Following my previous posting, l now have my blood results back from Medicheck. TSH 0.006 (0.27-4.2), Free T3 5.29 (3.1-6.8), Free Thyroxin 20.8 (12-22),Thyroglobulin Antibodies 13.9 (<115) , Thyroid Peroxidase Antibodies 55.5 (<34 )
The advise is still to reduce the thyroxin dose, which I'm not happy to do, as I'm fit and healthy on my present dose of Thyroxin 100mcg alternating daily with 125mcg. I have no symptoms of overtreatment. My new GP thinks l should still reduce the dose, this is causing me anxiety as l know l will not be able to function well, having tried reducing the dose in the past.
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pembrokeshire
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Your FT3 and FT4 are both within range. You don't need dose reduction
See you also have B12 injections so your gut is compromised by hypothyroidism and likely conversion is poor.
Do you have PA ?
Do you take a vitamin B complex? Or vitamin D?
Presumably you know Your antibodies are high and this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
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
Ideally ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first
Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse
Your TSH is showing over replacement. Your T3 looks good to me. However it's how you feel at the end of the day.Our correct levels are so individual. If you feel more anxious than normal it would mean over replacement. If you can talk to your GO negotiate a small decrease for 6 weeks. Then retest. By small I mean 25 mg on T4 only treatment. I am no expert but veer on the side of caution if you are feeling good. It's your life at the end of the day. Best wishes.
TSH is not an indicator of thyroid hormone level, it's the FT3 that tells you if you are overmedicated, if that's over range then you're overmedicated. Your FT3 is 59% through range.
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the magazine for doctors):
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l. In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l. This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).*"
*He recently confirmed, during a public meeting, that this applies to Free T3 as well as Total T3. You can obtain a copy of the article by emailing Dionne at
tukadmin@thyroiduk.org
print it and highlight question 6 to show your doctor.
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