Where on range should I be please?

[Dollydaydream11]

My TSH is 2.25mu/L (0.2 - 4.5)

Free T4 is 16.4 pmol/L(9.0 - 24)

Free T3 is 3.1 pmol/L (2.89 - 4.88)

Also have high antibodies for Thyroglobulin and Thyroid peroxidase indicating Hashimoto’s.

Could someone tell me where I need to be to be optimal please.. TIA

[SeasideSusie Remembering]

Dollydaydream11

Are you prescribed Levo? If so the aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo if that is where you feel well.

As you have Hashi's, it's worth trying a gluten free diet as many members finds that can help reduce antibodies (but it doesn't work for everyone) and supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies.

As Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies, it's worth testing Vit D, B12, Folate and Ferritin, if they've not already been tested.

[Dollydaydream11 in reply to SeasideSusie]

Thank you for replying, I’m not on Levo yet, I have an appt with my GP on the 11th December.. I went gluten free about 7 weeks ago and these tests were taken about 3 weeks afterwards.. my TSH has come down but so has my T4 and T3.. TPO has also come down and is within range but I’m still waiting on results for thyroglobulin antibodies before my gp will consider treatment.

I’m B12 deficient and do my own injections and take folic acid and b complex and I was vitamin d deficient but on the vitamin d protocol and now have a good level..

I have bought selenium but have held off taking them as wanted to see what going gluten free did first.

[Mary-intussuception]

Your TSH should be lower than 2.

Your FT3 is very low in range.

Is this the only set of blood results you have? What was date of tests and when was Levothyroxine started ? Your FT4 seems ok.

Try asking your Endocrinologist for a little T3?

Are you still having symptoms?

Have you asked for the following nutrients levels to be tested yet :

Vitamin D

B12

Folate and Ferritin.

You may have deficiencies that need to be addressed (especially Vitamin D ).

[Dollydaydream11 in reply to Mary-intussuception]

Thank you for replying, I’m not on Levo yet, waiting on last antibody result to come back at gp’s before he makes a decision about treating me or not.

I’m on injections for B12 and take folic acid and b complex, also on vitamin d protocol

[ABDC]

I always like when my TSH is in the ones, but it’s different for everyone. All your labs look good except I do not see your TPO antibodies. If you can get them optimal you will feel better. With Hashimoto’s, I have not felt totally myself since diagnosed 14 years ago, except when I started KETO Dieting. I have never felt better. Good luck with your journey

[Mary-intussuception in reply to ABDC]

What do you mean by getting TPO optimal? Do you mean the FreeT3 & FreeT4 perhaps?

[Jodypody]

T3 too low and TSH a little high >1 would be better. Are you on medication?

[Dollydaydream11 in reply to Jodypody]

Thank you for replying, I’m not on treatment yet but seeing the dr on the 11th where he will decide to treat or not.. hope he does as I feel rotten..

[SlowDragon Administrator]

Essential to test vitamin D, folate, ferritin and B12

These are frequently very low and need improving by supplementing

Come back with new post once you get results and ranges

Vast majority of people do absolutely fine on Levothyroxine. Certainly not advisable to start on T3. So not sure why you are asking about this on more recent post

Standard starter dose is 50mcg of Levothyroxine

Bloods should be retested 6-8 weeks after each dose increase

Regular retesting of vitamins too

[Dollydaydream11 in reply to SlowDragon]

Thank you for replying.. I’m B12 and d deficient so on vitamin d protocol and take folic acid and self inject B12..

I asked about t3 as my level was 3.1 on my last test.. I’m going to do another medichecks test as my gp will only test TSH and so if it’s still low I was wondering about how easy it is to buy liothyronine..

I’m still in a lot of pain, was hoping t4 would ease my pains.. I’ve noticed my heart rate has increased a little as was low and my hands and feet aren’t ice cold like they used to be, I’d always feel cold but this has improved..

[SlowDragon Administrator in reply to Dollydaydream11]

Levothyroxine (FT4) is converted into FT3 in the liver and cells.

FT3 should rise as dose of Levothyroxine is increased

Sounds like you are now on Levothyroxine?

If so how much?

Bloods should be retested 6-8 weeks after each dose increase. Dose of Levothyroxine should be increased in 25mcg steps until TSH is around one and FT4 in top third of range. FT3 should then slowly improve to about half way in range. Only then, if it remains low do we then consider adding small dose of T3

Low vitamin D, folate and low B12 all likely directly linked to low Thyroid

You also need ferritin tested. Needs to be at least half way in range.

Has vitamin D been retested? If not it needs to be

How much are you currently taking?

Needs to improve to at least 80nmol and many find improving to around 100nmol is better. GP will only prescribe to get level to 75nmol, or may be only to 50nmol

As you are self injecting B12, Supplementing a good quality daily vitamin B complex, one with folate in not folic acid may be beneficial. (Rather than current folic acid)

chriskresser.com/folate-vs-...

B vitamins best taken in the morning after breakfast

Recommended brands on here are Igennus Super B complex. (Often only need one tablet per day, not two). Or Jarrow B-right

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-7 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

As you have symptoms, low FT3 and FT4 and high thyroid antibodies you should be started on 50mcg Levothyroxine.

If GP refuses then request/insist on referral to an endocrinologist

Also ask GP for ferritin tested

Email Dionne at Thyroid Uk for list of recommended thyroid specialists. See if there's NHS one near you, then request referral to them. Or consider private consultation

[Dollydaydream11 in reply to SlowDragon]

Thank you for replying.. my last vitamin d level was 171 so am now on maintenance dose of 5000iu with cofactors, I have a medichecks test here which I’m going to send off tomorrow to check level..

My ferritin was 73 last test and I’m getting this done with test kit I have tomorrow..

I do need to buy a better b complex so thank you for the links.. I’ve been taking folic acid with no problems and my levels are good, up in high teens last test..

I’m also going to test my thyroid levels tomorrow with medichecks as my gp only tested my TSH which doesn’t give me much to go on..

once I have my results I’ll post them

Thanks again

[SlowDragon Administrator in reply to Dollydaydream11]

Your vitamin D is pretty high.

5000iu is probably/possibly too high a dose

2000-3000iu is even a high maintenance dose

[Dollydaydream11 in reply to SlowDragon]

Vitamin d protocol is 1000iu per 25lbs of body weight for maintenance but once I’ve done my test I’ll have a better idea if too much for me.. with autoimmune problems levels need to be and maintained around 200

[SlowDragon Administrator in reply to Dollydaydream11]

Usually recommended on here that around 150nmol is considered high enough

[Dollydaydream11 in reply to SlowDragon]

Ah ok, I got my info on a Uk vitamin d group..