I'm new here and it looks like a helpful community.
I'm a male in my mid 30's.
Could someone help me read my thyroid test results from 3 separate dates?
I was able to see a endocrinologist recently. She diagnosed me with hypothyroidism based on her review of my medical information. She started me on a low dose of Levoxyl 25mcg once a day and a blood follow up test in 6 weeks with a re-visit with her. I was happy to have some diagnosis after suffering low energy, brain fog, always cold, etc for many years. I've been on the medicine for 1 week, day 1-4 i felt fine (maybe better than normal), day 4-7 i'm so tired and irritable. Is there an adjustment period?
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Test results:
Normal range values listed in brackets [ ] to the right of the test values.
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March 2016
TSH 1.250 uIU/ml Normal Range [ 0.450-4.500]
Triiodothyroine (T3), Free 3.3 pg,mL [2.0-4.4]
T4, Free(direct) 1.05 ng/dL [0.82-1.77]
Thyrogolobulin anitbody <1.0 IU/mL [0.0-0.9]
Thyroid Peroxidase (TPO) Ab <6 IU/mL [0-34]
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Dec 2016
TSH 0.8 mcIU/mL normal range [0.40-4.50 ]
Free FT3 3.1 pg/mL [2.3-4.2]
Free FT4 0.71 ng/dL [0.8-1.8]
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January 2018
TSH 1.10 mcIU/mL normal range [0.40-4.50 ]
Free FT3 3.5 pg/mL [2.3-4.2]
Free FT4 0.7 ng/dL [0.8-1.8]
Written by
icehenge
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As reference ranges vary from a lab to lab, we need the ranges from your lab to interpret your results. Can you please edit your post and add them. You can edit by clicking on the down arrow V below your message, choose EDIT, make changes then click on the green EDIT RESPONSE button.
The trouble with 25 ug starting doses in younger people is that they can have exactly the opposite result required. That is, they can actually partially suppress the conversion of T4 into the essential hormone T3 by the body. Much better to start with a 50 ug dose, where this temporary suppression is often not so evident.
Maybe have the Thyroid anti-bodies - TPO & Tg tested to rule out Hashimotos Also test B12 - Folate - Ferritin - VitD - in case your symptoms are lined to LOW nutrients - as often happens here on the Forum with many members ....
Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.
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 delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)
If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
About 90% of all hypothyroidism in Uk is due to Hashimoto's. Low vitamins are especially common with Hashimoto's. Food intolerances too, especially gluten. So it's important to get tested.
Thank you for the tips and details on the test to get done. I'm going to look them up and look to have some of those done on my own like you suggested. As Diogenes mentioned if this is to low a starting dose can i wait it out or will i feel like crap till the up dose to 50mcg? Would this 25mcg eventually equalize and i'd feel somewhat normal till the next 6 week checkup is what i wonder?
See how you get on, if it's unbearable, then see GP and insist on dose increase. You may be fine
Also what brand of Levothyroxine are you started on? Many people don't get on well with Teva brand.
Always 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
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 especially for brand change when dose is increased
Usually not recommended on here to take a multivitamin. They contain too little of what we do need and stuff we don't want too. Like iodine. If you have Hashimoto's you don't want extra iodine
Ok on multivitamins. Mine looks to be iodine free. I used to get sick very often. I Still get sick but the multivitamin helped so i continued. I have selenium on hand and will take that now that i know it helps. Looks like I'll have to look into scheduling a blood test to check those values though. Appreciate your help.
Here are my blood results after 8 weeks on Levoxyl 25ug.
I tested in morning, no medicine before (usually take Levoxyl in AM), and fasted.
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TSH
0.57 uIU/mL,
Range [0.34 - 5.00 uIU/mL]
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FT4 - Free Thyroxine
0.81 ng/dL,
Range[ 0.60 - 1.80 ng/dL]
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Thyroid Peroxidase Auto Antibody
<10 kIU/L,
Range[ 0 - 35 kIU/L]
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Vitamin D (25 OH)
110 nmol/L
Range [Sufficient > 100 nmol/L]
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Symptoms same about the same and sometimes no better off i'd guess.
The endo said she thought it might be Hashimotos but the Peroxidase test seems negative?
She increased my dose from 25ug to 50 ug of Levoxyl.
And I know …I said I’d test the folate, ferritin and B12 levels but I have to pay out of pocket and time was an issue. I now have the time next week and will have those test done.
I wanted to do an update though on the bloods and hear if others think my treatment sounds right?
Also just to confuse matters you can have Hashimoto's and never have raised antibodies. Diagnosis can be from ultrasound of thyroid then, Thyroid appears granular if it's Hashimoto's
Your FT4 is low, very good dose has been increased to 50mcg. Perhaps ask GP to test folate, B12 and ferritin at next Thyroid test.
Considering how low your FT4 is, your TSH should be higher
Likely to need several more dose increases in Levo. It should never be increased by more than 25mcg at a time. Retesting 8 weeks later approx after each dose increase.
NHS guidelines saying standard starter dose is 50mcgs and that majority of patients eventually need between 100mcg and 200mcg Levothyroxine
Sounds good. Thank you. I'll get that additional bloods test done and see the results. I'll post then what appears in one new message. Thanks for the help.
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Also test B12 - Folate - Ferritin - VitD - in case your symptoms are lined to LOW nutrients - as often happens here on the Forum with many members ....
I'm looking for an answer, my doctors are apparently useless.
