Weird?

[Blondiejayjay]

So I recently posted how pleased I was with my results from medichecks. They were better than I’ve ever had before.

So I visit GP for joint swelling, pain, bone pain etc. She starts me on HRT and says I’d just like to check your thyroid again as it’s been chaotic in the last few years. I say it’s ok it’s been great lately.

She said let me check anyway and I got results today with an invite to see doctor to discuss

TSH 0.018 (0.34-5.5)

FT4 6.7 (7-15)

Ft3 3.8 (3.6-7)

Bit surprised 😮

I’ve been working on diet and vitamins. I have got cold sores at the moment and low neutrophils with high tpo anf thyroglobulin antibodies.

Is this typical Hashimoto?

[SilverAvocado]

Hi Blondiejayjay, I didn't understand the mystery at first from your post, so looked back at your old posts and saw you had these results from 2 weeks ago:

TSH 0.005 mIU/L (0.27-4.2)

Free T4 21.9 pmol/L (12-22)

Free T3 4.76 pmol/L (3.1-6.4)

The results you've posted today show frees looking very undermedicated. The 2 week old results you look much closer to optimal.

Is this what it looks like? These results were taken two weeks apart, under identical conditions, both on identical dose, both early in the morning fasting, without medication taken 24 hours ago?

If they were both taken correctly, one thing to consider is that an error has been made. The results could have been mixed up or contaminated. Sometimes other medications or even naturally occurring body chemicals can disrupt the testing.

I do see you mention in an older post that results were up and down, but I didn't see why, so if you've had strange results in the past it makes it more likely these are real.

Your question if this is typical in Hashimotos, yes, it is something that can happen in a Hashimoto's. Your thyroid is being constantly nibbled away, which means thyroid function will slowly reduce over time. But it can also dump excess thyroid hormone into the bloodstream, which means levels go up and down.

For most people this is a rare occurance, but others can be unlucky and get them frequently. There isn't much discussion on the forum about how the handle them, and I don't have Hashimoto's so haven't experienced it.

A few things I might suggest just based on general knowledge:

Work on your antibodies, try being gluten free, as that helps about 80% of sufferers, lactose another 20% or so. There is probably more that I know less about, make sure vitamins and other things are optimal.

If you can afford it, get blood tests frequently to help give yourself a sense of what's going on.

In addition take every thyroid measure you can to try and figure out the symptoms that characterise a flare up, take temperature, pulse, blood pressure (the little cuff machines aren't too expensive), I take mine morning and night, but it's probably better to spread them over the day.

In terms of dosing, you really want to be dosed for the lowest your blood tests ever are, because this is your 'baseline'. Both of the two blood tests show low-ish T3, you want to get that up near the top of the range.

Once you're more optimally medicated you will go over range during a flare, which means you'll get hyper symptoms, and may need to know enough to reduce your own dose until the flare passes. Before you're optionally medicated you may feel better during a flare, because it will take your levels up to more livable levels.

Unfortunately your doctor will probably know nothing about this, and its up to you to learn your own up and down patterns.

[Blondiejayjay in reply to SilverAvocado]

Thank you this is really helpful.

I have had thyroid issues since 1982 aged 22 and vitamin supplements was the approach used. It wasn’t until 1993 that tests were done to confirm Hashimoto and treatment began.

I was given 25mcg until 2008 and didn’t know then as much as I do now but the doctors were aiming at keeping my TSH under 5.

As most hypo people I have always felt lack lustre but trying persuading a doctor that you aren’t on the right meds is exhausting.

I eventually got them to up dose to 100mcg with FT4 around 15 and FT3 around 4.8 but the suppression of the TSH made them panick and I was reduced to 75mcg.

This resulted in being admitted to a&e suspected Angina or heart attack. Thankful it was neither but I was Bradycardia with a heart rate of between 36 and 40. After 4 days I was let home and received further treatment for plaque in the arteries. That was in 2015.

I saw an Endo who informed GP to ignore the TSH and use the FT4 to manage my dose due to ‘antibodies in Chronic Autoimmune thyroiditis affecting the assay’ (blood test).

So from what you respond it seems you are bang on.

I take ferritin vitamin D3 and B12 spray and my levels are lower side of normal. I don’t do b complex because I ended up with too much folic acid and I read somewhere that gives false high readings fT4 and Ft3.

I’ve just found out I have a lot of allergic reactions after a week of patch testing so I think gluten free could well be the next step for me after I’ve dealt with the dairy. Step by step or it becomes overwhelming.

Thank you for your help as I now have the confidence to request a dose change from GP on Saturday.

2 of my sisters who also have Hashimoto but about 20 years after me (I’m 59) have had ultrasound on their thyroids. One has partial atrophy and the other complete and therefore is given T3.

I shall be bold and suggest that I might require such investigation.

Note I had one and only one appt with Endo and was discharged back to GP.

[SilverAvocado in reply to Blondiejayjay]

I your vitamins are low end of normal they are probably far too low. Like with thyroid hormones, you want then to be optimal not just okay. It's worth looking into and trying to improve, because they can cause symptoms and need to be good for thyroid hormone to work properly. If your current dose of supplements isn't improving your levels you may need to increase doses or take more bioavailable forms. There is a lot on the forum about this, and you probably had good advice on your last post. If you didn't it's worth making a new post just with your vitamin results.

I agree with you it's best to change only one thing at a time and not get overwhelmed. There are so many things to try its got to be a slow, steady process.

Good luck going for your dose increase!