Advice on results please

[jm03]

Hello,

I wondered if anyone could advise me on my medicheck results?

Diagnosed April '18. TSH 8, free thyroxine 13.8.

Started on 50mcg levo and went up to 100mcg. October results were then:TSH .64 (.27-4.2)

free T3 5.12pmol/L (3.1-6.8)

Free thyroxine 21.7 pmol/L (12-22)

Thyroglobulin antibody 13.1 kIU/L (<115)

TPAntibodies <10.4KIU/L (<34)

I thought I was stable but after Christmas experienced new symptoms such as constipation, fatigue, hair breaking and a strange skin rash with spots and peeling dry skin on my forehead.

Redid my tests: latest TSH is only 2.19mIU/L (.27-4.2)

Free T3 4.5, free thyroxine 17.2, thyroglobulin antibody 11.1, TP ANTIBODIES <9

Should I get such symptoms when my TSH is quite good? The pharmacy has given me a new brand of levo. I started eating a little but of gluten recently. I only wait 30mins before having caffeine in the morning. Have I done something to cause my TSH to rise or is this par for the course?

Many thanks in advance!

[SeasideSusie Remembering]

jm30

The pharmacy has given me a new brand of levo.

What is the new brand?

Was it after the change of brand that you experienced the symptoms of "constipation, fatigue, hair breaking and a strange skin rash with spots and peeling dry skin on my forehead."

Are your latest results whilst taking this new brand?

I started eating a little but of gluten recently.

Did this cause any reaction?

A gluten free diet is recommended to try for members with Hashi's (when antibodies are raised). Others may benefit from it too.

I only wait 30mins before having caffeine in the morning.

You should have water only for one hour each side of taking thyroid meds.

Your latest test shows that your TSH has increased and your FT4/FT3 have decreased. Presumably you were taking the same dose of Levo?

Did you do both tests under the same conditions, we always advise:

* Book the first appointment of the morning. This is because TSH is highest early morning and lowers throughout the day. If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.

* Fast overnight - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Eating may lower TSH, caffeine containing drinks affect TSH.

* Leave off Levo for 24 hours before blood draw, if taking NDT or T3 then leave that off for 8-12 hours. Take after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.

[These are patient to patient tips which we don't discuss with doctors or phlebotomists.]

Have I done something to cause my TSH to rise or is this par for the course?

Possibly not, you may just need an increase in dose. The aim of a treated hypo patient generally is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their ranges if that is where you feel well.

[jm03 in reply to SeasideSusie]

Thanks SeasideSusie. Yes, I did the test in the morning before food and the daily levo tablet. Yes, my symptoms started with the new meds.in January.- the pharmacist changed from tevo to actavis. Firstly I noticed a very uncomfortable pain in my stomach which woke me at night and then I progressed quickly to the other symptoms which I have never experienced before,even when my TSH has been a lot higher. (I only had some gluten pre Christmas so not related to gluten).

Thanks for your reply

[SeasideSusie Remembering in reply to jm03]

Actavis brand is one that suits many people, we rarely hear of anyone having problems with it, but of course we can all react to different fillers. Teva is the one most people have trouble with and yet you seem to get on well with it.

I would ask to go back onto Teva. Discuss with your GP or pharmacist that you have had these symptoms since changing from Teva to Actavis and that you wish to go back to Teva brand and get a new prescription if necessary. Check your pharmacy bag before leaving the shop because once out of the door they wont accept returns. If the pharmacy can't dispense that brand then ask for your prescription back and ring round other pharmacies until you find one that can dispense Teva.

[SlowDragon Administrator]

If Teva does suit you, as it appears to. You might want to consider trying dairy free or lactose free diet

Teva is the only lactose free Levothyroxine