New Results help please

[lt1806]

HinAll Inhave just received my latest tsh and free T4 I am currently on 75mcg of Levothyroxine. I still have severe achy swollen joints knees fingers and elbows!

Previous tsh 6.41(0.27-4.20)

Free t4 11.1(12.00-22)

Latest

Tsh 2.9 (0.27-4.20)

Free T4 13.2(12.00-22)

I have a consultation today with a rhumatoidologist for the joint pain. Any advice on my levels and the dosage I’m on before my gp appointment tomorrow would be appreciated.

[SeasideSusie Remembering]

lt1806

Presumably these results were before starting Levo:

Previous tsh 6.41(0.27-4.20)

Free t4 11.1(12.00-22)

and now on 75mcg Levo you have these results:

Tsh 2.9 (0.27-4.20)

Free T4 13.2(12.00-22)

Your latest results show that the Levo is doing it's job of reducing TSH and incresing FT4. However, you are still undermedicated as 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. So really, thyroid tests should include TSH, FT4 and FT3 and to rule out, or in, autoimmune thyroid disease then thyroid antibodies should be tested.

So you need an increase in your Levo, 25mcg now and retest in 6-8 weeks, continuing the increasing/reteting every 6 weeks until your levels are where they need to be for you to feel well.

As you have joint pain, it's possible this could be low Vit D, and because thyroid hormone needs optimal nutrient levels to work properly you should ask for the following to be tested:

Vit D

B12

Folate

Ferritin

Most doctors are satisfied if they are somewhere within range, we hypos need them to be optimal which doctors don't seem to understand. Come back with your results (and reference ranges/units of measurement) and we can let you know how close to optimal you are.

[lt1806 in reply to SeasideSusie]

Thank you yes 1st results were before treatment started.

I had many blood tests at the beginning the Tpo antibody came back negative. They other tests that came back as abnormal were

Urea and electrolytes and serum creatine at 85 creatine(45-84)

serum ferratin which was 283 range 13-150ng/ml. Do these mean anything or are they unrelated?

They did many more but stated satisfactory all though many at the top of range!

Thanks again

[SeasideSusie Remembering in reply to lt1806]

High ferritin is worth keeping an eye on. It can be raised where there's inflammation or infection, in which case one might expect to see CRP raised too. But there are other causes for high ferritin. If it continues your GP might want to look into it.

Is your diet very high in red meat/protein, this can cause raised creatinine.

Creatine and Us & Es are to do with kidney function I think. As your doctor about them if they are abnormal.

TPO antibodies are just one, there are also Tg (thyroglobulin) antibodies. We can have negative TPO but positive Tg antibodies connected with autoimmune thyroid disease.

But vitamins and minerals listed are important and should be tested

[lt1806 in reply to SeasideSusie]

Thanks you are right my crp is also raised at 8 ( 0.00-5.00) hence rhumatoidologist appointment! Will discuss vitamins etc with gp tomorrow.