New to Hypo and Hashis

[AussieInNorfolk]

Hi!

It's so great to read this forum.

I was diagnosed 6 weeks ago and was prescribed Levothyroxine.

I was hoping for great improvements with my symptoms but all that has happened is my

TSH levels have reduced.

I privately tested last week for T3 and that too seems to be in range 5.06

I am thinking of going to an Endo to get a fuller picture

Any thoughts from the more experienced on extra blood tests?

[SeasideSusie Remembering]

Flansey

It can take many months to become well after starting Levo, it's a long process. It takes 6 weeks for the full effects of starting Levo (and any dose change) and very often we get good test results before we feel properly well. So patience is the key with hypothyroidism.

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. Retesting and dose increases in 25mcg increments should be done every 6 weeks until your levels are where they need to be for you to feel well.

When booking thyroid tests, always book the very first appointment of the morning and fast overnight (water allowed) . This gives the highest possible TSH which is needed when looking for a diagnosis, an increase in dose or to avoid a reduction. TSH is highest early morning and lowers throughout the day. It also lowers after eating. Also, take your Levo after the blood draw because if you take it before then your FT4 will reflect this and show higher than what is normally circulating. We usually advise 24 hours between last dose of Levo and blood draw so if you take your Levo in the mornng then delay until after the test, or if you take it at night then delay that dose until after the test.These are a patient to patient tips which we don't discuss with doctors or phlebotomists.

Take your Levo on an empty stomach, one hour before or two hours after food, with a glass of water only. Take any other medication and supplements at least 2 hours away from Levo, some need 4 hours.

If you are in the UK then many people are very disappointed with their endo appointments. Most endos are diabetes specialists with little to no knowledge of thyroid disease, you may end up worse off than just seeing your GP. If your results are in range an endo may refuse to see you anyway.

You will have seen from reading other posts that we advise full testing to include

TSH

FT4

FT3

Thyroid antibodies (both TPO and TG)

Vit D

B12

Folate

Ferritin

All vitamins and minerals need to be optimal for thyroid hormone to work.

If antibodies are raised then that confirms autoimmune thyroid disease aka Hashimoto's, and a strict gluten free diet helps reduce antibodies.

FT4 and FT3 need to be in balance so both should be tested at the same time. unfortunately that's something the NHS rarely does. It's not possible to know if good conversion of T4 (the storage hormone) to T3 (the active hormone) takes place until TSH is down to about 1.

[AussieInNorfolk in reply to SeasideSusie]

Thankyou so much for your quick response.

I will continue taking Levo and when TSH is below 1 I Will privately test T3 again. I had taken Levi morning of tests so I suppose the results may be misleading.

I now have a full range of test results. With Ferritin high antibodies high TSH high.

TSH coming down with Levo

I enjoy reading this forum and take comfort that many people are getting good responses to T3

[SeasideSusie Remembering in reply to AussieInNorfolk]

Taking Levo before a test means that the FT4 result will be higher than normal. Levo peaks in the blood up to 6 hours after taking it, so the test would measure the dose you'd just taken rather than what is normally circulating.

Have you had some of those other tests done then? Can you post the results (with reference ranges), there may be more information to pass on, particularly if you have raised antibodies.

Don't test FT3 on it's own, to mean anything g it needs to be done with FT4 and preferably TSH as well.