Hello. Here are my latest results from medichecks.
I am at the hospital to see my Endo on Tuesdays. I asked to be referred back to him because every six weeks I have a blood test and I’m either taking too much or too little lyvothyroxin. As you can see my tsh is in range and this test was done two weeks ago by medichecks and I had one done at the doctors last week and my tsh is lowering its now 2.5. The thing is when I get to 3.00 I start feeling ill! So at this point i up my medication by 25mcg before that happens. But then in six weeks I will have to reduce by 25mcg again because it will be out of range as in taking too much... there’s never a happy medium. What shall I say to him about these results because I’m basically medicating myself now to stop me from feeling ill. When I say medicating myself I mean if I see my result is heading towards 3.00 I add 25 or if I’m going the other way say 0.21 I remove the 25 Mcg. Someone on fb told me what I am doing is dangerous but the doctor would leave me until my tsh was really underactive and out of range . When that happens I am depressed and crying and pacing the kitchen floor!
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NickyUk
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Adjust so that you feel well, don’t use the tests to adjust to. Just check periodically where you are in the ranges when you feel well. You will find that when you feel well the test results are always about the same. I’ll be interested to see what your endo says!
Once you are on thyroid hormone replacement, we only care about the TSH if it goes too high. And, yours is too high at the moment. It should be 1 or under.
And, the reason it's too high is because you aren't converting very well. Your FT4 is right at the top of the range, but the FT3 is well below mid-range, and that's too low. It's low T3 that causes symptoms.
And keep increasing and decreasing your dose of levo, whilst not dangerous, is just not going to help.
If you increase your levo again, your FT4 is going to go over-range, and that will negatively impact your conversion because your levo will start converting to more rT3 than T3, so your FT3 will decrease.
The only way you are going to help yourself feel well is by adding some T3 to a reduced dose of levo, and dosing by the FT3. There is no other way to do it.
However, it's rather doubtful that your endo will agree with that - or even understand it.
rT3 is the inactive form of T3. Normally, T4 converts to equal parts T3 and rT3, but under certain circumstances it will convert to more rT3 than T3, so your FT3 level drops.
If you don't feel right with a 25mcg dose change, try 12.5mcg.
As Greygoose has said, you aren't converting T4 to T3 particularly well.
Do you have your latest nutrient levels? If they're not optimal then thyroid hormone can't work properly and good conversion can't take place. Ferritin in particular needs to be at least 70.
Supplementing with selenium can help conversion.
Did you know that your raised antibodies confirm autoimmune thyroid disease aka Hashimoto's? This wont be helping because the antibody activity causes fluctuations in results/symptoms.
If you haven't already been given information about how to address Hashi's, this is what I normally post:
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.
Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies, so it's important to test, address any low levels and keep them optimal.
Thank you very much . Yes I knew I had hash. Endo said so do a lot of people it’s nothing. Do they do 12.5 in lyvothyroxin or would I have to cut it down ?
Essential to test vitamin D, folate, ferritin and B12. Always get actual results and ranges. Post results when you have them, members can advise
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels. Low vitamin levels affect Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
Ideally ask GP for coeliac blood test first to rule it out
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