Would you give me thyroid meds with these results?

[Hashi-hacker]

Hi, I've just had an appointment with an endo and he told me to go back to my GP as my symptoms are not related to underactive thyroid - he said he only looks at TSH and would only consider meds if it was over 7 and that all other thyroid markers are irrelevant.

Can anyone take a look at my most recent thyroid panel (medichecks and not NHS) and let me know what you think. I was there to find out if I should start thyroid meds and if not, what I should be doing to improve my symptoms. Would you have given me a trial on low dose thyroid meds??? And if not, what would you suggest???

Background: I am 46, and about 60kg. Gluten and dairy free diet, supplement with selenium, magnesium, vit C, D and K, and methylated B mix. Take 4.5ml LDN daily. Exercise 3-4 times a week. Ongoing symptoms: although my general health has improved and symptoms reduced since taking LDN and focussing on gut health, I am always tired on waking after 8 hours sleep, low mood/irritable, permanent black eyes, brain fog and memory problems.

Most recent results:

ENDOCRINOLOGYRANGEUNITRESULT

Thyroid Function

THYROID STIMULATING HORMONE0.27 - 4.20mIU/L2.01

FREE THYROXINE 12.00 - 22.0pmol/L14.3

TOTAL THYROXINE(T4) 59.00 - 154.00nmol/L82.7

FREE T33.10 - 6.8pmol/L3.01

REVERSE T310.00 - 24.0ng/dL14

REVERSE T3 RATIO15.01 - 75.014

THYROGLOBULIN ANTIBODY 0.00 - 115.0IU/mL34

THYROID PEROXIDASE ANTIBODIES0.00 - 34.00IU/mL102

HAEMATOLOGY

Vitamins

ACTIVE B12 25.10 - 165pmol/L98.2

FOLATE (SERUM) 2.91 - 50ug/L18.35

25 OH VITAMIN D 50.00 - 200nmol/L78.3

Interpretation of results:

Deficient <25

Insufficient 25 - 49

Normal Range 50 - 200

Consider reducing dose >200

BIOCHEMISTRY

Inflammation Marker

CRP - HIGH SENSITIVITY 0.00 - 5mg/l0.41

Iron Status

FERRITIN 13.00 - 150ug/L127

The only improvement in my results since Dec 2016 is that my Thyroglobulin antibody has reduced from 244 to 34, which is now within a normal range.

Thanks!

x

[greygoose]

You have Hashi's, and your FT3 is under-range. So, yes, I would have started you on 50 mcg levo. I would also give you vit D3 supplements.

That's one hell of a bad endo, you had there. Totally ignorant! I wouldn't see him again, if I were you!

[Hashi-hacker in reply to greygoose]

Thanks greygoose, I just wanted to be sure I wasn't totally off the mark thinking my results were under and I will not be back to that endo for sure! I will go back to my GP and see if I can persuade him to look at my results more closely and consider a trial of meds. The irony is that I asked to be referred to the endo as I thought I would be speaking to someone with the most knowledge/experience....

[greygoose in reply to Hashi-hacker]

Ah, no. Endos rarely know much about thyroid. They're usually diabetes specialists who think they can wing it with thyroid.

[Hashi-hacker in reply to greygoose]

Hi, I just went to see a random GP and my surgery and they actually listened however as the consultant said no to thyroid meds, they can't undermine that decision as they are not senior enough. So, they are requesting a second opinion from an endo in Glasgow, which no doubt will take months to come through. Feeling very frustrated just now!.

They suggested using a man made hormone called Tibolone, which looking at what it should be prescribed for (sweats, hot flushes), that doesn't apply to me! Any thoughts?

Cheers

Lyndsay

[greygoose in reply to Hashi-hacker]

Well, that just goes to show how much they know about hormones! I suppose one hormone is as good as another, to them. lol Tibolone is for the menopause. It's HRT. And can have a lot of side-effects. So, personally, I wouldn't take that. It won't do anything for your thyroid status or your antibodies. And, personally, I don't think they should give it to anybody without first testing their oestrogen/progesterone. I think that's most unprofessional.

[Hashi-hacker in reply to greygoose]

Thanks greygoose. I am heading towards menopause, but I've got a few years to go I'd hope! The Tibolone isn't for me. I will wear them out, one of them has to prescribe me a trial of the thyroid meds! Unfortunately you have to wait weeks to get hold of my usual, more senior, GP, but I do have patience and persistance (stubborn) on my side!

[greygoose in reply to Hashi-hacker]

You're welcome. Good for you!

[Hashi-hacker in reply to greygoose]

Hi greygoose, finally after seeing a private endo I have managed to get approval for starting meds, partially because I scored a 6 on my TSH (I know that's daft but they like their rules met) but also because my T4 and free T3 are so low. They are going for 25mcg of levothyroxine which seems a very cautious dose but it's a start. A comment from a post I made on another thread suggested that I must be over 50, have high blood pressure and/or weak heart, but I'm none of those! Anyway, just thought I'd better share the good news! x

[greygoose in reply to Hashi-hacker]

Well, as you said, it's a start - just don't forget to go back for a retest after six weeks!

Be aware that you could feel worse on such a low dose, because it's enough to stop your thyroid producing hormone, but not enough to replace it.

[Hashi-hacker in reply to greygoose]

Now that sucks! But forewarned is forearmed as they say! I'm speaking to the GP tomorrow to get the prescription sorted so wish me luck x

[greygoose in reply to Hashi-hacker]

Good luck! Fingers crossed.