looking for review of diagnosis and treatment

[icehenge]

Hello,

I was diagnosed with hypothyroidism in early April 2018 and posted a message about that time. It was a relief to know my symptoms: achy joints, tiredness, brain fog, always cold had a cause. I’m a male in my mid 30’s and have had symptoms for years.

At this time I’m looking for a second opinion on my diagnosis and treatment so far.

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Past test results before treatment:

March 2016

TSH: 1.250 mIU/L, Range [ 0.450-4.500]

Triiodothyroine (T3) Free: 3.3 pg/mL [2.0-4.4]

T4, Free(direct): 1.05 ng/dL [0.82-1.77]

Thyrogolobulin anitbody: <1.0 IU/mL [0.0-0.9]

Thyroid Peroxidase (TPO) Ab: <6 IU/mL [0-34]

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Dec 2016

TSH: 0.8 mIU/L normal range [0.40-4.50 ]

Free FT3: 3.1 pg/mL [2.3-4.2]

Free FT4: 0.71 ng/dL [0.8-1.8]

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January 2018

TSH: 1.10 mIU/L normal range [0.40-4.50 ]

Free FT3: 3.5 pg/mL [2.3-4.2]

Free FT4: 0.7 ng/dL [0.8-1.8]

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*April 2018*

First visit to Endocrinologist. Diagnosis hypothyroidism. Started Levoxyl 25ug

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June 2018…… 8 weeks later blood tests results:

Tested in morning, no medicine before (usually take Levoxyl in AM), and fasted.

TSH: 0.57 mIU/L, Range [0.34 - 5.00 uIU/mL]

FT4 - Free Thyroxine: 0.81 ng/dL, Range[ 0.60 - 1.80 ng/dL]

Thyroid Peroxidase Auto Antibody: <10 kIU/L, Range[ 0 - 35 kIU/L]

Vitamin D (25 OH): 110 nmol/L Range [Sufficient > 100 nmol/L]

I visited the Endo after the blood draw results were in and she looked over my labs.

She indicated it was Hashimoto but with a Peroxidase not showing I wondered.

I was happy she increased my dose from 25ug to 50 though as my symptoms have no improved.

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Additional private lab test dated: 25/6/2018

Fasting: Yes. No vitamins taken for 84 hours.

Ferritin: 142 [range: 20-345 ug/L]

Vitamin B12 / Folate,

Serum Panel

Vitamin: B12 668 [range 200-1100 pg/mL ]

Folate, Serum:15.2 [ug/L Low=<3.4 , Borderline=3.4 - 5.4, Normal > 5.4 ]

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Thru some reading I thought possible central hypothyroidism (secondary)?

I don't understand why my Free T4 was so low before treatment, with TSH above it and T3 higher than both. Then my Free T4 went up with medicine slightly but my TSH went down.

[silverfox7]

Did you have all the testing done around the same time? Levels change throughout the day.

[icehenge in reply to silverfox7]

Hi,

Good question. I just checked and it looks like these labs were all in the morning between 7:30 and 9:30 am. All fasting.

[silverfox7 in reply to icehenge]

Good but may be try and get them a little closer if you can.

[icehenge in reply to silverfox7]

OK. Will do.