Hashimotos

[Emma_17]

Recent results

TSH 2.51

FREE T4 16

FREE T3 4.2

Was on 225mcg levothyroxine GP upped to 250mcg once a day. And i still feel terrible. Hospital endocrinologist wants my TSH kept undetectable

[SeasideSusie Remembering]

Emma17

What are the reference ranges please?

Are those results from a test when you were taking 225mcg Levo?

For quite a high dose of Levo, your TSH is remaining high. Maybe you have an absorption problem, gut and absorption problems are quite common with Hashi's. Have you had nutrient levels tested:

Vit D

B12

Folate

Ferritin

Results of those should show if you have an absorption problem and if you do then it will need addressing.

[Emma_17 in reply to SeasideSusie]

I wasn't given the ranges just the results in a letter. Is it correct your t4 should be higher in the range? What about t3? Would you say i need a t3 converter tablet? I havent had my vitamin levels done in over 6 months only when I was pregnant. And yes these results are when taking 225mcg.

[SeasideSusie Remembering in reply to Emma_17]

Emma

The reference ranges are essential for FT4 and FT3 so that they can be interpreted. For FT4 we see on here 7-17, 9-19 and 12-22 so you see you could be at the top of the range for one of them but only 40% through the range for another. Knowing where your FT4 falls within range tell us if you are converting T4 to T3 well enough, so it's impossible to tell you if you need to take T3 as well as Levo.

Your dose was raised due to your TSH level.

As I said, gut and absorption problems are very common where Hashi's is present, so what were your results for vitamins and minerals when last tested, and do you supplement with anything? It's important to get them retested.

If your doctor wont do all the necessary tests, then you should consider doing what hundreds of us here do and that is private tests with ThyroidUK's recommended labs.

There really isn't anything helpful anyone can say at the moment until we have reference ranges for your thyroid results and results for vitamins and minerals.

[greygoose]

Forgive me for asking, but how do you take your levo? Do you take it on an empty stomach, with a large glass of water, and wait at least one hour before eating or drinking anything but water? Do you take any other medication or supplements at the same time?

[Emma_17 in reply to greygoose]

I always take on empty stomach at first felt better taking it at night but changed to morning and now makes no difference when I take it. Was taking it with Sertraline but now take separate no change

[greygoose in reply to Emma_17]

How long ago did you stop taking it with Sertraline?

[SlowDragon Administrator]

Which brand of Levothyroxine are you taking?

Do you always get same brand?

Many people find Levothyroxine brands are not interchangeable.

Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased or at repeat prescription.

Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients

Do you Always take Levo on empty stomach and then nothing apart from water for at least an hour after?

Many take early morning, on waking, but it may be more convenient and possibly more effective taken at bedtime.

verywell.com/should-i-take-...

Do you take Levo morning or evening?

Other medication at least 2 hours away, some like HRT, iron, calcium, vitamin D or magnesium at least four hours away from Levothyroxine

Absolutely essential to test vitamin D, folate, B12 and ferritin

When were these last tested?

What supplements, if any, do you take?

Can you add results and ranges of vitamin tests

If not been done for 6 months, ask for these to be tested too when Thyroid levels are tested 6-8 weeks after latest dose increase

Have you tried dairy free diet?

You say you have tried gluten free diet.

Was it absolutely strictly gluten free?

Did you retest antibodies to see if they dropped while gluten free?

Please add reference ranges on these results

[Emma_17 in reply to SlowDragon]

100mcg tablets I take are mercurypharma the 25mcg are te a

I haven't had nutrients tested in over 6 months and I think they only did it as i was pregnant.

Taken on a morning with nothing else on empty stomach

Was strict gluten free and no haven't tried dairy free.

[SlowDragon Administrator in reply to Emma_17]

Teva can be very very upsetting for many

Make sure to get Mercury Pharma for all tablets at each prescription

You can change straight away by taking 2 x 100mcg and cut a 100mcg in half for 50mcg

Essential to test vitamin D, folate, ferritin and B12. Ask GP to test