I am feeling unwell see below tests

[Terry117]

Please can someone help me read these blood tests. I am taking 50 levothyroxine and 12.5 cytomel.

Teresa Wilson.

[SlowDragon Administrator]

Although your TSH is very low, your FT3 and FT4 are both too low as well. Normally with such low FT4 and FT3 the TSH should be high

When you did this blood test did you take last dose of Levothyroxine about 24hours before blood draw, and T3 about 12 hours before?

Are you prescribed T3 by endo? Or self medicating?

Do you have Hashimoto's also called autoimmune thyroid disease diagnosed by high thyroid antibodies?

Have you ever had a TPO and TG antibodies tested? If not they need testing at least once

Also absolutely essential to test vitamin D, folate, B12 and ferritin. These are often too low and can badly affect ability to use thyroid hormones

So for full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies.

Plus very important to test vitamin D, folate, ferritin and B12

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should ideally be done as early as possible in morning and fasting. If on Levothyroxine, don't take in the 24 hours prior to test, and if on T3 don't take in 12 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's. Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once.

[Terry117 in reply to SlowDragon]

I have already been diagnosed with Hashimoto’s. TPO 180.

[SlowDragon Administrator in reply to Terry117]

So if you already know you have Hashimoto's, it's very likely you have low vitamin levels

Politely insist GP tests these

Are you on strictly gluten free diet?

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, sometimes 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...

[jimh111]

Your TSH is way too low for your low thyroid hormone levels indicating your pituitary is not producing sufficient TSH. Leaving a long gap between your last tablet and taking the blood (to get a higher TSH) would be shooting yourself inthe foot. Challenge your doctor on the low TSH, fT3, fT4. Fasting makes no difference to blood test results, so don't go hungry!