First Endocrinologist appointment

[goofball]

Finally the appointment that I have been waiting for with an Endocrinologist is nigh. Please can someone help with what I need to ask him/her.

My last blood test in December 2018 was based on 75 umg of Levothroxine, which was only just increased in November after a year on 50 umg.

TSH 4.0 (0.27-4.2)

Free T4 25.0pmol/L (12.0-22.0) abnormal result

Free T3 3.2pmol/L (3.1-6.8)

Vit B12 346ng/L (180.0-914.0)

Folate 4.6ug/L (3.0-20.0)

Ferritin 30 ug/L (10.0-307.0)

Vitamin D 47.9nmol/L ( already taking suppliments)

I forgot to importantly get my Thyroid antibodies tested, but know from the test I had in November 2018 they were;-

107ku/L (60.0) = antibody positive result.

I have been told that I have Hashimotos as a result of this.

The surgery will not re test at the moment as my last test was December, so will have to take these results with me.

This is what I think I should be asking for:-

T3, not 100% why but think my conversion rate isn't as it should be, not sure that is the right term. My TSH was 6.5 on 50 umg of Levothyroxine, so some improvement there but not in the free T4 result at 25 is outside of range. Would T3 bring this result down, and how does a high free T4 adversely affect the body?

I am going gluten free as much as I can, not sure if that would bring down antibodies.

Will he or she tell me about taking other suppliments?

Will they help with any bloated symptoms that I get with Levothyroxine? not pleasant, I have been told that other medication is worse, any thoughts please?

Thank you for any help.

[greygoose]

How long a gap did you leave between your last dose of levo and the blood draw? It looks like you took it about 2-3 hours before, which would be why it was so high.

If so, you cannot judge your conversion - although your FT3 is low, but then, your TSH is still too high.

Taking T3 will bring your FT4 down a bit, but if that is your real level then you would need to reduce the levo by 25 mcg when introducing 5 mcg T3.

A high FT4 like that will adversely affect your conversion, causing more T4 to be converted to rT3 than T3.

You need to be 100% gluten-free for it to have any effect at all. But, if you're counting on it reducing your antibodies, I wouldn't bother. It may or it may not, but you would still have Hashi's, even if it did. The antibodies are not the disease, they are the result of the disease.

I doubt very much if any endo would know about supplements. Doctors don't learn about nutrients in med school. You'll get better advice about that, on here! And, by the way, your nutrients are all much too low, but your endo will think they're 'fine' because they're in-range.

I doubt if it's the levo causing your bloating, it's a hypo symptom. But, it's not unusual to develop extra hypo symptoms when starting levo. If you went 100% gluten-free, that would probably help with your bloating.

[goofball in reply to greygoose]

Thank you.

I often take the Levothyroxine early in the morning, say 1.30-3 am which I know is slightly odd, so think that I would have taken it well before the blood draw. (8 or so hours)

Am I to assume that the endocrinologist will probably do nothing? Also I have read on here that they will not prescribe T3, or is that just the doctor?

I am generally 100% gluten free, and have been on Levo for over a year, just seem to have noticed a big increase in bloating mainly since I had the dose upped to 75. I take it they take the bloating to be nothing much as a side effect, you say is a hypo symptom, does this mean changing medication will make no difference, if at all that would ever be on the cards.

[greygoose in reply to goofball]

8 hours is not long enough. You should leave 24 hours between your last dose and the blood draw. But, even so you would still have a conversion problem, I think. Your FT3 is very low. So, not surprising you have hypo symptoms.

The endo will probably reduce your levo, but nothing else. It's very rare to find an endo that will prescribe T3, these days, due to the cost - and even rarer to find one that understands the need!

I don't suppose any doctor would be remotely interested in your bloating - unless there's a drug then can prescribe. They know nothing about hypo symptoms, nor side effects of medication. Who knows if it will go away if you change your medication. It is a hypo symptoms, but could be caused by a reaction to something you eat. Have you tried dairy-free?