Can I have thyroxine now?

[Redrosegirlie]

Hi all,

You helped me recently when my GP diagnosed hyperthyroidism and you thought I maybe was actually experiencing a Hashimotos flare so I have had tests done via Medichecks this week.

NHS

Dec 2017 @ 4pm tested because of hypo symptoms

TSH 2.9 (0.35-5.00)

FT4 21.4 (11.00-23.00)

NHS

6/11/18 @ 10am (after coffee) tested because of a big increase in anxiety

TSH <0.02 (0.35-5.00)

FT4 31.1 (11.00-23.00)

FT3 9.1 (3.90-6.80)

Prescribed carbimazole at this point however I haven’t started to take them

Medichecks Test

3/12/18 @ 08:30 Fasted

TSH 12.6 (0.27-4.2)

FT4 12.400 (12.00-22.00)

FT3 4.03 (3.10-6.80)

TGAB 600.00 (0.00-115.00)

TPO 30.2 (0.00-34)

VIT B12 90.300 (37.50-188.00)

FOLATE 4.44 (3.89-26.80)

25 OH VIT D 89.8 (59.00-200.00)

CRP 1.86 (0.00-5.00)

FERRITIN 65.6 (13.00-150.00)

Do you think my GP will now prescribe levothyroxine based on these results or will he say my T4 is normal?

Thanks

[greygoose]

Well, he might say your FT4 is normal. But he can't possibly say your TSH is normal! It's hypo. And, your antibodies say you have Hashi's.

[Redrosegirlie in reply to greygoose]

Hi greygoose, thank you.

Yes, it’s clearly Hashi’s and hypo. I just hope that because I am symptomatic I can start Levo but I am worried he will want to continue to monitor me without treatment.

My levels are obviously swinging at the moment

[greygoose in reply to Redrosegirlie]

I think you're going to have to put your foot down, and insist on how bad your symptoms are, and how bad you feel, and you want to start treatment now. Any doctor who wanted to continue monitoring someone with a TSH of over 12, without treatment, is a sadist and should be reported for mal-practice.

[Redrosegirlie in reply to greygoose]

Thank you 😊

I have an appt next Tuesday. Let’s see how that goes.

What do you think of my vitamin levels?

[greygoose in reply to Redrosegirlie]

Your vit B12, folate and ferritin are too low, and your vit D could be higher.

B12 and folate should be at least over mid-range, and ferritin and vit d up around 100.

[SlowDragon Administrator]

Your folate is very low, though GP unlikely to prescribe as it's within range

Ferritin should be slightly higher, eating iron rich foods, such as liver or liver pate once a week, should help improve

Very high TG antibodies is very likely due to Hashimoto's, but NHS only really considers high TPO antibodies. Yours are only just within range

healthline.com/health/antit...

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower antibodies

Ideally ask GP for coeliac blood test first

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

thyroidpharmacist.com/artic...

[Redrosegirlie]

Thanks greygoose and SlowDragon.

I am going to look into supplementing these. I don’t find eating liver pleasant though.

Why does the NHS only look at TPO antibodies? I thought I had a definitive diagnosis of Hashi’s there 😐

[Peanut31 in reply to Redrosegirlie]

Hi

Greygoose and SlowDragon have given you good advice and several links.

I just hope your GP isn’t one of those that likes to buggar about, and keeps saying return in a month for another thyroid blood tests, mean while your symptoms get worse.

From my understanding (as I learnt from my own experience) once your TSH reaches 10 or above, then you should be started on Levothyroxine by the NHS.

If you have a very sympathetic GP then he would of started you on medication beforehand.

You mentioned your T4 is normal, and you are worried about this, well most GP’s are just obsessed with TSH results and don’t bother with your T4 & T3 results, so I don’t think you have to worry about that.

You will soon learn that T3 is very important, and when having blood test for thyroid we need to test TSH, T4 & T3.

As greygoose has said you need to be firm and insist on treatment.

Unless your elderly or have a heart condition, then insist that you start on 50mcg of Levothyroxine not 25mcg of Levothyroxine, that wouldn’t bring a fly back to life, let alone a human.

Take 50mcg for 6 weeks then go back again for a blood test, book as early in the morning as possible before 9am, don’t eat or drink before blood.

Then insist on another increase of 25mcg and keep repeating this process until your TSH reaches 1 or below, and your T3 & T4 are in the higher figures of the lab ranges.

The most important thing regardless of your blood tests is how well you feel.

Don’t let your GP keep you on the same dosage for months and months.

Best wishes & Good luck

Peanut31

[Redrosegirlie in reply to Peanut31]

Thanks so much Peanut.

I’m 48 and female.

I am going to be firm with the GP. After all, this is a GP in another practice within the group for a second opinion so he will know I am not just going to accept whatever they say.

I’ll update when I have been seen.

