Hi
May I please have results interpreted
*TSH 5.2 MIU/L (0.2 - 4.2)
FT4 14.8 PMOL/L (12 - 22)
FT3 3.3 PMOL/L (3.1 - 6.8)
*THYROGLOBULIN ANTIBODIES 613.5 IU/ML (<115)
*THYROID PEROXIDASE ANTIBODIES 376 IU/ML (<34)
Symptoms:
Sweating
Goitre
Constipation
Joint pain
Dry skin
Weight loss
Hair loss
Tiredness
Puffy eyes
Puffy ankles
Diagnosed 2011 with hypothyroid taking no Levo thankyou
Kristin
If you have a diagnosis of hypothyroidism, why aren't you taking Levo? Your TSH is over range, you should be taking some.
You have raised antibodies confirming autoimmune thyroid disease aka Hashimoto's.
Thankyou I have been told my symptoms are not thyroid related
Would you like to give us some more background information.Past results? Past doses? What symptoms? Why you've been told they're not thyroid related.
Sweating
Goitre
Constipation
Joint pain
Dry skin
Weight loss
Hair loss
Tiredness
Puffy eyes
Puffy ankles
Sweating and goitre, weight loss. Constipation, dry skin, tiredness. Some hyper-type symptoms and some hypo symptoms. Very typical of Hashi's. Obviously whoever told you they're not thyroid related doesn't know very much about autoimmune thyroid disease.
What about the other questions?
Dose changes most recent first
25mcg levo
175mcg levo
150mcg levo
175mcg levo
200mcg levo
175mcg levo
150mcg levo
125mcg levo
100mcg levo
75mcg levo
175mcg levo
150mcg levo
125mcg levo
100mcg levo
50mcg Levo
150mcg levo
125mcg levo
100mcg levo
75mcg levo
50mcg levo
25mcg levo (diagnosis)
Do I include results/dates?
Well, dose has been up and down like a yoyo, presumably as your levels have fluctuated they've changed your dose.
Just pop the dates and results with these most recent ones. Please include reference ranges for the results and hopefully you'll have had TSH, FT4 and FT3 and not just TSH tested.
25mcg levo
175mcg levo
150mcg levo
175mcg levo
200mcg levo
Ok thankyou
25mcg levo (Nov 2017)
*TSH 5.2 MIU/L (0.2 - 4.2)
FT4 14.8 PMOL/L (12 - 22)
FT3 3.3 PMOL/L (3.1 - 6.8)
*THYROGLOBULIN ANTIBODIES 613.5 IU/ML (<115)
*THYROID PEROXIDASE ANTIBODIES 376 IU/ML (<34)
175mcg levo (Sep 2017) GP didn't like TSH or FT4
*TSH 0.08 (0.2 - 4.2)
*FT4 23.6 (12 - 22)
FT3 4.0 (3.1 - 6.8)
150mcg Levo (Jun 2017) Endo liked results but I didn't, I requested increase to 175mcg
*TSH 0.02 (0.2 - 4.2)
*FT4 22.4 (12 - 22)
FT3 3.6 (3.1 - 6.8)
175mcg levo (Jan 2017)
TSH 1.89 (0.2 - 4.2)
FT4 16.2 (12 - 22)
FT3 4.1 (3.1 - 6.8)
200mcg levo (Nov 2016) GP didn't like where FT4 was
TSH 3.8 (0.2 - 4.2)
FT4 17.3 (12 - 22)
FT3 4.5 (3.1 - 6.8)
Kristin
Were any reasons given for these dose changes.
November 2016 you were on 200mcg Levo but undermedicated with a TSH of 3.8, FT4 half way through range and FT3 pretty low, yet your dose was lowered to 175mcg.
January 2017 your TSH was 1.89, FT4 less than half way through range and FT3 low yet your Levo was reduced again.
Jun 2017 your TSH went below range and FT4 slightly over range, possibly due to a Hashi's hyper-swing yet your Levo was increased from 150 to 175mcg.
In September 2017 it looks like you were still experiencing the Hashi's hyper-swing.but to reduce your Levo from 175 to 25mcg was sheer madness. Dose changes should always be 25mcg at a time. These are hormones we are taking and to deprive your body of such a huge amount in one go is ridiculous.
Have you ever been prescribed T3? Your June/September 2017 results show poor conversion and you should have had a reduction in Levo and the addition of T3.
Is this an endo or your GP who is looking after you? Whichever, they haven't got a clue. You really need to find someone who has even half a clue.
