Really appreciate thoughts on my results as medicheck say normal,
Tsh 2.32. Mid 0.27 -420
Free thyroxine 19.900 pm. 12-22
Free T3 4..51. 3.10-600
Thyroglobulin antibody. 36.000 iu/ml 0.00. 115
Thyroid antibodies 23.8 iu/m 0.00 34 definitely don’t feel normal !
Can see from previous posts your GP reduced Levo dose 2 months ago
How much are you currently taking?
When was dose last changed?
All thyroid blood tests should ideally be done as early as possible in morning and fasting. Do not take Levothyroxine dose in the 24 hours prior to test, delay and take immediately after blood draw. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
Is this how you did the test?
If so you need 25mcg dose increase in Levothyroxine
Vitamin levels need testing after a period of under medication too
Vitamin D, folate, ferritin and B12
As you are type one diabetic this is most likely Hashimoto's (despite antibodies bring just within range)
Are you on strictly gluten free diet?
If not
Suggest you read Susan Blum book the immune system recovery plan
amymyersmd.com/2017/02/3-im...
chriskresser.com/the-gluten...
thyroidpharmacist.com/artic...
scdlifestyle.com/2014/08/th...
drknews.com/changing-your-d...
New NHS England Liothyronine guidelines November 2018 clearly state on pages 8 & 12 that TSH should be under 1.5 when on just Levothyroxine to be adequately treated
sps.nhs.uk/wp-content/uploa...
Yes followed protocol for blood testing
Have been on 125 for nearly 6 months
Was originally on 150 + had it reduced to 100 + that’s when all my problems started
Have followed advice regarding vitamins currently taking
Igenuos mega B
Methylcobalamin b12
Bit d 3 -4000 iu
Zinc
Folic acid 400 ug
So I do have hashi ?
I brought this up with endo + was told 3 x that I don’t !
I have in the last 3 weeks been getting stiff calf’s + redness
I have also just finished loading dose of B12 injections
So you suggest an increase of thyroxine 25 mg
Do you have the results from when on 150mcg?
GP probably freaked at low TSH
If GP reluctant to increase back to 150mcg with 25mcg increase, ask for 12.5mcg increase ( 125mcg alternate days with 150mcg)
Levothyroxine dose very often needs incredibly fine tuning......not a massive reduction of 50mcg
If you were over medicated, which would be both FT4 and FT3 over range, not just a low TSH......then a tiny reduction of 12.5mcg or absolute maximum of 25mcg is all that's needed
Highly likely you weren't over medicated at all.
Was FT3 and FT4 even tested?
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
Professor Toft recent article saying, T3 may be necessary for many. Otherwise we need high FT4 and suppressed TSH in order to have high enough FT3
rcpe.ac.uk/sites/default/fi...
So if your GP refuses, or is very reluctant to increase Levothyroxine, suggest you say you will be insisting on referral to endocrinologist for trial prescription of T3 instead.
As T3 is ridiculously expensive and comes out of GP budget, he might be more inclined to try an increase in cheap Levothyroxine instead!
Type one diabetes is usually considered autoimmune. So it's more likely your thyroid disease is too. I.e. Hashimoto's
Trying strictly gluten free diet is the only way to actually know if it helps.
But testing for coeliac first just to rule it out first is recommended
You do not need any gut symptoms of any sort to still find improvements, sometimes significantly. I found that out the hard way.....20 plus years wasted. More on my profile
thank you slowdragon for your time as there are so many needing advice, no never had an indepth thyroid sample done,for 20 years its always been tweaked up down by 25mg- moved from south to north england ,changed doctors + became very ill after thyroxine was reduced-hospitilised 5 times this year, latest discovery was low cortisol,I truly believe it was caused by my thyroid being out,I am going to make appointment with doctor next week + discuss dose-no I CORRECT MYSELF-inform doctor that I have increased my dose !Am going to start on 12.5 mg + retest again in 2 months time,will also ask for vit + iron to be tested, thank you for your time
