Test results -any thoughts?

[Manorchimp]

18 July (no medication and no diet or supplements)

TSH 8.07 (>4.3)

FT4 16.3 (12-23)

FT3 3.41(3.1-6.8)

TPO 106 Kiu/l (>34)

T4 92.6 (66-181)

Tgab 334 ku/l (>115)

This week (50mcg levo and gluten free for 2 months)

TSH 2.1 (0.27-4.3)

FT4 21.3 (12-23)

FT3 4.37 (3.1-6.8)

TPO 101 Kiu/l (>34)

T4 110 (66-181)

Tgab 270 ku/l (>115)

B12 379 (250-569)

D 74.4 (50-100)

FERRITIN 30.5 (13-150)

Does this look OK? Have first endo appointment next week.

Thanks

[Nanaedake]

How do you feel?

[Manorchimp in reply to Nanaedake]

Good question! I feel significantly better than I did before. I've stopped crashing after lunch and am more alert and less foggy. Also less anxiety. My skin problem has stopped but I thinking that might have been a gluten intolerance. I still cannot lose any weight but accept that might be something which doesn't change with medication. So my view is that all is good. My main thoughts are whether the conversion is OK and if the ferritin is acceptable.

[Nanaedake in reply to Manorchimp]

50mcg levothyroxine is generally a starter dose, however, as you are feeling better, you may want to stay on it for another 6 weeks and retest. Since you've only just gone gluten free, your absorption might improve over the coming weeks so you could give it a little more time before making another change. It's likely you'll need more levothyroxine eventually but it can be very individual and related to your age. Ask your GP about your ferritin levels, your GP could do a full iron panel to check iron levels are ok. Your ferritin is not below range and you can increase levels by eating iron rich foods if you need to.

[Manorchimp in reply to Nanaedake]

Thanks -probably shouldn’t have started medication and dropped gluten at the same time as now not sure what is having what effect. But it was the sudden realisation that gluten was causing my skin issue that prompted me to.

[Hidden]

It looks as if you are heading in the right direction. TSH has come down but is usually best around the bottom of the range (under 1). Although a lot depends on how you feel

Ferritin and B12 look a bit low to me, though I'm no expert. Have you had your folate tested? Vitamins and minerals, as well as T3 and T4, should be near top of range for most of us to feel well

50mcg of Levothyroxine isn't much, and you may well need an increase. Do the antibody ranges (TPO and Tgab) mean they are high? I think the > (more than) should be a < (less than), but could be wrong - I am easily confused with things like that!

If you still have symptoms, even if you feel much better than before, make a list and give it to the endo. Include how they affect your life as well.

[Manorchimp in reply to Hidden]

Thanks - I’ll focus on the symptoms and see how the endo goes

[Nanaedake in reply to Manorchimp]

You could investigate coeliac disease since thyroglobulin antibodies are over range, perhaps it's connected? The only problem is that you need to be eating gluten to get it properly tested, which you might not want to do. I would ask Endo about it but no guarantee Endo will know anything much as it's more the specialism of a gastroenterologist.

[Manorchimp in reply to Nanaedake]

I didn't realise tgab was an indicator for coeliac. Will have a think.

[Nanaedake in reply to Manorchimp]

Well, TgAb can be raised in a number of conditions besides Hashimotos thyroiditis so you could work with GP to eliminate possible causes. Coeliac seems the first obvious one to rule in/out due to what you've said about your skin symptoms.