Have you had vitamins and minerals tested
Vit D
B12
Folate
Ferritin
Because Hashi's can cause low levels or deficiencies. If you've got results for those, please post with their ranges, and say if you are supplementing.
EDITED TO ADD
Just seen these results below, will comment there.
Thankyou sorry brain not working properly. Reasons added to results. Prescribed T3 but was removed. GP and endo been changing dose between them
Kristin
Who do you think was looking after you best, the endo or your GP? Really, as far as your thyroid treatment is concerned, the endo trumps the GP so your GP shouldn't be messing around with your dose.
Are any of those results when you were on a Levo/T3 combination. How did you feel when you were taking T3? Who took your T3 away? If you were doing well and showed a clinical need for it then it shouldn't have been removed and you can appeal that decision. Others will have information about that if you feel you would be better with T3 added back in.
Thankyou I felt better on levo/T3 together. The endo took it away saying he is anti T3 and if I want his help I stay off it. I felt like I had no say at all in this.
SlowDragon Do you have the information about how to appeal against T3 being taken away? Does it apply in this case as it looks like one endo was happy to prescribe it then a different endo took it away. I'm not up to speed on this I'm afraid.
Kristin87 See what SlowDragon has to say, she knows more about this than I do.
I am not sure there's anything you can do to change a narrow minded bully's views
If the endo is adamant you don't need it, just walk away
The only answer is to find a more enlightened endo
You are ENTITLED to second opinion on NHS but you may have a very long wait and definitely only request to see a T3 friendly endo (so essential to do research first on who you want to see)
You may need to go down private route
If however your endo is keen to prescribe but CCG or GP refuses to prescribe on grounds of cost, then contacting PALS, your MP, Lord Hunt, Lord O'Shaughnessy etc - it can be possible to overturn that decision
See Improve Thyroid Treatment campaign on Facebook for lots of info and letter templates for this
Thanks SD, I did think that might be the case when a second endo is anti-T3 
Suggest you get a different endo ASAP
Send him these dire vitamin levels, which are direct result of T3 being stopped
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
tukadmin@thyroiduk.org
Also request the list of recommended thyroid specialists, some are T3 friendly
Professor Toft recent article saying, T3 may be necessary for many
rcpe.ac.uk/sites/default/fi...
Thankyou my endo is aware of the vitamin and mineral levels and said the GP should be dealing with it. He is not being very helpful
That's an understatement on your endo
You will almost certainly need to be strictly gluten free
You could look at DIO2 gene test too
thyroiduk.org.uk/tuk/testin...
If you read my profile I had very long battle to get correct treatment. Tried T3 ten years ago without being gluten free and low vitamins, result was not good
Vitamins and food intolerances must be addressed
I really think you could do without this endo Kristin. If you really want to continue with an endo then send for the list of thyroid friend endos that SlowDragon has mentioned, see who is in your area and you can get to, then ask on the forum for feedback. Members will have to reply by private message if they have any information to pass on.
What symptoms do you have?
Sweating
Goitre
Constipation
Joint pain
Dry skin
Weight loss
Hair loss
Tiredness
Puffy eyes
Puffy ankles
All of them except sweating and weight loss are classic symptoms of hypothyroidism...
Sweating and weight-loss can also be symptoms of hypo. 
You're right...
At time of bloods was taking 25mcg Levo
Kristin
You were undermedicated then and needed a dose increase. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo
Absolutely essential to take high enough dose of Levothyroxine to bring TSH down to around one and FT4 towards top of range and FT3 at least half way in range
Your antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
About 90% of all primary hypothyroidism in Uk is due to Hashimoto's
Essential to test vitamin D, folate, ferritin and B12.
You vitamin levels are likely absolutely dire
Always get actual results and ranges. Post results when you have them, members can advise
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
Ideally ask GP for coeliac blood test first
amymyersmd.com/2017/02/3-im...
chriskresser.com/the-gluten...
thyroidpharmacist.com/artic...
scdlifestyle.com/2014/08/th...
drknews.com/changing-your-d...
thyroidpharmacist.com/artic...
But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood
Thankyou my results for vitamins are
*FERRITIN 13 NG/L (15 - 150)
*FOLATE 2.2 NG/L (2.5 - 19.5)
VITAMIN B12 211 PG/L (190 - 900)
VITAMIN D 30.5 NMOL/L (25 - 50 deficiency)
Taking 800IU D3 tablets
Kristin
So here we have the result of your Hashi's trashing your nutrient levels. If all you are taking is D3 then your doctor needs shooting. These are very serious deficiencies.
