Fluctuating TSH

[healthymarge]

Every time I have bloods done my gp calls and tells me to either up or reduce my Levo. The latest result was 0.26 (0.38-5.33). Free T4 12.7 (8.3-15.6). Ferritin 47.8 (11-307) TSH in the past has been 0.63 and 3.46. On one occasion a couple of years ago gp called and said to come in urgently to the surgery as the thyroid blood test registered as 00. He was in a panic! I feel okay most of the time except for sweats, palpitations, skipped heartbeat and anxiety on/off. Any advice welcome. Many thanks!

[SeasideSusie Remembering]

To be able to compare results accurately, we need to have tests done under the same circumstances each time. We always advise here to book the very first appointment of the morning (no later than 9am), fast overnight (water allowed) and leave off Levo for 24 hours. Have all your tests been done this way?

TSH is highest early morning and lowers throughout the day so if you have an early blood draw one time and an afternoon blood draw another time then the TSH will be quite different.

Also, if you take your Levo before the blood draw your FT4 will be higher as it will ref the dose taken.

By the way, these are patient to patient tips we don't discuss with doctors or phlebotomists.

Sweats, palpitations, anxiety on and off could mean that you have autoimmune thyroid disease aka Hashimoto's. Have you ever had thyroid antibodies tested and were they raised. There are two types, thyroid peroxidase and thyroglobulin and if thyroid peroxidase is negative we need thyroglobulin tested as we may be posit for that.

Your Ferritin is too low, it needs to be at least 70 for thyroid hormone to work properly, preferably half way through range. Eating liver regularly, maximum 200g per week, will help raise your level.

[healthymarge in reply to SeasideSusie]

Thanks for reply. I always fast from the night before and take the first gp appointment. I thought the Ferritin was a bit on the low side but I'm vegetarian and have a good range of healthy foods so liver is out! I take a spoon of molasses daily and plenty green veg but guess I will have to look into upping my ferritin levels. Don't think I ever had antibodies tested and can't see them on my blood results. Would they be under a different heading?

[SeasideSusie Remembering in reply to healthymarge]

I haven't had antibodies tested on the NHS, only with a private test, but if they have been done it will only be thyroid peroxidase and it might say TPO Abs. They're rarely done in primary care and thyroglobulin (TG) would probably only be done by an endo. I think you would know if they have been tested.

As you always do your blood tests the same way, I wouldn't be surprised if you do have raised antibodies. If you do have Hashi's then a strict gluten free diet and supplementing with selenium l-selenomethionine 200mcg daily can help reduce antibodies.

List of iron rich foods apjcn.nhri.org.tw/server/in...

[healthymarge in reply to SeasideSusie]

Wow you are such a great help! Rooted through my blood tests and found one from October last year where a different gp tested my bloods and TPO Antibodies were 12 (0-24) and Free T3 4.22 (3.10-6.80). Don't see VitD tested anywhere. Will try and cut out gluten although I love my toast and honey. All the best. Marge.

[SlowDragon Administrator in reply to healthymarge]

Gluten free toast is pretty good - M&S has good range

But before starting on Gluten free diet suggest you get full testing done

Definitely get vitamin D tested and B12 and folate

For full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies. Plus vitamin D, folate, ferritin and B12.

Essential to test thyroid antibodies, FT3 and FT4, plus vitamins

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

thyroiduk.org.uk/tuk/testin...

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 both antibodies tested.

However you can still have Hashimoto's without ever having raised antibodies!

Ideally ask GP for coeliac blood test first before changing to strictly gluten free diet

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[endomad]

I had no idea quorn had aluminium my hubby loves quorn but he's not hypo. He thinks if it's good enough for Mo Farrah...so glad I grow my own fruit an veg food contamination is a nightmare. Thanks for the heads up on quorn.

[Angel_of_the_North]

Rock dust is a great addition to many soils.

[janisjlo123]

I don’t know too much about levels, but my doctor switched me from Levo to Nature Throig 1/2 gram in morning, that helped me out so much better. Just a thought

[ChrisH100 in reply to janisjlo123]

Hello jsnisjlo123 how did you manage to get dr to prescribe nature throig?

[healthymarge in reply to ChrisH100]

Trying to get courage to mention to the gp if I could give it a try😀

[janisjlo123]

I told my doctor I was feeling the same as you did.

Nature Thyroid has T4 & T3 it really helped

I just told him to switch meds and he did

[healthymarge in reply to janisjlo123]

Grand will ask him! Fingers crossed!

[janisjlo123]

See above text

[endomad]

lol hubby calls me Monty Don as i am religious with my compost heap, i have access to unlimited horse poo and chicken poo, i rely on birds for slug control and grow at least double of what i need so i dont get upset when someone has had a nibble of my crops. Lots of deer locally but they only eat my dahlias every year. I rotate my beds each year and every 5th we move the beds to another area to allow fertiliser crops like clover to enrich the soil.