Results Advice Please

[Judthepud]

TSH 1.3 (0.27 -4.20)

Free Thyroxine17.100 (12.00 -22.00)

Free T34.94 (3.10-6.80)

I've been on 150mcg of Levothyroxine 4 times a week and 125mcg 3 times a week for four weeks. My past history is that I increased my dose of 125mcg daily to 150mcg last October (as my TSH was creeping up). After 3 months or so I developed extreme anxiety/feelings of panic (weight loss, nausea, diarrhoea, shaking etc etc). Thought I was over-medicated and reduced right down to 100mcg for couple of weeks, then back to 125mcg, and a Medichecks blood test (when I had just started back on 125mcg daily) showed that I was badly hypothyroid (TSH 12.5, FT4 11.9, FT3 2.86), so I continued on 125mcg for four weeks and the next blood test showed improved results, but not good enough apparently (TSH 2.94, FT4 16.200, FT3 4.62) as my symptoms hadn't got any better. So I've now been on my current dose for a further four weeks and have just got the blood results above.

Many people on this forum suggested that I had been hypo all along (even on my increased dose of 150mcg daily), which had caused my anxiety, but looking at my current results, which are heading for normal, it seems unlikely that I was undermedicated on 150mcg (as I'm taking less than that now), so if I was over-medicated, as I had thought, why did my symptoms not abate when I reduced the dose back down?? .... and what do I do now? Do I remain on my current dose for a few weeks more and see if things even out, or do I increase to 150mcg daily and risk becoming over-medicated? My anxiety's still there, although I'm aware that anxiety begets anxiety. However, over the past few days I haven't felt as tired as before, which is probably a sign that things are improving.

Please can anyone offer some advice? Thanks everyone

[SlowDragon Administrator]

Probably best to stay on current dose and retest in another 6-8 weeks

Have you had vitamin D, folate, ferritin and B12 tested?

If not, get them done next time too

[Judthepud in reply to SlowDragon]

Yes thanks, I've just had my Vit D done which was fine and my other vitamins and minerals were OK too. If I was over-medicated after 3 months on 150mcg daily, do you have any theories as to why my symptoms didn't abate when I reduced back down?

[thyroidorwhat in reply to Judthepud]

"Fine" may mean within range but not optimal. Can you post the results with ranges?

[Judthepud in reply to thyroidorwhat]

Thanks for your post Thyroidorwhat, my results were as follows:

Vit D 111.6 (greater than 50 considered adequate, greater than 220 considered toxic

B12 133.000 (25.10-165.00)

Serum Folate 19.98 (2.91-50.00)

Ferritin 53.9 (13.00-150.00)

Thyroglubulin Antibodies 14.200 (0.00-115.00)

Thyroid Peroxidase Antibodies 13.9 (0.00-34.00)

[SlowDragon Administrator in reply to Judthepud]

Can we have actual results and ranges

Suspect your gut was affected by bowel operation

B12 absorption issues possibly

Worth trying strictly gluten free diet and/or adding daily probiotic

Gluten intolerance can cause anxiety

Only make one change at a time

[Judthepud in reply to SlowDragon]

Thanks again SlowDragon, my results were as follows:

Vit D 111.6 (greater than 50 considered adequate, greater than 220 considered toxic

)

B12 133.000 (25.10-165.00)

Serum Folate 19.98 (2.91-50.00)

Ferritin 53.9 (13.00-150.00)

Thyroglubulin Antibodies 14.200 (0.00-115.00)

Thyroid Peroxidase Antibodies 13.9 (0.00-34.00)

Do they seem OK to you? Don't think the bowel operation should have affected absorption because it was my large bowel that was affected. However, I have been considering trying a gluten free diet, but haven't been able to think straight to get my head round it!

[thyroidorwhat in reply to Judthepud]

Your B12 and folate seem fine but your ferritin could be a bit higher, in the upper third of the range.

[Judthepud in reply to SlowDragon]

Yes I have had them tested results as follows:

Vit D 111.6 (greater than 50 considered adequate, greater than 220 considered toxic

)

B12 133.000 (25.10-165.00)

Serum Folate 19.98 (2.91-50.00)

Ferritin 53.9 (13.00-150.00)

Thyroglubulin Antibodies 14.200 (0.00-115.00)

Thyroid Peroxidase Antibodies 13.9 (0.00-34.00)

[greygoose]

Have you actually given us the results on 150 mcg daily in the question? They seem to me to be all on 125.

