Hi All - I have my Medicheck results and would really appreciate some advice. I have been on the loading therapy of Vit D for 6 weeks and this has certainly improved and I have been on the 150 dose of thyroxine for 3 weeks (was 125) but this shows I am slightly over medicated? I certainly feel better in myself - the chronic fatigue is much improved and I am sleeping well - no more crappy 2am TV! However the joint and muscle pain is still an issue - my hips are not as painful but the rest of my joints are still constantly painful - yesterday I did a couple of hours light housework and today my arms, hands, fingers are so painful. By the end of the day I still get the heavy thigh and tops of arms muscle exhaustion - when it is difficult to climb stairs and lift my arms above my head. I did the blood tests as recommended - fasting and before taking my dose - 24 hours previous
Inflammation
CRP HS X 6.16 mg/L (Range: < 5)
Iron Status
Ferritin X 200 ug/L (Range: 13 - 150)
Vitamins
Folate - Serum 4.53 ug/L (Range: > 3.89)
Vitamin B12 - Active 82.300 pmol/L (Range: 37.5 - 188)
Thyroid Peroxidase Antibodies X 34.3 kIU/L (Range: < 34)
these are the notes attatched to the results
Your CRP level is a little high. This may indicate increased inflammation and/or infection within the body. If you are experiencing pain,
fever or other symptoms that suggest infection or inflammation then I recommend that you discuss this further with your GP. The type of CRP test that you have had is one which can also indicate future risk of cardiovascular disease. I recommend repeating this test in 6-8 weeks to see whether it remains above 3. If it does then I recommend that you take a more aggressive approach to managing other cardiovascular risk factors such as blood pressure, cholesterol, diet, smoking and exercise levels.
Your ferritin is also increased, whilst this can be caused by inflammation it can also be caused by iron overload. I recommend an iron
status check with your repeat CRP test.
Your folate is towards the lower end of normal. I recommend increasing your intake of folate rich foods such as broccoli, brussels
sprouts, asparagus, peas, chickpeas and brown rice. I am pleased to see your vitamin D levels are within the normal, healthy range.
Your thyroid stimulating hormone is low and you have high thyroxine which suggests that your thyroid medication dose may be too
high. You should discuss this further with your doctor who can advise you whether you need a reduction in your dose.
The concern is that having very low levels of thyroid stimulating hormone for several years has been associated with the development
of osteoporosis. If your thyroid stimulating hormone always tends to be substantially below the normal range then it may be worth discussing with your GP whether a bone density scan is advised to monitor for the development of osteoporosis. You do not need to worry about the occasional low reading, only if you get repeated very low levels.
Your thyroid peroxidase antibodies are marginally elevated. This antibody is commonly associated with autoimmune thyroid disease. It
is frequently seen in conditions such as Hashimoto’s disease.
Any advice is much appreciated - thank you
Written by
Mrsbuns
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It is common for many doctors/specialists to take more notice of the TSH and decide that if it is low we are taking too much hormones. In fact, if we are taking thyroid hormones the TSH will begin to reduce as that's why we've been diagnosed in the first place, i.e. a high TSH.
First TSH is not a thyroid hormone, it is from the pituitary gland and rises as the thyroid gland is unable to provide sufficient hormone replacements itself and that's why levo (T4) is prescribed.
The fact is that the majority of specialists in the treatment of hypothyroidism is that they appear to only take account of TSH - most do not test the 'Frees' i.e. FT4 and FT3. It is FT3 which is the more important. If we don't have sufficient T3 in the millions of T3 receptor cells we will not feel well and be symptom-free. The brain and heart have the most T3 receptor cells.
The following is by one of TUK's advisers (he is now deceased) he was a Researcheer, Scientist and a Critical Analyst. The latter means that he could take apart another's 'paper' and put it back together again with a report. I don't have the link:-
"Osteoporosis [Q&As are placed in reverse chronological order. In other words, the latest Q&As come first. Earlier ones are further down the page.]
