1st retest after changing medication

[Foggyk]

Hi. This is my first test after my initial testing and increasing my thyroxin.

I've been following a GF diet as recommended on here and taking B12, ferritin, selenium etc

Any feedback helpful. Thanks so much

[Foggyk]

Also B12 96.1

CRPHE 3.2

Folate 17.42

Ferritin 68.2

[SeasideSusie Remembering in reply to Foggyk]

Ranges for these please

[SeasideSusie Remembering]

Looks like you could do with an increase in your dose of Levo. Your TSH is good but your FT4 is only 43% through range and your FT3 is only 10% through range.

When on Levo only, 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.

Your FT4 and FT3 aren't in balance so conversion of T4 to T3 isn't that good.

[Foggyk in reply to SeasideSusie]

Any suggestions? Dr is clueless.

I've been on GF diet and taking vitamins for 3 months and my antibodies have actually increased!! Very confused now

[SeasideSusie Remembering in reply to Foggyk]

I'm not meldically trained, but these are my thoughts based on my own experience, reading and research.

I think the first step is to increase Levo by 25mcg, retest in 6-8 weeks. Aim to get TSH below 1 with FT4/FT3 in upper part of ranges with further increases if necessary.

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

[e-mail]

print it and highlight question 6 to show your doctor.

Ensure all vitamins are optimal:

Vit D - 100-150nmol/L according to the Vit D Council/Vit D Society

B12 (serum) - minimum 550pg/ml

to top of range

B12 (Active) - below 70 suggests testing for B12 deficiency, I would be looking to achieve over 100 with a range of 37.50-188.0 (Medichecks range)

Folate - at least half way through range

Ferritin - half way through range, I've seen 100-130 recommended for females

If all vitamins are optimal, and FT4 is in the upper part of it's range, if FT3 remains low then consider adding T3 to Levo.

[Foggyk in reply to SeasideSusie]

Thankyou.

My TSH is below one now after the increase. It was 2.4 now 0.782.

I'll speak to my GP . I'm not sure she'll increase again as she's already saying it's now too low 🙄

[SeasideSusie Remembering in reply to Foggyk]

Show your GP Dr Toft's article, point our your thyroid hormone levels - FT4 and FT3 - remind her that TSH is not a thyroid hormone but a signal from the pituitary - ask her if the UK's leading endocrinologist is wrong.

[Foggyk in reply to SeasideSusie]

Thank you

[NWA6]

I’ve had similar ranges throughout my 10yrs of Hashi’s. Each time I raise my Levo my T3 doesn’t change but my T4 edges its way into the 20’s. My conclusion is that it doesn’t matter how much Levo I take it’s not good enough.

[Foggyk in reply to NWA6]

Thanks. This is first test since upping my thyroxin.