Test result interpretation please

[Smartie1]

These are my latest test results:

T3 2.50. (2.63-5.70)

T4 7.0. (9.01 a 19.05)

TSH 3.90 (0.35 - 4.94)

I am currently taking 200 Levothyroxine and 150 T3 (bought from USA).

When I was diagnosed 3 years ago my antibodies were very high but havnt been tested since. No other tests are done routinely.

I am still gaining weight, I am tired and depressed, puffy and blotchy. Any suggestions welcome.

[SeasideSusie Remembering]

Smartie1

When did you take your last doses of Levo and T3 before this test?

Once antibodies have tested positive, there's not much point in further testing. Postive antibodies confirm Hashimoto's, it doesn't go away, the antibodies will fluctuate. Eventually Hashi's completely destroys the thyroid and then there is nothing left for the antibodies to do so they should no longer be a problem.

Have you had the following tested, they are often low or deficient when Hashi's is present:

Vit D

B12

Folate

Ferritin

Post results and ranges if you have them, include units of measurement for Vit D and B12. If you haven't had them tested, you should get them done.

[silverfox7]

You may be doing something else 'wrong' through no fault of your own. Absorption could well be an issue but there are ways of taking your meds plus taking other meds and supplementstgat you haven't been told about. If you look on the site of Thyroid U.K.-they run this forum-that has loads of info on the best way to take medication and how long to leave other things as we don't break down our food aswell as orgersso some things are recommended to be spaced out to make absorption easier. Doctors often think that when they prescribe your medication it's job done!

[SlowDragon Administrator]

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw). This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

If/when also on T3, make sure to take last dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you do your tests?

How do you take your thyroid hormones

Always take Levo on empty stomach and then nothing apart from water for at least an hour after.

Many take Levothyroxine early morning, on waking, but it may be more convenient and possibly more effective taken at bedtime.

verywell.com/should-i-take-...

Other medication at least 2 hours away, some like HRT, iron, calcium, vitamin D or magnesium at least four hours away from Levothyroxine

Many people find Levothyroxine brands are not interchangeable.

Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased or at repeat prescription.

Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients

Your antibodies are high 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

Assuming test is negative you can immediately go on strictly gluten free diet




(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)




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...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...