I just hope this thyroxine can give me back my brain and my energy 😊

[SlowDragon Administrator in reply to Redrosegirlie]

High TG antibodies can be due to other things as well as Hashimoto's

Other countries consider TG antibodies and symptoms would confirm Hashimoto's

healthline.com/health/antit...

[Hidden in reply to SlowDragon]

Hi SlowDragon

That link implies that small amounts of TG ab can be other things, but high levels implies "autoimmune disorder, such as Graves’ disease or Hashimoto thyroiditis" but they don't define either high or small.

Curious because I don't think I've ever had TPO antibodies, but my thyroid is being destroyed (seen on scan) and I'm hypothyroid which certainly points to Hashis!

[SlowDragon Administrator in reply to Hidden]

I would agree......but medics may not

[Hidden in reply to SlowDragon]

That high TG is hashis?

[Hidden in reply to SlowDragon]

I thought it was either or both antibodies? That was why it was important to do both?

[Hidden in reply to SlowDragon]

From Wikipedia, how interesting:

"Thyroglobulin antibodies

Thyroglobulin antibodies are specific for thyroglobulin, a 660kDa matrix protein involved in the process of thyroid hormone production. They are found in 70% of Hashimoto's thyroiditis, 60% of idiopathic hypothyroidism, 30% of Graves' disease, a small proportion of thyroid carcinoma and 3% of normal individuals.[1][3] Anti-TPO antibodies are present in 99% of cases where thyroglobulin antibodies are present, however only 35% of anti-TPO antibody positive cases also demonstrate thyroglobulin antibodies.[14] "

So I'm a 1%!

[SlowDragon Administrator in reply to Hidden]

Yes, we have a few on here with only high TG antibodies. With only high TG antibodies it's often a struggle to get diagnosed

But your TSH is way over range, so GP should agree to start Levothyroxine

[Redrosegirlie in reply to SlowDragon]

Maybe with my TPO antibodies being at the upper end of ‘normal’ this is significant? Doesn’t Izabella Wentz say that to be negative means <2?

[SlowDragon Administrator in reply to Redrosegirlie]

Your TPO are so near top of range, along with high TG antibodies, this is likely autoimmune thyroid disease (Hashimoto's)

[Redrosegirlie in reply to SlowDragon]

Thanks SlowDragon. Let’s hope the GP understands it

[Valarian]

This would be the GP that tried to put you on carbimazole, and lave you there without testing for three months ???!!!

[Redrosegirlie in reply to Valarian]

Valarian I’m seeing a different GP in a different surgery but part of the same group. Simply because my own GP treated me in that way.

Hopefully the new one is more knowledgable 😊

[JAmanda]

I doubt your doctor will believe the Dec Medichecks results over the Nov NHS results. And the NHS tests look hyper not hypo..? In my experience getting my folate up was a huge help. (But an expert in anything.)

[JAmanda in reply to JAmanda]

Not an expert

[Angel_of_the_North in reply to JAmanda]

If you want the earlier test ignored, try telling GP that you think the test was inaccurate because you were taking a very high dose of biotin and you've read that biotin interferes with the lab assay. So you were very careful to stop taking it before the Medichecks test. Worth a punt.

[Redrosegirlie in reply to Angel_of_the_North]

Thanks Angel but I am going to explain the Hashi’s hyper swing and hope that he grasps it rather than say I have been taking biotin.

I’m not taking anything that could interfere with the results.

[Redrosegirlie in reply to JAmanda]

I fear this scenario JAmanda. I am so tired and mentally unhappy I really hope I can start treatment rather than wait for another lot of blood tests 😩

[Redrosegirlie]

Yes reallyfedup.

All my future tests will be done early morning on an empty stomach. I work in the NHS so I can easily ask a colleague to take my blood for me and no need to wait for a practice nurse appt

[vocalEK]

Hi Redrosegirlie: When I saw the title of your post, I had to smile. I am in a similar boat, but my title would read, "Can I have my T3 now?" My last tests showed TSH under 1, FT4 near the top of the range, and FT3 just under where the range begins. Doctor commented that "Your free T3 level was slightly low, but remaining labs are normal. I recommend we continue the current dose of levothyroxine and repeat labs in 4-6 weeks."

[Redrosegirlie in reply to vocalEK]

Vocal, I haven’t got to this point yet but if I do I think I would try and get it from abroad.

I don’t know much about it but it ya appalling that people can’t have the medication that they need 😒

[Redrosegirlie]

Reallyfedup, Can you find that info on the internet for me? I can’t see it anywhere

[Redrosegirlie]

That’s really interesting. Thank you reallyfedup 😊

[Beautifulmagnolia]

Hi redrosegirlie, there’s a big difference in the medicheck results & I hope you get all the support you need from your doctor. I hope you feel better soon. 😀

[Redrosegirlie in reply to Beautifulmagnolia]

Thank you Beautifulmagnolia.

I also hope I am diagnosed correctly one way or another soon 😊