Latest blood results. Need advice

[ceedee81]

TSH *<0.01 mIU/L 0.27 -4.2

FREE THYROXINE *23.3 pmol/l 12.0 -22.0

TRIIODOTHYRONINE(T3): 2.1 nmol/L 1.3 - 3.1

FREE T3 6.2 pmol/L 3.1 -6.8

REVERSE T3 *32 ng/dL 10 -24

REVERSE T3 RATIO *12.615.01 –75.0

Thyroglobulin Antibody *3810.0 IU/mL 0-115

Thyroid Peroxidase Antibodies*35.9 IU/mL 0 -34

Active B12 104 pmol/L 25.1 -165.0

Folate (serum) 18.0 ug/L > 2.925

OH Vitamin D 64 nmol/L 50 -200

Inflammation MarkerCRP -High sensitivity 3.8 mg/l 0.0 -5.0

FERRITIN 59 ug/L 13 -150

Selenium -Serum *218 ug/l 65 -150

I currently take 150mg T4 and 25mg T3 daily. I will be reducing my T4 to 100. My previous thyroglobulin antibodies were 4000 on 24th April. Since then I have been 100% strictly gluten free (I'm already dairy free) yet my antibodies have barely reduced. My notes from the doctor say I am at high risk of developing cardiovascular disease - this is a big shock to me as I have never smoked, don't drink, exercise at least 4 times a week and eat reasonably healthily. I am 36 years old.

My TSH is April was 5.36. it is now 0.01. Any advice on what has caused this massive drop?

Am I right in thinking my T3 levels are fine?

TIA

[jimh111]

Your TSH has dropped because you are on large doses of hormone and both your fT3 and fT4 are high normal. Usually fT3 and fT4 will be around mid-interval. You are at increased risk of developing cardiac problems, specifically atrial fibrillation (not so much cardiovascular disease which is associated with hypothyroidism). You seem to need these high hormone levels to function so it's Hobson's choice. Your doctor could prescribe a low dose of beta blocker to protect your heart a little and if possible you should do exercise to improve your heart.

There's no reliable evidence to show gluten or dairy free reduces thyroid antibody levels, they tend to decline in time. Your antibody levels are very high and there is some research that shows that eliminating helicobacter pylori infection might help reduce antibody levels in subjects with very high levels. So it might be worth asking your doctor (or phamacist) if they can check you out for HP infection. Whether reducing your antibody count will help is another issue but it can't do any harm.

[SlowDragon Administrator]

Your GP is only looking at low TSH.

On T3, TSH is almost always suppressed

Vitamin D is too low. Needs improving. Are you supplementing at all?

Many, many Hashimoto's patients find strictly gluten free diet does help reduce symptoms

[ceedee81 in reply to SlowDragon]

So the low TSH isn't really a problem? I am taking a liquid vit D3 as it was low last time. It has improved slightly.

I really believed my antibodies would have dropped a lot with me being gluten free. I'm pretty shocked they haven't. I don't really know what to do now 😕

[SlowDragon Administrator in reply to ceedee81]

But they are dropping

TPO respond to gluten free

Dropped from 70 to 35 which is impressive

TG dropped from over 4000 to 3810

They will likely drop further over time. With antibodies not an instant result but a long slow improvement

Increase in level of Vitamin D may help too

holtorfmed.com/vitamin-d-au...

ncbi.nlm.nih.gov/pubmed/286...

[SlowDragon Administrator]

If you decide you need to reduce Levo, it only needs tiny reduction at any one time. Eg down to 125mcg /150mcg on alternate days. Retesting after 8 weeks.