11/7/2018 Serum free T4 12.6 (12.0-22.0)
Serum TSH 4.7 (0.3-4.2)
18/10/2018 thyroid peroxidase ABS 336 ku/L (0.0-34.0)
Serum TSH 3.0 mu/L (0.3-4.2)
12/3/2019 Serum free T4 12.6
Serum TSH 9.5 mu/L (0.3-4.2)
I have been asked to go back for repeat tests in 6 months time, are the above readings ok?
I am female aged 70 years
No. You should have had an increase in dose each time. Your results got worse, was your dose reduced. I would ask to see an Endocrinologist and get FreeT3 tested too. But your TSH is too high ( needs to be lower than 2) and your T4 too low.
What dose Levothyroxine were you on at each test time and now.
Have you had Vitamin D tested? Or B12, Folate or Ferritin? If not ask GP to do these.
What diagnosis were you given? Do you have Osteoporosis or any other conditions or are you on any other medication or taking supplements?
Never take Multivitamins or multiminerals.
I put the dates on the left side before putting test results, I’m not on Levothyroxine, as Dr hasn’t said I’m hypothyroid, Dr has just said to have repeat tests in another 6 months so in September I will be on my 4th test in 14 months
You have Hashimoto's Autoimmune Thyroiditis and Hypothyroidism.
PLEASE DO NOT wait 6 months
Demand an urgent referal to an Endocrinologist. If refused , change doctor. Take a family member with you if possible or an assertive friend!
Ask GP to send you for an Ultrasound scan of your Thyroid whilst you wait to see the Endocrinologist.
Your results scream Hypothyroidism caused by Hashimoto's - would it be possible to see a different GP at the practice?
You could try finding out the name of the Endocrinologist in your hospital - write him/her a brief letter asking for their advice. List your results then your symptoms. Say what your GP said.
The other avenue would be a complaint - Practice Manager and /or local health board. But that's up to you. Many times I should have complained but never got round to it. So I can't really advise on that.
Yes, I edited my first reply - please read again.x
Firstly, how do you feel?
Have you got any symptoms you are struggling with?
Your GP should have started treatment after results in July last year.
Your FT4 was right at very bottom of range.
TSH above the top of range
Your antibodies are very high, which confirms cause is autoimmune thyroid disease also called Hashimoto's
Now your TSH is significantly higher
Standard starter dose is 50mcgs Levothyroxine, but when over 50 years old, it's recommended to start on 25mcg Levothyroxine
NICE guidelines
cks.nice.org.uk/hypothyroid...
Bloods should be retested 6-8 weeks after each dose increase. Dose of Levothyroxine is increased slowly in 25mcg steps upwards until TSH is under 2 and FT4 in top third of range
Essential to test vitamin D, folate, ferritin and B12
Vitamins are frequently very low as direct result and may need GP to prescribe vitamin supplements to improve. Or if they are low but within range you may need to self supplement
See GP and request that Levothyroxine be started as per guidelines
Vitamins tested and coeliac blood test too
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
chriskresser.com/the-gluten...
amymyersmd.com/2018/04/3-re...
thyroidpharmacist.com/artic...
scdlifestyle.com/2014/08/th...
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