Result of private blood tests after coming off thyroxine for 2 months after 20 years. Private blood test results.

[Topsy147]

I posted a question 2 months ago re coming off thyroxine after 20 years. Thanks to all who gave me advice. I have since had private blood tests and would welcome advice/comments. It seems the only abnormalities are high levels of iron, low levels of D3 and elevated thyroid peroxidase antibodies. I do not take iron supplements or eat a lot of iron rich foods. I take prescribed calcium and D3 for osteopaenia and cannot account for elevated antibodies.

[SlowDragon Administrator]

Well although your TSH is in range, your FT4 is right at bottom of range (should be at least half way in range), your total T4 is low at 69 and your FT3 is low as well. This needs to be half way in range minimum.

All this strongly suggests you need to be on Levothyroxine

In addition your high Antibodies confirm you have Hashimoto's, more commonly called autoimmune thyroid disease here in UK

With Hashimoto's you probably should be on Levothyroxine

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

[e-mail]

Your ferritin is extremely high. GP needs to investigate this.

Vitamin D is ok, but make sure to also get some sunshine through the summer. Around 100nmol is best

Folate is Ok, but likely to fall if Levo not reinstated

[SeasideSusie Remembering]

Topsy

Looking at your previous thread it seems that your GP didn't like your TSH being at 0.14 which was slightly below range.

Your new results show that removing your Levo has made your TSH rise and has undoubtedly lowered your Total T4 resulting in lower FT4 and FT3.

You have Hashi's, as SlowDragon has said, and this is where antibodies attack and gradually destroy the thyroid. The antibodies fluctuate and this can cause fluctuations in test results and symptoms.

It may be that when you had your GP test done, with the TSH at 0.14, it might have been done late in the day and after eating. If it had been done at the very first appointment of the day after an overnight fast then it might have been higher and within range. We always advice here

When booking thyroid tests, always book the very first appointment of the morning, fast overnight (water allowed) and leave off Levo for 24 hours. This gives the highest possible TSH which is needed when looking for an increase in dose or to avoid a reduction. TSH is highest early morning and lowers throughout the day. It also lowers after eating. This is a patient to patient tip which we don't discuss with doctors or phlebotomists.

If you continue without your Levo then you will most likely start to experience normal symptoms of hypothyroid as your TSH continues to rise and your FT4 and FT3 continue to decrease.

You need your Levo reinstated.

Your high ferritin should be discussed with your GP.

Your folate is actually too low, ideally it should be at least half way through range.

Vit D is recommended to be between 100-150nmol/L according to the Vit D Council.

[Topsy147 in reply to SeasideSusie]

Thanks for your reply. I'm seeing GP tomorrow to discuss

[SilverAvocado]

Hi Topsy147, You don't mention whqt question you want to answer, or how your symptoms are?

I've had a skim of your previous thread and looks like you were taken off tablets against your will, and started developing symptoms straight away?

I'm guessing you are feeling pretty rubbish now, 2 months later? Or have things calmed down?

These results look quite bad. The high antibodies shows you definitely have Hashimoto's. The TSH is about average, but that maybe means it's a tiny bit raised. But both freeT4 and freeT3 are more extreme, they are at the bottom of the range. A healthy person would be most likely to be bang in the middle.

These results look a bit mixed. The TSH hasn't raised, but the frees are both very low. I think your TSH response is a bit sluggish, as it hasn't raised high to reflect the low amount of hormone This is a shame, as doctors may take TSH too seriously. I hope the positive anti body result, plus your symptoms, will be enough to persuade them a bit. Hopefully they will understand that the frees are very low.

[Topsy147 in reply to SilverAvocado]

Thanks for your reply. I am actually not feeling too bad but am seeing GP tomorrow to discuss.

[SilverAvocado in reply to Topsy147]

Good luck!

[diogenes Remembering]

If you have been on T4 for 20 years, your TSH will only respond sluggishly to changes, perhaps over many months, to what is actually happening to your response to stopping medication. Therefore it should be completely ignored as to an indication of your present state. As others have said, your active thyroid parameters - FT4 and FT3 - are unacceptably low and after a while you will feel the effect. It simply is not responsible to chop and change at will after so long a period on therapy. I know it is tempting to stop therapy because it is a perennial responsibility, but this is NOT the way to do it.

[Topsy147 in reply to diogenes]

Thank you for info. Seeing GP tomorrow.

[Marz in reply to Topsy147]

So what did the GP say ?

[Aurealis]

Good luck, but be very careful. Perhaps write a list of any symptoms you’ve developed since stopping your meds and take these with you to GP appointment. Also keep a copy at home Ask for copy you take with you to be added to your file

You may have slowed down mentally while not taking anything and it could be difficult to get your views across during an appointment with a GP that’s excited that you’ve achieved your two months of medication deprivation. He may think he’s cured you. (What are they teaching GPs these days?)

Hypothyroidism is an insidious, creeping slowing down of all body systems and you can feel well for a while with medication withdrawn. Then suddenly you hit a brick wall. We don’t w@nt you to end up in hospital, or feeling really poorly with difficulty getting your meds reinstated later.