Latest Updates to drlowe.com
Date: May 29, 2000 Question: Is the concern over thyroid hormone causing lost bone density justified? One of my doctors says yes; another says no.
Dr. Lowe: The possibility of reduced bone density from the use of thyroid hormone has been seriously overblown. We must consider each patient on an individual basis, but ordinarily, bone thinning isnt a problem. In fact, the use of thyroid hormone enables many patients to exercise more, and due to this, their bone density actually increases.
Thanks Shaws very interesting reading - just wish I was confident I understood the 'science'. Because I've taken thyroxine for so long and been 'well' I've never had to think about all this - so now I have a lot of catching up to do 😮
If someone is hypo and is fine on levothyroxine, there's no need for them to search the internet and they feel well. That's the aim of replacement hormones.
All we need to know is what hormones make us well again and it is usually levo for most. However, as you've found out some cannot improve or have done so but levo doesn't work for some reason. The person may even develop more symptoms. Also with doctors only taking account of the TSH and people don't have internet connection, they can become quite desperate and GP fails to know very much except to adjust dose up/down.
I hope you recover soon. A simple change in the original medications can cause problems.
First of all, It takes 6 weeks for a dose change to become fully effective and we should leave 6-8 weeks after a dose change for hormone levels to settle. Those results may not be accurate, and after 6-8 weeks you may find that your FT4/FT3 could be higher. If they stayed the same I would say that you're not overmedicated but the dose is giving you a FT3 result which is good, and that you need your FT4 to be at that level to give you that level of FT3. Hard to say with complete accuracy though as you only left 3 weeks after your dose change.
As for your slightly raised TPO antibodies, this could be suggesting Hashimoto's as the comments have mentioned. This is where the immune system attacks the thyroid and gradually destroys it. Fluctuations in symptoms and test results is common with Hashi's.
You can possibly help reduce the antibodies by adopting a strict gluten free diet which has helped many members here, although there is no guarantee.
Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.
You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.
Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.
Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies and probably the cause of your low Vit D and low folate.
Folate - Serum 4.53 ug/L (Range: > 3.89)
Vitamin B12 - Active 82.300 pmol/L (Range: 37.5 - 188)
A good B Complex such as Thorne Basic B or Igennus Super B should raise your B12 and your folate levels. When doing any blood tests in future (not just thyroid), leave off the B Complex or any other supplement containing biotin (B7) for 7 days. This is because if biotin is used in the testing procedure then supplementing with biotin causes false results. We have had confirmation from Medichecks that biotin is used in their testing procedure.
Vitamin D 75.6 nmol/L (Range: 50 - 175)
You now need to bring your level up to that recommended by the Vit D Council/Vit D Society as mentioned in reply to your previous post here:
and then follow the advice about maintaining that level.
Your ferritin is a fair bit higher than last time, are you supplementing or did you have high iron food close to the test, eg liver, liver pate, black pudding? If not then I'd keep an eye on it, although your CRP is raised so it just could be inflammation.
thank you so much for the information. No I have not been taking any supplements except my Vit D and i don't eat liver, pate, black pudding etc or anything else i can think of that would have been high in iron close to the test. If it is Hashi's does that mean that the partial thyroid I still have will eventually stop working - meaning my dose would need to be higher?
I now plan to have the test redone in about a month so they dose/results will be fully effective - and I will leave off taking the supplements till then so I have a true base line to work from - does that sound like a good plan going forward?
Yes, if it is Hashi's (and I think with over range, however slight, the level is we can assume it is) then your immune system will gradually destroy what's left of your thyroid. However, as you say "partial thyroid", can you tell us your thyroid history? Presumably you've had part of your thyroid removed? What was the reason?
Hi SeasideSusie - I developed Graves Disease in my late 20s and had a partial thyroidectomy in 1995 as I was never well on carbimizol. I have been mainly stable and 'well' since then but the last few years the underactive symptoms have become worse and worse
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