlowDragon. I will insist on this on Monday
Hi
Well I went back to the GP yesterday as I was showing them my medichecks results and I came out so angry from my appointment. The GP asked why I had had a private test done, I never got to tell him all the symptoms I am experiencing, he said my results were normal even though I said the results specified I should speak with my GP and have my dosage altered. He said he didn’t agree & what did I myself then want to do?!!!!! I said I was feeling anxious & agitated and he said I can see that! I mentioned I was worried about my cholesterol & BP being raised recently which was worrying me no end, this fell on deaf ears & he also said it could be other factors?!!! I said I believe it to have occurred since my doses have kept being lowered. The only new thing to come out of the visit was he is writing to an endocrinologist for me. I am so angry with my experience at the doctors, should/would anyone complain to the practice?
So are you still only taking 75mcg and how long since dose was reduced?
What dose were you on when this Medichecks test was done?
Blood should only be retested 6-8 weeks after each dose change. 8 weeks or longer after dose reduction.
Request that GP tests vitamin D, folate, B12 and ferritin.
With Hashimoto's it's extremely common for these to be too low. Then you tend to get low TSH, high FT4 and low FT3
Have you asked for coeliac blood test before trying strictly gluten free diet?
I have been on the 75mg for a month. I was on 100 when I had my medichecks done. Not had any vitamins tested when I asked should I go to have my bloods done after I had seen the doctor as I had an appointment with the nurse straight after, he said well there’s no point as you’ve just had that test done!
You say below in reply to SeasideSusie that test was done after dose reduced from 100mcg to 75mcg, but not how long after
Anyway needs retesting by GP 8 weeks after dose reduced. Ask that they test vitamin D, folate, ferritin and B12
Strictly gluten free diet helps very very many with Hashimoto's, but obviously you still need correct levels of Levothyroxine and optimal vitamin levels too
If GP won't test all these then you need private testing again
I am trying to educate myself on what I need to be doing to help myself but it is overwhelming me. Not sure what to do/day when I go and see this Endo in July
Are you still taking 100mcg Levo? How do you feel?
TSH: 0.85 mIU/L (0.27 - 4.20)
FT4: 17.8 pmol/L (12.00 - 22.00)
TOTAL T4: 86.6 nmol/L (59.00 - 154.00)
FT3: *3.03 pmol/L (3.10 - 6.80)
Your TSH is actually in a good place most of hypos are best when it's 1 or below.
Your FT4 is just slightly over half way through range which is lower than where most of us on Levo feel best, most feel best when it's up around 19 with that range.
Your FT3 is below range and confirms your conversion is poor. If you are symptomatic this will be the reason. You may need T3 added to your Levo but see comment below *
**
THYROGLOBULIN ANTIBODY 12.100 IU/mL 0.00 - 115.00
THYROID PEROXIDASE ANTIBODIES*47.5 IU/mL 0.00 - 34.00
Your TPO antibodies are above range and confirm autoimmune thyroid disease aka Hashimoto's. A strict gluten free diet and supplementing with selenium l-selenomethionine 200mcg daily an help reduce the antibodies.
**
As you have Hashi's it's possible you have gut/absorption problems which lead to low nutrient levels or deficiencies. You need to test
Vit D
B12
Folate
Ferritin
It's a shame you didn't get the Medichecks Ultravit bundle which includes them.
If you do have low nutrient levels these will need to be addressed, optimal levels will help thyroid hormone to work so *this should be done before considering adding T3.*
Sorry meant to add I was gonna n 100mg of Levothyroxine but was reduced down to 75mg 3wks ago?
Was the Medichecks test done before or after the change in Levo dose? If after then it was too soon and it's not a true indication of your levels on 75mcg, you should leave 6 weeks after a dose change before retesting.
Why did your GP reduce your Levo, have you got the results that prompted the reduction?
It was done after the dosage change & I was experiencing severe anxiety, raised cholesterol (not massively) but the racing heart was causing me concern & that’s how I got the reduction
When your dose change has had time to be fully effective, ie after 6 weeks, it's very likely that your FT4 and FT3 will be even lower and you will have more symptoms.
I think it's likely that your symptoms are due to undermedication, the Hashi's and low nutrient levels. Raised cholesterol is a sign of hypothyroidism so reducing your dose won't help.
SlowDragon knows her stuff, she has Hashi's herself, so you should check out the links she has given you., and you really need those vitamins and minerals tested.
Will do. Thank you
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