Hey guys, I am new here, I am 36, got diagnosed woth hashi's before a couple of years, after a life threatening hashi attack. I am sure i had hashi's growing up. I am slowly coming out of the fog. I got some tests today and need some help trying to figure them out. I am currently on 75mcg of levothyroxine.
Here are my levels-
TSH - 0.160 uIU/mL (0.45 - 4.5)
T3 Total - 153.2 ng/dL (70 - 204)
Free T3 - 3.31 pg/mL (1.4 - 4.4)
T4 Total - 8.34 ug/dL (5.1-14.1)
Free T4 - 1.55 ng/dL (0.8 - 1.8)
Any advice would be super helpful. Thanks.
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Do you mean only T3 medication? My Gp jas askwd me to go down to 62.5 mcg thyroxine and see how it works. I could add the T3 along with it. Makes sense?
Oh, sorry. I thought you were taking T4 and T3. And I meant increase the dose of T3. My mistake!
No, I didn't mean change to T3 only. But, why on earth would you want to reduce your thyroxine? You are in no way over-medicated. If on T4 only, I would want a slight increase in dose - say 75 one day, 100 the next.
Interesting. Neither me or my GP would think of increasing the dosage. In fact we have been doing the opposite, working on lowering the dosage as much as possible. I started witb 300 mcg, was on 400 mcg for a while, and have worked my way to 75 mcg, with a remarkable improvement in symptoms (no where near ideal tho). I no longer fall asleep while arguing with my boyfriend.
First: how does your 75mcg dose of T4 compare to the T4-only full-replacement dose, which is 1.5-1.7 mcg/kg body weight?
Second: I think your FT3 is low. You did not provide a range, so I will tell you that the lab my doc uses says the range is 2.77 < FT3 < 5.27 pg/ml. This is higher than your lab, which is using a range more appropriate for sick people. Under this range, you are only 21% up in range. Addition of T3 to your regimen would likely help. Your FT4 is high enough, so you might want to reduce your T4 slightly before adding T3 (use a T3 power factor of 3-4).
Third: what are your antibody readings now? Have you looked at references like the "Root Cause" and figured out what might be causing antibodies?
Four: are you on a supplement program to replace the nutrients lost when your gut is compromised during Hashi's? A compromised gut reduces your absorption of many things, and esp. amino acids. Keep in mind that amino acids (esp. tryptophan->5HTP) are a big factor in supporting the sleep cycle. You can check to see if your Total Blood Protein is low; it needs to be in the upper half of the range, say at least 7 g/dl. Many other nutrients need to be supported like magnesium, iron, selenium, folate, B12, D3, etc etc
Looks like you've got supplements down cold. The question that needs to be asked now is: is there something in your body that needs to be removed? Those non-zero TPO and TG antibodies say to me that you could have had an environmental exposure (have you ever checked mercury & lead?), and/or that you are sensitive to something in your diet. Have you ever looked into the most common food sensitivities, and tried eliminating those for several months to see if your antibodies decrease? Another approach to the food sensitivity problem is to use a lab like Enterolab that knows how to do fecal testing; they might be able to tell you if there are indicators of gut problems like enteropathy or dysbiosis. Many practitioners now stress that a damaged gut is often involved in autoimmune issues, and esp. Hashi's.
I am very sensitive to gluten, in terms of gastrointestinal issues. I had a major suppression 3 years back (at this stage nails and body hair had stopped growing)
,one dietican put me of wheat and veggies only diet. I have been sensitive to diary almost most of my life. I do consume a little bit of dairy here and there, mostly because I love it.
I am looking into the gut angle too.
And as per your suggestion i will also get tests done for mercury and lead.
Could you please explain what you mean by non - zero TPO and TG anti-bodies?
Your test results included "TPO Antibody" and "Thyroglobulin Antibody". Both of those are above zero, meaning you have Hashimoto's Autoimmune Thyroiditis. The antibodies to TPO mean that your thyroid, which uses the TPO enzyme to make thyroid hormone, is being prevented from making hormone because antibodies are attacking the tissue that produces TPO. Thyroglobulin is a protein made by the thyroid gland, which carries thyroid hormones, and the TG antibodies mean that the tissues which make TG, are also being attacked. Have you ever gone on a diet that excludes most of the allergenic/sensitivity-causing foods? Such a diet would include things like green veggies, low-sugar fruits, clean proteins such as lamb raised on grass, and perhaps a safe carb such as rice; but no substances like gluten, dairy, refined sugars or artificial sweeteners, etc. etc. I have not used her program, but Izabella Wentz (thyroidpharmacist.com) has created books and programs about how to lower anti-thyroid antibodies. BTW, have you ever had an FT3 test to see what your level of active thyroid hormone is?
You have already explained in one of your replies above that it is quite low. I will be switching over to NDT in the next couple of weeks or so. Let's see what happens then.
It's been a while since i have been gluten free. Will look into Izabella Wentz books.
As far as FT3, I would point out that the 1.4 - 4.4 pg/ml range is an old range that includes too many hypothyroid subjects. I mentioned before that my lab uses the range 2.77 - 5.27 pg/ml, and you want to be in the upper half of that, i.e. above 4. But, so long as you have antibodies, an increase in FT3 might not get you all the way to feeling truly alive/well.
It is common for people to have non-zero antibody test results. Laboratory tests are imperfect. Low, non-zero results could be due to the testing process.
Further, there are other reasons for these antibodies being present including physical injury.
As I understand, the antibodies simply mop up thyroid peroxidase or thyroglobulin and do not affect the internal processes of the thyroid.
I'm not sure what you mean by "do not affect the internal processes of the thyroid"! My understanding is that, over a period of time, the antibodies destroy thyroid tissue. That explains to me why the long-term Hashi's I previously had (antibody counts are now ~0) means that I now have to use exogenous thyroid hormones, and if I don't, I go into hypothyroidism within ~1 week.
I got lucky. Gluten was what precipitated my plunge into hell. After I went GF, my TPO antibodies gradually decayed to zero over a period of 18 months. However, I did not get well at that point; it took many more years of nutritional supplements and dietary experimentation to repair my gut (from gluten enteropathy) and re-build my nutritional stores. My main continuing problem is that my ability to digest and retain proteins has never fully recovered; I use free amino acids as a quick way to push up my level of amino acids, as that has a lot to do with sleeping well and feeling well.
An antibody is a protein molecule. It doesn't destroy anything.
It is lymphocytes and macrophages that destroy.
At most, in some circumstances, antibodies attach to "things" which then identify that thing as something to be destroyed. In the case of thyroid peroxidase and thyroglobulin antibodies, they attach to thyroid peroxidase and thyroglobulin molecules respectively in the bloodstream. The thyroid-peroxidase/TPO antibody complex, or thyroglobulin/TG antibody complex, can be destroyed and taken out of the system.
If sufficient of your thyroid has been destroyed, yes, indeed, you will become hypothyroid unless you take adequate thyroid hormones.
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