If you can add the reference ranges to your results, we will be able to interpret them. Ranges vary from lab to lab so we need the ranges from the lab that did your tests
Can you also say how you feel on your current dose please, if you are symptomatic in any way.
You haven't said how you feel so I can only just comment on what the results mean.
TSH 0.405 mIU/L 0.27 - 4.20
Free Thyroxine 22.7pmol/L 12.00 - 22.00
T4 136 nmol/L 59.00 - 154.00
Free T3 5.2/pmol/L 3.10 - 6.80
TSH is good, FT4 just very slightly over range (107% of range), FT3 is well within range (56% through range) and this is the important result, it tells us if we are overmedicated or not. FT4 and FT3 aren't particularly well balanced as they should both be balanced in the upper part of the range. However, if you feel well on your dose that's fine, if not then Levo dose could be a bit lower and some T3 added.
Both types of antibodies are raised, so this confirms autoimmune thyroid disease aka Hashimoto's, which is where the antibodies attack and gradually destroy the thyroid. The antibody attacks cause fluctuations in symptoms and test results.
Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.
You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks. You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.
Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.
Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies. Yours aren't too bad but some improvements can be made.
Active B12 93.100 pmol/L 25.10 - 165.00
This isn't low enough where it's recommended to test for B12 deficiency (<70) and as long as you have no signs of B12 deficiency - check that here b12deficiency.info/signs-an... - then you could raise it by supplementing with sublingual methylcobalamin lozenges 1000mcg daily.
When using B12 we need a good B Complex to balance all the B vitamins.
Folate Serum 8.93 ug/L 2.91 - 50.00
This is too low, it's recommended to be at least half way through it's range. Eating leaf greens and other folate rich foods will help, as will the B Complex but choose one containing 400mcg methylfolate, eg. Thorne Basic B, Igennus Super B.
25 oh vitamin D 63.5 nmol/L 50.00 - 200.00
The Vit D Council recommends a level of 100-150nmol/L so you could do with increasing yours. As you have Hashi's then an oral spray will give better absorption, eg BetterYou. They do a 3000iu dose one and that should be fine.
There are important cofactors needed when taking D3
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
BetterYou do a combined D3/K2 spray which may be better for you.
CRP - High sensitivity 1.58 mq/L 0.00 - 5.00
This is an inflammation marker and well within range so that is fine.
Feritin 75.9 uq/L 13.00 - 150.00
This is fine, recommended is half way through range, with a level of at least 70 for thyroid hormone to work. If you eat liver, then having it once every couple of weeks should maintain your level.
Hi, Many thanks for your reply. How I am feeling at present:
Six weeks ago when I started taking 100 levothyroxine I felt great but as the weeks have wore on I am feeling less great. The tingling in my feet is back, together with lightheadedness. I also have double vision corrected to a degree with prisms in my specs. That seem to get better but is slowly going backwards again. Tinnitus is also getting louder - hospital appt coming up in July. , Insomnia - sleeping 2-3 hours then waking up, reading, sleeping again 2-3 hours. Aching muscles and cramp. Memory is not good either. I have mastered the idea of lists in order to survive.
You are likely to benefit from strictly gluten free diet
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
I think your nutrient levels may have something to do with your symptoms.
Tingling and tinnitus can be low B12, so I would supplement as suggested.
Muscle (and joint) aches and pains can be low Vit D so that needs improving.
Cramp can be helped with magnesium. There is a topical spray or cream that might help, or supplement in powder or tablet/capsule form.
Insomnia - I can't help much there because my sleep isn't brilliant.
Memory - yes, lists are wonderful
I am virtually the same age as you, but I have been taking thyroid meds since about 1975. My GP is TSH obsessed so I do have to battle there. But I have given up trying to get them to understand it's about thyroid hormones being good, not the TSH. So I self source T3 and add it to my Levo. I could not survive on Levo alone because I wasn't converting well enough.
Wow. I could have done with speaking with you years ago. Thanks for the advice and reading matter. I will definitely start with the vitamins as you suggest and see where that leads. If I go down the T3 route can you suggest supplier of T3.
You may find that optimising nutrient levels and addressing the Hashi's will make a big difference, so do that first, give it a few months, retest everything and then we can look at your thyroid results and see whether T3 would help.
Do check out SlowDragon's links, she is our resident Hashi's/gut/absorption expert.
Don't start all supplements together. Start with one, give it a week or two and if no reaction then add in the second one, give it another week or two and if no reaction add in the next one, etc. By doing it this way, if you do have any reaction you will know what caused it.
I agree.Thanks for SlowDragon's links. I totally understand the link to me as I was originally diagnosed with asthma then that changed to acid reflux which after trying medication I decided on diet and it worked a treat.
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