feeling better but increased anxiety, help with test results

[bd79og]

I am being treated for hypothyroidism. In Feb I had the GP standard test when taking 3 days a week of 75 mg levo and 4 days of 100 (the GP thinks I'm on 100 daily as of 18 months ago but I found slightly less made me less anxious). My results were 2.89 TSH and fT4 of 12.8 (sorry no ranges as I got the result verbally from receptionist). I was feeling very tired so increased my dose to 100 every day. After 6 weeks I checked via medichecks my levels (not for my GP though). i had just had some very good days and was feeling better than for years when I took the test. The results are

ENDOCRINOLOGYThyroid Function

THYROID STIMULATING HORMONE *0.155 mIU/L 0.27 -4.20

FREE THYROXINE 21.4 pmol/L 12.00 -22.00

TOTAL THYROXINE(T4) 112.0 nmol/L 59.00 -154.00

FREE T3 4.45 pmol/L 3.10 -6.80

THYROGLOBULIN ANTIBODY <10 IU/mL 0.00 -115.00

THYROID PEROXIDASE ANTIBODIES 18 IU/mL 0.00 -34.00

HAEMATOLOGYVitamins

ACTIVE B12 *>300 pmol/L 25.10 -165.00

FOLATE (SERUM) 19.67 ug/L 2.91 -50.00

25 OH VITAMIN D 86.5 nmol/L 50.00 -200.00 Interpretation of results:Deficient <25Insufficient 25 -49Normal Range 50 -200Consider reducing dose >200

BIOCHEMISTRYInflammation MarkerCRP -HIGH SENSITIVITY 0.31 mg/l 0.00 -5.00

Iron StatusFERRITIN *154 ug/L 13.00 -150.00

I have been feeling better but still have a lot of joint pain and no smell (polyp growth may account for this). I supplement with b12 and calcium and vit D and vit k and a good multivitamin and mineral and also started taking zinc as a taste test said I was low. I have had a lot of tummy problems which may be due to accidental gluten (I am dairy and gluten free).

Could such a small increase of levo cause such an improvement in readings? Is it bad to be "over medicated?" (TSH under the range)?

I have been feeling very anxious but this may actually be normal for me (recently starting to self identify as autistic) and having a lot of potential change on the horizon. Could the increase in levo (only 75mg up per week!) be contributing to this anxiety and should I adjust the dose down again? Not collapsing every afternoon with tiredness is nice but anxiety is not!

[SeasideSusie Remembering]

bs79og

The way you have listed your test results is extremely difficult to read and very hard on the eyes. Would you mind editing your post and putting one test/result per line, eg

TSH......

FT4.....

FT3....

etc.

You can edit your post by clicking on the downward arrow V below your post, click EDIT, make the changes then click EDIT RESPONSE.

Thanks.

[bd79og in reply to SeasideSusie]

Done ! hope that is easier, the ranges are on the same line after my result for each thing

[SeasideSusie Remembering]

bd79og

THYROID STIMULATING HORMONE *0.155 mIU/L 0.27 -4.20

FREE THYROXINE 21.4 pmol/L 12.00 -22.00

TOTAL THYROXINE(T4) 112.0 nmol/L 59.00 -154.00

FREE T3 4.45 pmol/L 3.10 -6.80

FT4 is within range (94% through range) and FT3 is very low in comparison (36% through range). Your conversion of T4 to T3 is poor and you could do with some T3 added to a slightly lower dose of Levo.

Is it bad to be "over medicated?" (TSH under the range)?

You're not overmedicated just because TSH is under range. FT3 would have to be over range to be overmedicated.

**

THYROGLOBULIN ANTIBODY <10 IU/mL 0.00 -115.00

THYROID PEROXIDASE ANTIBODIES 18 IU/mL 0.00 -34.00

These are good, no sign of autoimmune thyroid disease with these results. Have you had antibodies tested before and were they raised or low like now?

**

ACTIVE B12 *>300 pmol/L 25.10 -165.00

This is very high. I would stop the B12 supplement for now.

**

FOLATE (SERUM) 19.67 ug/L 2.91 -50.00

Folate should be at least half way through it's range, you're a bit short here. Have you been taking a B Complex along with your B12 to balance all the B vitamins? If not then you should start taking one and nudge up our folate level. Igennus Super B or Thorne Basic B are very good.

**

25 OH VITAMIN D 86.5 nmol/L

This still needs a bit of work as the Vit D Council recommends a level of 100-150nmol/L. How much D3 do you take? Do you take magnesium which is another important cofactor of D3 as it helps the body use the D3.

Is there a reason that you are taking calcium? Have you been tested and found to be deficient? If not deficient then we shouldn't take it. Taking D3 aids the absorption of calcium from food anyway so your calcium level would rise.

**

FERRITIN *154 ug/L 13.00 -150.00

Areyou supplementing? You don't need this any higher, 100-130 is a good level for females.

**

I would ditch the multivitamin. They don't contain enough of anything to help and tend to use the cheapest and least absorbable of active ingredients. If it contains iron then that affects the absorption of everything else. Most contain iodine and/or calcium, neither of which should be supplemented unless tested and found to be deficient. Iodine is anti-thyroid and used to be used to treat hypERthyroidism.

**

A small change in dose of Levo can make a big difference. I have recently added an extra 12.5mcg daily and that seems to have helped me.

**

As for your anxiety, l suppose there are many reasons, but you might consider testing adrenals. If you do, then do a Cortisol Plus DHEA test with Regenerus or Genova Diagnostics (details on Thyroid UK's main website under "Private Testing"). DHEA is necessary as well as cortisol for proper interpreation of an adrenal stress test.

[bd79og]

Thank you .

I would take t3 if I could get it via my GP in the uk but as that is a huge fight here I don't feel I have the strength for that!

So it is just to take slightly less levo and lots of work on improving conversion.

My antibodies have always been below range but rose a lot when on gluten three years ago (though still below range)

I do take iron as part of a good quality mega mineral supplement from Lambert's. Just before I got really ill my feratin level was borderline low and I was told that improving this would help with my seemingly allergic to everything problem.

The reason I take calcium is I am past the menopause, on a very restricted diet (FAILSAFE with no dairy and gluten). I am careful to take it and other supplements 8 hours away from the levothyroxine. I will look into getting tested.

My D3 was insufficient two years ago and for the first year I supplemented hard with drops (around 1,000 - 4,000 IU a day and lots of sun). This winter I hoped that a lower level of supplementing (200% of the government daily recommendation would do) but it has been a long winter and I'm pleased not to be deficient.

My B12 was also very low two years ago (hence the supplementing) and my uncle has just died from a strange periperal neuropathy which runs in the family and I'm very frightened of getting.

i will save up for a cortisol test which I expect to indicate very high stress.

It is helpful for anxiety just to mention that it is getting too high and having someone respond and try to help is good so thank you for your time. I suspect I will cut the levo by 25 mg a week and see if it helps even if just to feel in control of my symptoms!