Update on Bloods results: Hi all, Just had a... - Thyroid UK

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Update on Bloods results

hilary33
hilary33

Hi all,

Just had a telephone consultation with my GP regarding the latest blood results.

10.4.18 - TSH 0.05 (0.27-4.20), T4 9.7 (12.0-22.0) TPO 174 (Taking 1 Thyroid S)

12.3.18 - TSH 0.05 , T4 21.08, T3 16.4 (taking 2 Thyroid S which I had reduced from 3)

5.3.18 - TSH 0.05, T4 24.7, T3 16.4 (taking 3 Thyroid S)

She had advised me on 12.3.18 to stop all NDT for 4-6 weeks because previous results showed I was Hyperthyroid. However I did not feel I wanted to go that far and reduced my Thyroid S from 2 to 1. My basal temperature has dropped from 35.8 to 35.2, my resting heart rate dropped from 74 to 60 (taken before rising) I have gained approx. 3 kilos in weight, am extremely cold and have cramping in legs and feet. I accept I was hyper and had to reduce, which I did, even though I had no symptoms of being hyper.

I know I cannot do without thyroid supplement whichever form I take, however today she told me I am still Hyper because my TSH was 0.05 and to stop all supplements and we will retest in 6 months. I said I didn't see how I could be hyper with a T4 reading of 9.7, but she would not listen and said the TSH showed I was hyper - end of. I wish I could find a GP who understands what they are talking about!

13 Replies
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SeasideSusie
SeasideSusieAdministrator

Hilary

Why are you dose changes is increments of 1 grain? With NDT 1/4 grain dose changes are best so you don't miss your sweet spot.

Why wasn't FT3 tested on 10.4.18 - it's most important when on NDT (or T3) to have FT3 tested. TSH is going to be suppressed (or very low) and FT4 is usually low when taking any T3 containing meds (pity your doctor doesn't know this) so it's FT3 that we need to keep our eye on and it's best to keep that within range.

Your doctor should also be aware that you can't suddenly become "hyperthyroid" when you are hypothyroid, it's an impossibility. You can be overmedicated though.

You know from your current symptoms that you are now hypothyroid and undermedicated, but Hashi's (as confirmed by raised antibodies) makes test results fluctuate as and when the antibodies attack so dose adjustment may be necessary during those times.

In your shoes with your current results, before agreeing to come off NDT (which I wouldn't do anyway), I would insist FT3 is tested. If it's low you need an increase in dose but do it gradually - 1/4 grain at a time.

I have my doubts that there is any GP who actually knows what they're talking about where hypothyroidism is concerned, especially Hashi's and NDT.

Thank you for your reply SeasideSusie.

The reason I had reduced in 1 grain at a time was the results showed I was overmedicated and since the GP wanted to test again in 4-6 weeks, I thought it best to reduce more quickly to see if she would be happier with the new results. Sadly this was not the case and I think she doesn't know what will happen to me if I stop my meds altogether!

If you are taking NDT, why do you need the doctor at all? She obviously doesn't understand blood results or dosing when on NDT, and I'm assuming you are buying it yourself. You could just pay for blood tests and DIY.

Thank you for your reply Angel of the North. I propose to do just that, although my daughter is very anxious that I don't do anything to endanger my health. I have tried to point out to her that listening to my GP will do that!

Or just tell the GP you are changing to levo. Get the free prescription and ignore it, and continue as you are. Don't tell anyone - it's your body. Of course, GP will be very confused by bloods, but hey, let her worry.

Thank you - that made me laugh!

SlowDragon
SlowDragonAdministrator

What are your vitamin levels like after such reduction in dose?

Low vitamins can lower TSH

Do you have Hashimoto's?

hilary33
hilary33 in reply to SlowDragon

Thank you for replying SlowDragon. I had private bloods done on 15 December (before reduciing my Thyroid S). Vitamin B12 740, Vit D 39, Folate 13.5, Ferritin 128. Would these have reduced much in the intervening period. Yes I have Hashimoto's in December TPO 172.0 and on 10.4.18 174.

hilary33
hilary33 in reply to SlowDragon

Thank you for replying SlowDragon. I had private bloods done on 15 December (before reduciing my Thyroid S). Vitamin B12 740, Vit D 39, Folate 13.5, Ferritin 128. Would these have reduced much in the intervening period. Yes I have Hashimoto's in December TPO 172.0 and on 10.4.18 174.

SlowDragon
SlowDragonAdministrator in reply to hilary33

Assuming in UK Vitamin D is in nmol and much too low.

If abroad it will be ng/ml

endmemo.com/medical/unitcon...

As you have Hashimoto's Better You vitamin D mouth spray is good as avoids poor gut function . Aim for around 100nmol. Ideally retested twice yearly. You will likely need a maintenance dose to keep levels up

Folate looks low, but need ranges on all these to be sure

Have you tried strictly gluten free diet?

hilary33
hilary33 in reply to SlowDragon

Thank you for replying again SlowDragon.

Sorry, Vit D mistyped as 39 is in fact 139 nmol/L. Vit B12 740 pg/ml (197-771).

Folate 13.5 ug/L >2.9 (with the following comment: Note new reference range effective 03/04/2017. If no change in dietary habits, a normal serum folate makes folate deficiency unlikely). Ferritin 128 ug/L (13-150). TPO 264.0 IU/mL (0 -34) TG 172.0 IU/mL (9-115). These results were from Blue Horizon. I have been Gluten free for more than a year.

SlowDragon
SlowDragonAdministrator in reply to hilary33

Do you find gluten free gave improvements?

Yes, your vitamin D at 139 is excellent

Folate. I do wish they would put a top of range. It's very difficult to assess like that

Personally I take a good vitamin B complex with folate in to help keep folate levels up.

Any medication with T3 tends to lower TSH right down. It's the FT4 and FT3 that are important. Perhaps you had hashi flare.

Keep testing every 6-8 weeks until levels stabilise

hilary33
hilary33 in reply to SlowDragon

Thanks again SlowDragon. I have to say I haven't felt any different with Gluten free diet, however my TPO antibodies have reduced from 329.4 in 2016 to l74 to date, so I assume it is doing something.

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