So glad I was recommended to check out this forum. Lots of support and advice for those in need. I had no idea so many people are suffering 🙁
I’d be grateful for some collective thoughts on recent blood tests. In a nutshell, I have Hashimotos (no antibodies in testing) struggling big time on Levothyroxine (50mcg), it’s poisoning me. Realise I’m likely to be undermedicated at the moment but cannot tolerate any more Levothyroxine - I’ve tried. Not having good experience with endocrinologist either. NDT is the next step so will be looking for some advice on how to “phase in” with that 🙂
TSH 1.49(range 0.27-4.20)
Free T4 14.47(range 12-22)
Free T3 4.2 (range 3.1-6.8)
Total T3 1.8 (range 1.3-3.1)
Iron 9.5 (range 5.83-34.5)
Ferritin 100.4 (range 13-150)
B12 1209 - 3mthly injections (range 197-771)
Serum Folate 5.45 (range 3.89-26.80)
Vitamin D 123.4 (range 30-250)
Coeliac - negative
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Angie_Phalange
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As you have B12 injections its recommended on here to also supplement a good quality daily vitamin B complex, one with folate in not folic acid eg Igennus Super B or Jarrow B-right
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results
Are you on strictly gluten free diet? If not it's likely to help
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
Your results suggest you are under medicated. FT4 should be near top of range (around 20) and FT3 at least half way in range. You most likely need 25mcg dose increase in Levothyroxine
All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 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)
Is this how you did the test?
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.
Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor please email Dionne at
tukadmin@thyroiduk.org
If FT3 remains low when FT4 finally gets high enough after dose increase(s) then next step is to ask Endocrinologist for trial of T3
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