Test results any advice please x

[Amyvs]

Hi everyone, just got my test results back. Was diagnosed as hypo years ago and put on thyroxine, was ok until 5 weeks ago when I started feeling terrible and was told by the doc that I had gone “hyper” tsh 0.05 (0.2-2.00) t4 34 (10-20). I’m still not feeling great, any advice on how I can help myself would be greatly appreciated. Many thanks

[SeasideSusie Remembering]

Amyvs

You didn't go "hyper", that's not possible when you are hypothyroid but you were overmedicated with FT4 of 34 (10-20).

Unfortunately it's not possible to see your Medichecks results, they are too feint to read and also too small. Maybe you can either redo your picture and zoom in on the results/ranges, and if still difficult to see you could write them into your post.

Can you also mention what thyroid meds you are taking and if taking any supplements.

[Amyvs in reply to SeasideSusie]

Sorry about that. Results-

TSH 1.34 (0.27-4.20)

Free thyroxine 16.9 (12-22)

Free T3 2.78 (3.10-6.80)

Thyroglobulin anti 509 (0-115)

Thyroid peroxidase anti 349 (0-34)

Active B12 137 (25.10-165)

Folate serium 3.63 (2.9-50)

Vit D 45.2. (50-200)

CPR 0.14 (0-5)

Ferritin 189 (13-150).

Before I started to feel ill I was taking Levothyroxine 175, then doctors told me to reduce it to 100, I’m not actually taking any at the moment as I was feeling so shaky and my anxiety was off the scale! Should I start taking it again? I am not taking any supplements. Thank you for taking the time to read everything x

[Karenk13 in reply to Amyvs]

Amyvs Definitely don't stop taking your Levo altogether . Your Vitamin D is below range too you should start supplementing that as low vitamin D will generally make you feel unwell also.

[SeasideSusie Remembering in reply to Amyvs]

Amyvs

Thanks for typing them into your post

Thyroglobulin anti 509 (0-115)

Thyroid peroxidase anti 349 (0-34)

This is your problem. Did you know that 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.

When the antibodies attack, the dying cells dump a load of thyroid hormone into the blood and this can cause TSH to become suppressed and Free T4 and Free T3 to be very high or over range. These are called 'Hashi's flares' or 'swings'. You may get symptoms of being overmedicated (hyper type symptoms) to go along with these results that look as though you are overmedicated. This is most likely what happened when your FT4 was showing as 34. Unless a GP knows about Hashi's and these hyper type swings, then they panic and reduce or stop your thyroid meds.

The hyper swings are temporary, and eventually things go back to normal. Test results settle back down and hypo symptoms may return. Thyroid meds should then be adjusted again, increased until you are stable again.

Generally dose changes are in 25mcg increments, your GP did give you a rather large decrease, and stopping altogether isn't the best idea because now you've gone a bit too far the other way

TSH 1.34 (0.27-4.20)

Free thyroxine 16.9 (12-22)

Free T3 2.78 (3.10-6.80)

Your FT4 is just shy of 50% through the range and your FT3 is below range. FT3 is the important result, T3 is the active hormone which every cell in our bodies need, so we need a decent level of FT3. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it is needed for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo only.

I would suggest you restart your Levo at 50mcg then gradually build it back up, 25mcg every 6 weeks after retesting. Doubtful that your GP will agree to retesting that often, so you could just do the Medichecks Thyroid Monitoring which is just TSH, FT4 and FT3, that's all you need whilst adjusting your dose.

**

As for the Hashi's, most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.

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_...

**

Hashi's often causes gut/absorption problems which can lead to low nutrient levels. Yours aren't too bad on the whole

Ferritin 189 (13-150)

As you can see this is raised. Half way through range for ferritin is recommended. Raised ferritin can be caused by inflammation or infection. It's quite likely that the Hashi's has caused your level to be raised but I can't say for definite as CRP is also an inflammation marker and yours is nice and low.

CRP 0.14 (0-5) - excellent

Active B12 137 (25.10-165) - this is very good

Folate serium 3.63 (2.9-50) - this is way too low and you can raise folate by eating lots of leafy greens and other folate rich foods, plus a methylfolate supplement or a good quality B Complex containing methylfolate which keeps all the B vitamins in balance. I raised my folate from very bottom of range like yours, to very top of range in 2.5 months by taking 1 x Thorne Basic B capsule daily. I would recommend that but can't recommend a methylfolate supplement as I've never taken a separate one. Maybe start with the Thorne Basic B and see how it goes, I think that may be enough.

Vit D 45.2. (50-200) - too low. The Vit D Council, the Vit D Society and Grassroots Health all recommend a level of 100-150nmol/L so I would suggest that you supplement to raise this. As you have Hashi's then an oral spray is best for absorption as it bypasses the gut. BetterYou do a 3000iu dose of D3 and my suggestion would be to take 6000iu daily for 4-5 weeks then reduce to 3000iu daily. Retest 3 months after starting.

When you've reached the recommended level then you'll need a maintenance dose which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with City Assays vitamindtest.org.uk/

There are important cofactors needed when taking D3 as recommended by the Vit D Council -

vitamindcouncil.org/about-v...

D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems.

D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds.

Magnesium helps D3 to work and comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds

naturalnews.com/046401_magn...

Check out the other cofactors too.

[Amyvs in reply to SeasideSusie]

Thank you for the information, it’s really helpful

[greygoose]

Stupid doc! Your antibodies are off the scale! That's why your FT4 went so high. I just cannot understand their ignorance! It defies all logic. How can they imagine that a hypo patient can suddenly 'go hyper' or that a dose that he himself prescribed you, can suddenly make you go that much over-range? They must believe in black magic, or something.

What happened was, your immune system launched an attack on your thyroid, killed off a few cells, and the dying cells dumped all their hormone into the blood stream, causing your FT4 and FT3 to rise sharply, and thereby suppressing your TSH.

So, the levels will go down by themselves, eventually, and you will become hypo again. And, I imagine your doctor will be amazed by that, and unable to understand how it happened, poor thing. It really is incredible.

So, when were these labs done? Did your doctor alter your dose when you 'went hyper'?

[Amyvs in reply to greygoose]

The latest test was done last Friday, the other was done end of June. Yes the gp changed my dose after the test at the end of June but I haven’t taken any yet but I suppose I should? you are far more helpful than my gp so thank you. I have a appointment booked with an endocrinologist (private) next week. Do you think I should have a thyroid ultrasound? It was done about 8 years ago and showed nodules. Going abroad next week and worried about how crap I feel 😨

[greygoose in reply to Amyvs]

So, you've been off your levo for 5 weeks? According to the test above, the reason you feel crap is probably because you're a poor converter. But, if you haven't even taken any levo for 5 weeks, that's not going to help matters. You should start taking it again, but also consider procuring some T3.

[Amyvs in reply to greygoose]

I haven’t taken any for the last 10 days, I will start again. Thanks

[greygoose in reply to Amyvs]

You're welcome.