High antibodies and low fT3; should I take T3 or source NDT?

[Kwizzbit]

Please could someone help me to understand my results. I’m on 125 levo . Also very very high vitamin b 12 levels but I don’t take supplements so am worried about that

[SeasideSusie Remembering]

Kwizzbit

What you actually need at this stage is to increase your Levo, you are undermedicated.

You haven't put the ranges in, but for Medichecks I know they are

TSH: 3.13 (0.27-4.2)

FT4: 16.9 (12-22)

FT3: 3.9 (3.1-6.8)

The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo if that is where you feel well. So you need an increase in Levo to get your TSH down to around 1, and your FT4 is currently 49% through the range and FT3 is 21% through the range. Increasing Levo will raise your FT4 and once your TSH is around 1 we can see how well you convert T4 to T3 by seeing your FT4 and FT3 results together at that time.

Your raised antibodies mean that you are positive for autoimmune thyroid disease aka Hashimoto's which is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results.

You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks. You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.

Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.

Gluten/thyroid connection: chriskresser.com/the-gluten...

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

thyroiduk.org.uk/tuk/about_...

Your Vit D is on the low side, it's recommended to be 100-150nmol/L so that needs improving.

Can't comment on Folate without the range.

Where's your ferritin result?

[Kwizzbit in reply to SeasideSusie]

Many thanks for the information. I’d been in denial about going GF but if it’s going to help me get better I will. My ferritin is 70.3 and the range is 13-150. So I’m on 125 levo. So I need to increase my dose and get my TSH down to 1? It’s alarming that the reception doctor at my GP surgery said I’m fine and Thyroid results are in range... I’m seeing a endocrinologist called Dr Gruber in September and hoping for T3 therapy. Is the B12 level something for concern as I don’t take supplements so have no idea why it’s so high and I’ve read it’s common to be deficient in b12 with Hashimotos?

[SeasideSusie Remembering in reply to Kwizzbit]

Kwizzbit

Ferritin is just about OK, it should be half way through range.

The receptionist was correct, your results are in range, but it's where in range that is important and this is where doctors don't seem to understand.

As I said, most hypo patients feel best when TSH is 1 or below with FT4 and FT3 in the upper part of their ranges. You need an increase in dose of Levo at this point. Ask your GP and to support your request use the information in the article by Dr Toft in Pulse magazine where he said

"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)."

Dr Toft is past president of the British Thyroid Association and leading endocrinologist. You can obtain a copy of the article by emailing Dionne at ThyroidUK

[e-mail]

Print it and highlight question 6 to show your GP.

You need TSH down to 1 before you can know if you need T3, as explained above.

You also need optimal nutrient levels for thyroid hormone to work so you need

Vit D - 100-150nmol

Folate - at least half way through it's range

Ferritin - maintained at half way through range

If you're concerned about your Active B12 being 2 points over range then I would discuss it with your GP or ask over on the Pernicious Anaemia Society forum here on Health Unlocked.

[SeasideSusie Remembering]

PS

I believe the Active B12 range is 25-165 so you are only 2 points over range. If you are worried about that you should discuss it with your GP.