From hypo to hyper? My doc is confused

[Bilou]

So last year I hit menopause, had my appendicitis removed, had CMV Iprobably still in my system) and then hypothyroid.... unreal...have been treated on 50 synthroid since september.... helped a lot.... less tired and body temperature regulation normal.... Then for the past 3 months, I am always hot, cannot stand the heat, eat more, my hands sometimes tremble, tired all the time, more anxious and depressed or discouraged - I am so sick of it.... The last two tests were done 3 weeks apart to check my numbers. TSH 0.03 / T4free 16 and T3 15 - they are consistent. Checked for antibodies - negative.... Now the doc says it is perhaps I am having to much medication... and is sending me to an endocronologist... because he says I am now hyperthyroid.... waiting to get an ultrasound of my thyroid.

ME? CONFUSED!!! What can I do.... ?

TIA

[SlowDragon Administrator]

Have you had thyroid antibodies tested for Hashimoto's?

This is autoimmune thyroid disease (by far most common reason for being hypothyroid)

GP needs to test TPO and TG antibodies

Or if Graves' disease (hyperthyroid) you need TSI or TRab antibodies tested

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

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

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

List of hypothyroid symptoms

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

Low vitamin levels are common with both

For full hypothyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies and also very important to test vitamin D, folate, ferritin and B12

Post results and ranges if you have them already

Come back on new post, if need to get them tested

All thyroid tests should ideally be done as early as possible in morning and fasting. When on Levothyroxine, don't take 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)

[Bilou in reply to SlowDragon]

Antibodies negative.

B12 482 - above 220 so normal

Ferritin 186 (12 - 223)

ALT above normal 43 (should be below 36) - working hard cause I have cmv for the past year

TSH 0.03 (0.035-5)

FT4 16 (12-22)

Thyroid peroxidase ab is that TPO? 15 (should be under 35)

for your last comment - wow.... was never told about that bty GP.... will do next time

[SlowDragon Administrator in reply to Bilou]

These results are from when on 50mcg Levothyroxine? Had you taken medication that morning before test?

Your FT4 is not above range so not over medicated

TSH is very often low when on Levothyroxine, especially if vitamin levels are low

You need FT3 tested next time plus Thyroglobulin antibodies

B12, under 500 is low for some people, especially when on Levothyroxine

Range is typically 210-780 or higher

You need folate and vitamin D tested

10-20% of Hashimoto's patients never have raised antibodies

Perhaps ask for thyroid ultrasound.

[Bilou in reply to SlowDragon]

Yes when on 50 mcg levo I had the dose 13 h before blood was taken.

Makes sense for the vitamins... but hey no-one tests vtamins (except B12).... how do you get those done?

My thryglobulin was normal a year ago... haha

It's a fight every time I go there and want complete testing... and I don't have to much energy for negociation.... Perhaps you could give me some arguments for the list to ask for - am just remembering my GP is trained in the UK (and working here in Canada). That would be awesome.

So would taking vitamine D and folate be a good idea now? or do nothing until I meet the endocrinologist?

Have checked the symptoms list for that meeting

and am waiting for thyroid ultrasound

Will read more on Hashimoto's

This is taking forever to get balanced - it is soooo discouraging. Trying not to go crazy to not function at my potential!

TIA