Do I need more Levo ?

Hello x

I've got new test results I was hoping I could hear your opinions please

I've been on Levo 50 for 3 weeks

TSH - down from 11 to 2.59

FT4 up from 12 to 18 (11-22 range)

FT3 same at 6.7 (3-6 range)

TPO antibodies 70 down from 1000 (range below 35) antibodies went down gradually, not jumped from 1000 to 70, but over the last few blood tests have gone down , now at 70

I do feel like I have a bit more energy on the Levo.

Thank you to everyone who's taken the time to reply to my previous posts

Holly x

[bantam12]

3 weeks is to soon to test, you need to leave around 6 weeks between tests.

[Hidden in reply to bantam12]

I said that too, my doctor tested again at 3 weeks because my previous FT3 was over,they wanted to monitor that x

[bantam12 in reply to Hidden]

Your GP obviously doesn't know it takes 6-8 weeks for Levo to have full effect, testing at 3 weeks will give misleading results so don't agree to any dose changes based on those tests, if he/she continues to insist on early tests just delay making an appt.

[Hidden in reply to bantam12]

Ok. are my test results ok now if they were to stay this way?

[shaws in reply to Hidden]

The doctor will be happy with your results but the aim is a TSH of 1 or lower not 'somewhere' in the range as doctors seem to think. So you need an increase of 25mcg at least.

[Hidden in reply to shaws]

Thank you 🙌🏻🙌🏻 X

[Hidden in reply to bantam12]

Also one more thing pleeeeease !!! If my antibodies dropped to below 20, and stayed there does that mean I can taper off Levo?

[shaws in reply to Hidden]

You now have an Autoimmune Thyroid Disease due to having antibodies in your blood and if we are diagnosed you are on thyroid hormone replacements 'for a lifetime'. There is no cure for thyroid disease at all - even if you feel better.

Your autoimmune condition is commonly called Hashimoto's and I'll give you a link.

Be mindful that thyroid hormones run our whole metabolism from head to toe and we have millions of T3 receptor cells in our body, if not millions. Each and every one needs T3. Levothyroxine is also known as T4. T4 is an inactive hormone and has to convert to T3. It is T3 that provides the action in our body and heart and brain need the most.

This is a link which may be helpful for you:-

medium.com/boosted/which-st...

[Hidden in reply to shaws]

Shaws , a friend of mine had a baby and ended up with high antibodies and and underactive thyroid.

After about 13 months it all went away? She has low level antibodies , -40, well below her diagnosed range, and she only took Levo for 6 months then came off it.

Does anyone have any thoughts on this ? Or other triggers of immune systems changes that can wax and wane !

[shaws in reply to Hidden]

As I'm not medically qualified but if antibodies have gone, she may still have a problem with her thyroid gland and I assume she's had a recent blood test where her TSH is 1 or lower with FT4 and FT3 in the upper parts of the range.

It could be temporary i.e. caused through childbirth but I'm not medically qualified. Usually if we are diagnosed it is medication for life.

Who told her she no longer need thyroid hormones because many people with hypothyroidism do not and never had antibodies. Only the Autoimmune Thyroid Disease - also called hashimoto's is due to the antibodies attacking the gland until the person is hypothyroid.

[Hidden in reply to shaws]

The doctor told her that after 6 months on the thyroid hormone they would stop, because it wasn't going to be permanent. This was years ago though , she's been perfectly fine ever since.

I'm just concerned that a lot of people are being told once they have antibodies they will always have antibodies and are destined for thyroid function failure in the future without question, but I feel that's not true. I've just been researching and she happened to tell me one day about her story x

[jimh111]

Going by your numbers you do not need more levothyroxine at the moment. Your blood test was after three weeks so you have accumumlated about 7/8 ths of your most recent dose increase (based on the one week half life of levothyroxine).

You had very high antibodies and your fT3 was elevated. This is almost certainly due to the antibodies attacking your thyroid and causing it to release excess hormone. It tends to release excess T3 when this happens. In time your thyroid will die away and you will need further levothyroxine dose increases but not at the moment.

Your doctor was really on the ball in doing the blood test after three weeks. It gives long enough to give a rough estimate of fT4 levels, perhaps only 85% accurate but more importantly keeps an eye on your fT3 to see that it isn't going too high. It's rare to see a doctor with this level of expertise and common sense.

At the moment your overall hormone levels look a little high but they seem to be settling down. You will continue to have problems and variable hormone levels until your thyroid has finally packed in. There's not much you can do about that, continually adjusting your levothyroxine dose wouldn't help. Time will heal.

Sometimes thyroid antibodies can interfere with the TSH assay giving false high results. You had very high antibody levels so perhaps this might explain why your TSH was not low with your high fT3 levels. Your antibody count is much lower so it's ancient history now.

It seems the levothyroxine is helping to give you more stable levels but 50 mcg is not a lot, most of your fT4 figure will be coming from your thyroid so as it continues to fail you will need more levothyroxine in the future. It's important to keep an eye on your fT3 figure as I suspect this is having the most effect on how you feel.

[Hidden in reply to jimh111]

Wow thanks so much for this reply

Yeah my doctor did say my early test was from concern about the high ft3.

but, my doctor (who I'm lucky is also and endo) , seems to think that my hashimotos is viral. it's me who's Insisted on trying thyroid hormone. He was happy to let it take its course. He said thyroid antibodies can be present in lost of thyroid diseases, but won't always mean lifelong hahsimotos in the end. Do you have any thoughts on this?

[jimh111 in reply to Hidden]

The thyroid can come under transient attack and recover without the need for hormone tablets. This often happens just after a woman has given birth. Many people have high thyroid antibody levels, the are much more likely to become hypothyroid at some stage of their lives (8x as likely I think, can't remember the number) but there is no guarantee they will. Antibody levels fluctuate and can come and go. So yes he is right, sometimes antibodies lead to hypothyrodism and the life long need for thyroid hormone tablets and sometimes they cause a problem for a while and then just go away or even stay put and do nothing.

Your doctor is in a good position to make a judgement and I would go with their conclusion. Even if they have lots of knowledge and experience and were the perfect doctor they could make the wrong judgement, that's just the way our bodies work. What he says seems very reasonable. Your antibody count has come down really quickly which is unusual and suggests his suspicions of a viral infection is correct. Really only time will tell and we can all be smart in retrospect.

I'm a patient not a doctor.

[Hidden in reply to jimh111]

jimh I'm so happy you've replied to my post today !! thank you so very much for your advice !! So nice to hear someone agreeing with my doctor instead of saying he's doing the completely wrong thing for me. So I'll stay on this 50 for another 6 weeks and test again.

I feel so much more reassured now , thank you !!!!!

[Laundretta]

Hi Holly,

It was nice to see a positive update, great news that you stuck with it and feel better for it!

[Hidden in reply to Laundretta]

Thank you !! I'm feeling hopeful I'll just have to see what happens over the long term. Thanks a lot x