Do you have Hashi's? If so, that will explain your levels jumping around. But, your FT3 hasn't once been over mid-range. So, I rather doubt you were over-medicated on 150 mcg.

[Judthepud in reply to greygoose]

Sorry Greygoose, but I don't have comprehensive results for when I was on 150mcg daily. My TSH was checked by my GP after 6 weeks on that dose and it had come down into the 1s. I didn't start getting symptoms until a couple of months after that, and the symptoms were so bad that I reduced my dose down without going back to the GP.

My other results were as follows:

Vit D 111.6 (greater than 50 considered adequate, greater than 220 considered toxic

)

B12 133.000 (25.10-165.00)

Serum Folate 19.98 (2.91-50.00)

Ferritin 53.9 (13.00-150.00)

Thyroglubulin Antibodies 14.200 (0.00-115.00)

Thyroid Peroxidase Antibodies 13.9 (0.00-34.00)

Can these levels of antibodies indicate Hashimoto's?

Should I add 150mcg on another day (that would mean 150mcg five times a week, and 125mcg twice a week to try to bring my FT3 over mid-range?

[greygoose in reply to Judthepud]

No, I would take the risk and go for 150 mcg every day. The difference between four days and five days is so small.

Your nutrients are good, except for your ferritin. That is much too low.

Your antibodies are so low that it's rather unlikely you have Hashi's - but, you never know! Antibodies are sneaky things.

If all your Dr did on 150 mcg was the TSH, that's not much help, anyway. So, you just guessed you were over-medicated by your symptoms? That can be misleading, because so many symptoms cross over. Plus, it is possible to have hypo symptoms and hyper symptoms at the same time. The best thing you can do, I think, is to stick on 150 for six weeks, and get retested. That will probably tell us what we want to know. But, meanwhile, you do need to do something about that low ferritin. Did your doctor say it was OK?

[Judthepud in reply to greygoose]

Thanks for the advice Greygoose. I'm a bit of a coward - really scared that I might go back to square one by going back on 150mcg daily. Given that my current results are almost normal on 150mcg (4 times a week) and 125mcg (3 times a week), which equates to around 139mcg daily, that would suggest that 150mcg daily might have just tipped me over the edge into being over-medicated, isn't it unlikely that I was hypo on 150mcg, when my results are as they are today? If I added in another day on 150mcg that would equate to around 143mcg daily. What do you think?? Sorry to seem so entrenched, just really scared coz it's been such a long haul!

[greygoose in reply to Judthepud]

No way would you go back to square one! That's an enormous exaggeration. lol If you go slightly over-range, you just reduce slightly. You don't go back to 50 mcg.

TSH 1.3 (0.27 -4.20)

Free Thyroxine17.100 (12.00 -22.00)

Free T34.94 (3.10-6.80)

These results you're talking about? Your FT4 is just point one over mid-range. Your FT3 is point zero one below mid-range. Increasing by 11 mcg levo daily is not going to make you go over-range. That's an enormous jump. If it takes 139 mcg daily to get to mid-range, 150 mcg daily is not going to take you over-range. I just don't buy it.

But, if it makes you feel reassured, then increase on just one day extra and see how you feel.

[Judthepud in reply to greygoose]

You're so kind to get back to me so quickly Greygoose. My fear of going back to square one is because my symptoms didn't get any better when I reduced down the last time, and I've been feeling completely out of control since January. I really appreciate you advice though, thanks

[greygoose in reply to Judthepud]

Well, if they were hypo symptoms, they wouldn't get any better when you reduced your dose, would they? What symptoms do you have at the moment?

[Judthepud in reply to greygoose]

Anxiety, weight loss, diarrhoea, sweating, tiredness

[greygoose in reply to Judthepud]

They can all be hypo symptoms. But, if you want to increase really slowly, start by taking 150 one extra day and see how you go.

[Judthepud in reply to greygoose]

OK thanks grey goose

[greygoose in reply to Judthepud]

You're welcome.