*FERRITIN 13 NG/L (15 - 150)
You need an iron panel and full blood count to see if you have iron deficiency anaemia, I wouldn't be surprised if you do.
You need an iron infusion to bring your ferritin level up, that will work within 24-48 hours whereas tablets will take many months.
You can also help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...
**
VITAMIN B12 211 PG/L (190 - 900)
Check to see if you have any signs of B12 deficiency here, I'd be surprised if you don't b12deficiency.info/signs-an...
You need to ask your doctor for further testing for B12 deficiency/Pernicious Anaemia.
*FOLATE 2.2 NG/L (2.5 - 19.5)
You are folate deficiency. Your doctor should prescribe folic acid but don't start taking it until after further investigations for your B12 have been carried out and B12 injections or other supplementation started.
**
VITAMIN D 30.5 NMOL/L (25 - 50 deficiency) Taking 800IU D3 tablets
Well, 800iu D3 isn't going to ever raise your level. It is hardly a maintenance dose for someone with a reasonable level. You are 0.5 away from the level where you would be given loading doses - see NICE treatment summary for Vit D deficiency:
cks.nice.org.uk/vitamin-d-d...
"Treat for Vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 30 nmol/L.
For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU] given either as weekly or daily split doses, followed by lifelong maintenace treatment of about 800 IU a day. Higher doses of up to 2000IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders. Several treatment regims are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."
Each Health Authority has their own guidelines but they will be very similar. Go and see your doctor and ask if he will treat you with loading doses as you are just 0.5 above this limit. Come back and tell us what he says and if he wont increase your prescription from 800iu then I will tell you what to buy and the dose.
Your doctor wont know, because they are not taught nutrition, but there are important cofactors needed when taking D3
vitamindcouncil.org/about-v...
D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds.
Magnesium helps D3 to work and comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds
naturalnews.com/046401_magn...
Check out the other cofactors too.
**
Whoever this doctor is who has ignored these dire results needs reporting for negligence. See a different doctor.
Thankyou results of iron are
IRON 8.2 UMOL/L (6 - 26)
TRANSFERRIN 14 (12 - 45)
Only things abnormal from complete blood count were
*MCV 78 FL (80 - 98)
*MCHC 360 (310 - 350)
OK, so your low MCV and high MCHC confirm iron deficiency anaemia which needs appropriate treatment. Have a word with your doctor (or preferably a better one who knows something and actually cares about their patient), point out your below range ferritin, below range MCV, over range MCHC, also low in range iron and transferrin results, say you believe this all points to iron deficiency anaemia and you would like treatment for it.
See NICE Clinical Knowledge Summary for iron deficiency anaemia treatment (which will be very similar to your local area guidelines):
cks.nice.org.uk/anaemia-iro...
How should I treat iron deficiency anaemia?
•Address underlying causes as necessary (for example treat menorrhagia or stop nonsteroidal anti-inflammatory drugs, if possible).
•Treat with oral ferrous sulphate 200 mg tablets two or three times a day.
◦If ferrous sulphate is not tolerated, consider oral ferrous fumarate tablets or ferrous gluconate tablets.
◦Do not wait for investigations to be carried out before prescribing iron supplements.
•If dietary deficiency of iron is thought to be a contributory cause of iron deficiency anaemia, advise the person to maintain an adequate balanced intake of iron-rich foods (for example dark green vegetables, iron-fortified bread, meat, apricots, prunes, and raisins) and consider referral to a dietitian.
• Monitor the person to ensure that there is an adequate response to iron treatment.
Take each iron tablet with 1000mg Vit C to aid absorption and help prevent constipation, and take iron 4 hours away from thyroid meds and 2 hours away from any other medication and supplements as it affects their absorption.
I will see a GP tomorrow about this, thankyou. I will be going to the pernicious anaemia forum now about my symptoms and most of them I have just that I have lived with them for as long as I can remember.
With Hashimoto's you may find vitamin D mouth spray by Better You gives Improved results as it avoids poor gut absorption of the gut. You are going to need a higher dose than 800iu.
With Hashimoto's we tend to need somewhere around 3000iu-5000iu to increase levels. Suggest you try 3000iu strength and do one spray a day for a week. If no bad reaction (unlikely) then you could increase to two sprays per day for month or two and then perhaps retesting via vitamindtest.org.uk £29
Aim for around 100nmol.
Likely to need 1000-3000iu just as ongoing maintenance dose. Retesting twice yearly ideally. You may need higher dose in winter than summer
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