Hi All - new here. Advice on Hashi test results... - Thyroid UK

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Hi All - new here. Advice on Hashi test results and Liothyronine etc please!

zola25
zola25

Hello everyone.. I could really do with some help wading through all the information Ive finally got about my condition. Many thanks in advance for reading this

A little bit of background - originally diagnosed and prescribed thyroxine in 1990 - Ive been given this increasing amounts ever since. Two years ago an endocrinologist diagnosed me with Hashimotos and bumped up the thyroxine to 350mg per day.

In January my total inability to lose any weight despite following strict Slimming World rules and exercising daily made me finally realise that I actually need to take my condition seriously and to start understanding what is going on. In addition, for the last year or so I ache all over - sometimes so much that I cant get out of bed. Im constantly fatigued but cant sleep.

I researched the condition and went back to my doctor insisting that something be done - that I could not see how I could live with feeling so awful every single day.

Id read on forums that sometimes a lack of T3 can mean that the thyroxine is not working so I requested that the doctor carried out a full blood test ..

Following the test the doctor has raised my thyroxine to 400mg per day and also prescribed Sodium Liothyronine 10 micrograms per day....

I have the results but would really appreciate some kind of insight into what they mean and how the drugs will help/affect me

so..

Serum free T4 level - 17.7pmol/L

Serum free triiodothyronine 4pmol/L

Serum TSH level 7.5mU/L High asssuming full compliance and no recent change in thyroxine doseresults indicate underreplacement. Original result 7.5 mU/L (0.35-5.0)

Vitamin D - 93nmol/L

Are the more tests that I should have asked for (they may be on the huge list of results from the blood taken - Ive identified these as most obvious/recognisable)

Any help with this would be very, very gratefully received.

Thank you

8 Replies
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SlowDragon
SlowDragonAdministrator

Can you add ranges on those results

You are taking a very large dose of Levothyroxine and T3, but results are poor

This suggests you may have very poor gut function and malabsorption

Likely low vitamins

Have you had B12, folate and ferritin tested? Add results and ranges if you have them. If not ask GP to test these

Your vitamin D is good. Presumably you supplement?

As you have Hashimoto's are you on strictly gluten free diet? If not you probably need to try it

Hashimoto's affects the gut and often 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. Dairy is second most common.

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)

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

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

thyroidpharmacist.com/artic...

But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood

Presumably you know to take Levo on empty stomach and then nothing apart from water for at least an hour after. Many take on waking, but it may be more convenient and possibly more effective taken at bedtime

verywell.com/should-i-take-...

Many people find Levothyroxine brands are not interchangeable. Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased

All thyroid tests should ideally be done as early as possible in morning and fasting.

If on Levothyroxine, don't take in the 24 hours prior to test, and if on T3 don't take in 12 hours prior to test, delay and take straight after

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

Other gut issues can be low stomach acid and/or gut infections such as H Pylori

drmyhill.co.uk/wiki/hypochl...

scdlifestyle.com/2012/03/3-...

hypothyroidmom.com/hashimot...

I think you might ask for referral to gastroenterologist

zola25
zola25 in reply to SlowDragon

Dear SlowDragon

Thank you so much for this - amazing information - a lot of it new to me.

Re ranges =- there is nothing given on the printout that the doctor gave me - only the numbers quoted.. what are these ranges and how would I get them?

I asked about B12 - he said that it wasnt tested but "other results" (haemoglobin possibly) indicated that it was OK (I take B12 and Vit D supplements)

I'm so fighting the gluten-free route until I really have to - probably not a great move I know .. just feeling overwhelmed by it all tbh

I really tempted to go for the full Medichecks Thyroid test (Ultra) - maybe theyde give me more information.. any thoughts??

Thanks so much again

SlowDragon
SlowDragonAdministrator in reply to zola25

You could ring receptionist and ask for ranges. Or for the name and phone number of the laboratory that did the tests

I think I'd ask GP to do Coeliac blood test and to test ferritin and folate.

Also discuss possible referral for investigation by gastroenterologist. Endoscopy to check for H Pylori etc

If you are supplementing B12 it's not likely to be low. But you might want to add a good vitamin B complex to keep all B vitamin levels balanced

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...

Possibly consider experimenting taking Levo with vitamin C to improve absorption

thyroidadvisor.com/effects-...

ncbi.nlm.nih.gov/pubmed/246...

How do you take your hormone? Do you take it on an empty stomach, leaving at least an hour before eating or drinking? Do you take any other supplements - such as vit D - or medication at the same time?

zola25
zola25 in reply to greygoose

Well I take 400mg thyroxine in the morning - I try and leave an hour but must admit that I assumed the 'leaving an hour' also referred to after eating.....

I take the liothyronine with it (20mcg every two days)

I take sertraline at the same time

The vitamins I take either at the same time or in the evening (if Ive forgotten in the morning)

greygoose
greygoose in reply to zola25

OK. So, I don't really understand what you mean by assuming that 'leaving an hour' also referred to after eating. But, if you're taking your sertraline and vitamins at the same time, that explains why you're not absorbing it.

Thyroid hormone should be taken on an empty stomach, on it's own, at least one hour before eating or drinking anything other than water. And that means an hour without putting anything else in your stomach. You should also taking it at least two hours away from other supplements or medication - like sertraline - and four hours away from iron, vit D, calcium, magnesium or estrogen.

Also, you cannot take T3 like that. You can do it with T4, taking one dose one day and a different dose another day, but with T3 you need to take a regular, steady dose. So, 10 mcg a day, not 20 every other day, which will confuse your body. :)

Have you checked to see how Setraline affects your Thyroid Meds - if at all ?

zola25
zola25 in reply to Marz

no - maybe a good idea - Im now trying taking the sertraline in the morning as usual and the thyroxine later in the day to see if that helps but Im paranoid it will give me even worse insomnia

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