I'm currently on 75mcg of Levo and have had my first blood test since I was diagnosed with Hashimotos. I'm from the UK but currently in the Middle East so we have to organise our own blood at the lab and then take them along to the Endocrinologist. What do you think I should be asking him in my appointment? Do you think the bloods are looking good? Is the T3 a little low?
When I was diagnosed my results were
TSH 8.7
FT3 2.43
FT4 0.5
The most important thing is how do you feel?
TSH: 2.67 (0.3-4.5)
This is higher than where most people feel best.
FT4: 1.61 (0.9-1.9)
This is well up in range, 71% through range
FT3: 2.89 (1.5-4.2)
Mid range at 51%
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.
Your TSH has come down a lot, FT4 increased from below range to 71%, FT3 has increased slightly.
How long have you been on Levo?
I've been on Levo for 6 weeks and 1 day. It is difficult to judge how I feel as I also had low B12 and severely Vitamin D deficiency so although I feel a lot better, I'm not 100% but not sure which of the three has caused me to feel better. i.e levo, Vitamin D treatment or b12 treatment. Do you think it is possible that I struggle converting T3 as my levels have only gone up slightly?
You are only just starting your thyroid journey. It takes 6 weeks for Levo to be fully effective, which is why retesting is done 6 weeks after starting and 6 weeks after a dose change.
The B12 and Vit D deficiencies will be causing symptoms.
All vitamins and minerals need to be optimal for thyroid hormone to work properly, so at the moment you need to work on those as well, get them to optimal levels.
Did you also have folate and ferritin tested? Ferritin needs to be at least 70 for thyroid hormone to work properly, recommended is half way through range.
All building blocks need to be in place for thyroid hormone to work.
It's early days at the moment.
These are the optimal nutrient levels you need to aim for:
Vit D - The Vit D Council recommends a level of 125nmol/L [50ng/ml] and the Vit D Society recommends a level between 100-150nmol/L [40-60ng/ml]
B12 - top of range - are you having injections or sublingual lozenges?
Folate - at least half way through range
Ferritin - half way through range.
My Vitamin D was a shocking 11ng/ml but had it tested today and now 55.3ng/ml. I had two weeks of loading doses of B12 and now one every two months or sooner if symptoms come back. My folate and Ferritin was testing when diagnosed and I think it was halfway through range. At the beginning of the 6 weeks I was obviously at the beginning of addressing the B12 and Vitamin D. Do you think that based on my levels he will move me up to 100mcg? One thing I had noticed that was definitely thyroid related and not vitamin related was my body felt puffy and my hands and feet were freezing, the puffyness has gone down and my hands and feet have warmed up!
Over here they often do combined T4/T3 treatment is need be by no NDT or porcine treatments.
As you are now having regular B12 injections, you should take a good quality B Complex to balance all the B vitamins, one with melthylfolate rather than folic acid.
Based on your TSH your Levo should be increased.
It's a big improvement, but how do you actually feel? the TSH looks a bit high still, at least for most people. T3 could be a bit higher as well. But I'm no expert, having learned most of the little I know from this forum
You also need vitamin D, folate, ferritin and B12 tested
Have you had coeliac blood test?
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
Have coeliac blood test first, just to rule it out
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