Just wanted to post these as my gp reception advised me of no further action but I’m still not happy with how I feel
Serum triiodothyronine 4.2 (2.8-7.1)
T4 17.4 (9-26)
Tsh 0.62 (0.27-4.2)
My t4 has come down from 19.4 since it was last taken in July and although it’s only marginal my tsh has gone up
On 125 thyroxine and have hashimotos
Have high testosterone levels too and I’m waiting on a scan for pcos
I feel like a lot of my thyroid symptoms have come back recently cold hands pins needles back ache foot ache leg ache tummy problems pain and constipation tired and no energy
I’m thinking of going private with these results as I don’t feel I’m getting anywhere with my gp
Can anyone advise on next steps
Thanks
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Fox78
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For full Thyroid evaluation you need TSH, FT4, FT3 plus TPO and TG thyroid antibodies and also very important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common with Hashimoto's
Your FT3 is low and FT4 could be higher
What supplements do you currently take?
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or vitamins
Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.
All thyroid tests should ideally be done as early as possible in morning and fasting. When on Levothyroxine, take last dose 24 hours prior to test, and take next dose straight after test. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)
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 very often 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 just to rule it out
I don’t take any supplements currently what should I take?
I had all my vits done a while back and they were well in the top range and my ferritin was above range which indicates inflammation so probably caused by pcos?
I’ve also had a ceoliac test done too which was negative
And yes test was first thing fasting
My tpo on last test was 85
Do you think I’d have a case to try and see if I can ask for t3 should it be higher than it is as my result falls in the reference range?
If very high this suggests hemochromatosis, which can complicate Hashimoto's
Can you add actual results and ranges for vitamin D, folate and B12
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
You have room for further dose increase in Levothyroxine if GP will agree
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.
Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor please email Dionne at
tukadmin@thyroiduk.org
Also request the list of recommended thyroid specialists, some will prescribe T3
If I am converting t4 to t3 properly would you expect to see my t3 higher than it is? Do you think I have a case to go back and ask for a trial of t3 added to my current dose of t4.. I don’t think my gp would listen but I’m prepared to pay to go private?
You must have 25mcg tablets, just take two instead of one. You’ll know quite quickly if it relieves your symptoms - then (if it does) return to GP and present with results, the improvements made. GP will undoubtedly want a test done.
The goal of treatment is always to restore health, not ‘get test results in range’. GP has to treat you until well then test levels to find out where in the range you feel well. It’s highly individual.
If you raise dose yourself then you may be able to prove that you need it. Don’t forget if GP raises dose then GP has to be able to defend actions and how, if your test results are in range and they are currently the ‘gold standard’ for thyroid treatment. Help GP out and do it yourself. What’s the worst thing that could happen? But only raise by 25mcg and wait to see what happens. You may be surprised at how accommodating GP could be. Good luck x
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Levothyroxine Dose and stable levels - help with results 
Can someone advise me PLEASE!
Can someone shed some light on my test results please?
Could someone please comment on my results?
Help with results
