Dear all , I am a new member and have found these posts really helpful and interesting so would really appreciate any help. I have been under active for over 10 years but two months ago went from under active to over active . My Levo dose was reduced from 100 to 75. Had blood tests which they said were in range apart from my t4. Had a trip to a+e due to high heart rate and was put on beta blockers . These are now being reduced. I had medichecks blood tests as was still not feeling well. I have swelling on the left hand side of my neck and a hard lump just above my windpipe . I have had a hoarse voice for over five weeks so was sent to an ent with the camera up thru the nose down the neck to check vocal chords and these were all clear . I am waiting on a neck scan to check what the swelling and lump may be . The swelling does go up and down and causing breathlessness . I have attached my medichecks results and any advice would be much appreciated . Gp says TSH is fine and said takes three months for new dose to have an effect and basically sent on my not so merry way . Feeling really poorly with aches and pains and tiredness. Eyes are very dry and puffy but both Hashimoto and graves have been ruled out
1) antibodies fluctuate, so just because they were negative at the time of the blood draw, doesn't mean they will be next week.
2) there are two Hashi's antibodies: TPO and Tg antibodies. The NHS only tests TPO antibodies, but if the TgAB are high, you still have Hashi's.
3) not everybody with Hashi's ever develops high antibodies. They are only diagnosed with an ultrasound, once the damage to the gland is visible.
If you truly 'went over-active', as opposed to 'over-medicated', then you have Hashi's. There is no other explanation. Do you have the results of your blood test from when you 'went over-active'?
Many thanks for your response this is much appreciated. I only have the basic results at the time of being over active and I am not sure if it was the case of being over medicated or over active as the gp just said I had changed from under active to over active . The results taken back in September were t4 at 25.2 and TSH 1.89. Although my t4 levels have dropped ( still over range) since having meds adjusted it appears my TSH has increased from 1.89 to 3.2?
Sorry, none of that means anything without the ranges. Ranges vary from lab to lab, so we need your lab's ranges to make sense of the results.
But, your doctor isn't very knowledgeable. He should know that it's impossible for an under-active thyroid to become 'hyper'. It just doesn't happen. It's either over-medication or a Hashi's 'hyper' swing.
But, with that new info, sounds more like you were perhaps over-medicated with levo, but you weren't converting it into T3 very well. Now your dose has been reduced, you are under-medicated. So, even though your FT4 has reduced, so has your FT3, and it is now low enough to cause your TSH to rise. This is something that doctors just don't understand.
Suggest you get full private testing of thyroid, 8 weeks after being on constant unchanging dose. So that's TSH, FT3, FT4 and both TPO and TG antibodies
Meanwhile start improving your vitamin D by supplementing. Aiming to improve to at least 80nmol and around 100nmol may be better .
Vitamin D mouth spray by Better You is good as avoids poor gut function. Suggest you supplement 1000iu for 2-3 months and retest. It's trial and error what dose each person needs.
Once you Improve level, very likely you will need on going maintenance dose to keep it there.
Folate is on low side. Supplementing a good quality daily vitamin B complex, one with folate in not folic acid may be beneficial. B vitamins best taken in the morning after breakfast
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results
Only add one supplement at a time and wait at least ten days to assess any changes, before adding another
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
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
All thyroid blood tests should ideally be done as early as possible in morning and fasting. Do not take Levothyroxine dose in the 24hours prior to test, delay and take immediately after blood draw. This gives highest TSH and lowest FT4. (Patient to patient tip, not to be mentioned to GP or phlebotomist)
If also on T3, make sure to take last dose 12 hours prior to test
If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
About 90% of all hypothyroidism in Uk is due to Hashimoto's. Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .
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