Blood results what is going on???

[Ladyrandom]

Ok so diagnosed hashi in September on 50mcg thyroxine. Tsh was 18. Then had bloods repeated after 8 weeks and was at 3 ish which was upper end of normal. Quit fluoride, mostly quit gluten and dairy with the odd glitch. Still feel tired some days but is that just normal life!

Had thyroid ultrasound which was also normal though antibodies 600+ reference <35 normal.

So last week I had THE worst few days not sleeping well, sweating when at work when temp is in the minus numbers, feeling depressed. Coincidentally I had my scheduled blood test to check tsh that next day so I went first thing in the morning though waited till 10am for bloods as was busy I fasted before it and skipped my thyroxine and now my tsh has come out at 0.06 ref range 0.27 - 4.20 - gp wants a retest in 3 weeks.

I know you can flit from hyper to hypo with hashi but is it really this pronounced. I don't know if it's related but I have felt like that before I got diagnosed and it was always before my period night sweats etc and this period I came on the other day is the worst one I've had in ages. I'm 28 years old for context. Could it be to do with hormones?

Should I do the next blood test fasting also? As now I'm thinking I should have taken my medication but I was sure in the weeks before that I still felt hypo then it suddenly switched to hyper. I'm also worried she will take me off my thyroxine and then I will go hypo and majorly depressed again!!!

[greygoose]

If you were having a Hashi's 'hyper' swing, then it would be that pronounced, yes. TSH suppressed, FT4 around 30, FT3 around 12. That's the nature of the beast. But, of course, if they don't test the FT4 and the FT3, they have no idea what's going on. Just goes to show how little they know about thyroid. Does your doctor even know what Hashi's is? A lot of them don't.

If all your doctor tests is the TSH, it won't make any difference if you take your levo before the test, because the TSH doesn't move that fast. Taking levo before the test will only affect the FT4. What affects the TSH is the time of day - highest early morning, dropping throughout the day - and possible eating makes it drop, too. So, best to fast, we need as much help as we can get! Although, if your TSH is that low, it's not going to make that much difference at the moment.

But, your levels will come down by themselves, with time, and the TSH will rise again. You will become hypo again. So, if your doctor tries to take you off your levo, please do explain to her how Hashi's works!

[Ladyrandom in reply to greygoose]

Thank you I will speak to them about ft4 and ft3. My doctor is good but I feel pretty standard in the fact that she doesn't know a great deal about it...however she is open to my requests of adding blood tests vitamin panels etc.

It's just so shite this rollercoaster hashi emotions. My symptoms are coming back from when I was hypo tinnitus and heavy heavy periods yet they aren't going to want to let me increase my thyroxine now this has happened!

[greygoose in reply to Ladyrandom]

No. And if your FT4 and FT3 are high because of a Hashi's swing, you don't want your thyroxine increased. But, as I said, your TSH will eventually rise again. Do you know how Hashi's works?

[Ladyrandom in reply to greygoose]

I have read izabella wentz book but I don't think it mentioned hyper swings at all. That part confused me slightly...I've only seen about it on here. I didn't realise I had them as I always thought it was PMS before my period as it's only ever then but I suppose luckily due to the blood test I now know it was that!

[greygoose in reply to Ladyrandom]

Well, you don't really know, because you haven't had your FT4 and FT3 tested. It could just be your dose of levo causing your TSH to be suppressed. How much are you taking?

I can't imagine Izabella Wentz wrote a book on Hashi's without mentioning Hashi's 'hyper' swings. That's the whole point about Hashi's. Maybe she called them 'Hashi's flares'?

[Ladyrandom in reply to greygoose]

I'm on 50mcg of thyroxine. Tsh before thyroxine was 18 then it dropped to 3.13 after 6/8 weeks on levothyroxine. Now 3 months later it's 0.06. I'm annoyed they haven't at least done ft4 as they did ft4 on my original bloods however not these ones.

It possibly did mention it and I've not read it properly as I was focusing mainly on the diet and lifestyle changes to implement. Must read the book again!

[greygoose in reply to Ladyrandom]

They don't consider FT4 and FT3 necessary. They are convinced that the TSH tells them all they want to know. They wouldn't understand the FT3 if they tested it!

[SlowDragon Administrator]

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised and often drop when on low dose Levothyroxine

Low vitamins often equal low TSH

Recommended on here that 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 do your tests?

Ask GP to test vitamins

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

[Ladyrandom in reply to SlowDragon]

Yes I've just had ferritin folate b12 and d the receptionist said all normal however I will be getting a print out of these to make sure! As I'm aware lower end of their ranges is still not optimal.

My most recent blood test I fasted and skipped thyroxine.

Thank you!

[SlowDragon Administrator in reply to Ladyrandom]

TSH is completely inadequate when on Levothyroxine

Essential to test FT3 and FT4.

Hundreds of patients are forced to test privately

[Ladyrandom in reply to SlowDragon]

Yes I will have to speak to my doctor and arrange my own bloods in future if she won't agree!

[SlowDragon Administrator in reply to Ladyrandom]

Even if GP requests them, if TSH is within range, the lab will refuse to test FT3 or often FT4 too

[Ladyrandom in reply to SlowDragon]

I see thanks for that information.