Hi ive had thyroid issues postpartum and challenged by the whole ordeal. I had my son last May and was ill from July then diagnosed with graves disease in August and prescribed propylthiouricil. In October my thyroid went under active so i was taken off all drugs and then when i remained underactive i was given levothyroxine since December. I am tested every 6 weeks and my results are all over the place. TSH has gone from 0.01 to 55.21 then back to 0.01 (range 0.40-4.50). My T4 has gone from 46.2 down to 3.3 and back up to 15.9 (range 7.00-17.00). Im currently on 50mg levothyroxine, reduced at my last test from 75mg as T4 15.9 and TSH 0.01
My results this week are T4 8.6 (range 7.00-17.00) and TSH 0.22 (range 0.40-4.50). I am still breastfeeding and understand this can effect results but for the first time since before i was pregnant i feel good. The doctor wants to reduce the levothyroxine as states my results say overactive. I need some advice please
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For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if Thyroid antibodies are raised
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?
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins
Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random
Your symptoms could be due to Hashimoto's, rather than Graves' disease
Important that ALL Thyroid antibodies are tested
If TPO or TG antibodies are high this is usually Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease). Though they can also be raised due to Graves' disease
To definitely diagnose Graves' disease TSI or TRab antibodies need to be tested.
Private testing for suspected Graves - TSI or TRab antibodies
About 90% of all hypothyroidism in Uk is due to Hashimoto's. Hashimoto's frequently starts with temporary hyperthyroid phases as thyroid starts to breakdown releasing lots of thyroid hormones
Low vitamins are especially common with Hashimoto's and Graves' disease . Food intolerances are very common too, especially gluten.
So it's important to get ALL thyroid antibodies tested at least once .
For most people: 50–100 micrograms once daily, preferably taken at least 30 minutes before breakfast, caffeine-containing liquids (such as coffee or tea), or other drugs.
This should be adjusted in increments of 25–50 micrograms every 3–4 weeks according to response. The usual maintenance dose is 100–200 micrograms once daily.
Thank you so much. I had read on here to miss dose of levothyroxine before test i did this last week. I have a telephone appointment with the doc as they want to reduce the levothyroxine. I am confused by this choice of actions when looking into what my results mean.
When my thyroid was overactive last year i was seen monthly by an endocrinologist and they did full thyroid function but when my thyroid went underactive they passed me back to the GP. The GP has not been much help.
Hi, sorry to hear of your problems. Sometimes when your thyroid results swing so much it’s a sign of an adrenal issue. However, Sheehans Syndrome and Lymphocytic Hypophysitis should be considered pituitary.org.uk/media/4597.... These are both classes as rare diseases so many GPs will not be aware. Good luck.
gives information on the daily dose needed for women, and for breast feeding. The two doses are different. Women need only 150mg a day but nursing mothers breast feeding, need 250mg a day. No need to reply.
Thank you...certainly more confused now. I was going to request an appointment with the endocrinologist for more informed treatment but seeing as they diagnosed Graves disease from my results that doesnt seam like a good idea
I was given propythiouracil and then baby was tested for 2 months to ensure it was not affecting his thyroid. Thanks for the information i really appreciate it.
Your TPO antibodies are high this is more likely Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease). Though you can also have raised TPO with Graves' disease
You can also have Graves and Hashimoto's at same time
To definitely confirm Graves' disease you need TSI or TRab antibodies tested. GP may be able to do this, or it may need to be by endocrinologist
Hashimoto's and Graves both affect the gut and often 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
When i speak to the doctor this week i will request vitamin levels as i am breastfeeding too which is probably affecting me. I am taking supplements (breastfeeding multi-vit, B12, vit D, vit C & zinc). I will see what they say about trying to reach a 'proper' diagnosis through more testing.
Thanks for the dietary information. I am a believer in diet changes for health benefits. I have been staying away from gluten for some months due to stomach problems. I am vegan so dairy not an issue. I have reduced my soy intake to occasional bit of soy sauce.
Thanks yeah i use gluten free soy. Ok thanks not sure how i will get around the presence of iodine in the breastfeeding vitamins. I need to take these while im breastfeeding and need a good dose of iodine whilst breastfeeding. Ill speak to the doctor... not holding out hope they will know. I might contact a lactation specialist and see if they can advise
Selenium can protect the thyroid gland from taking iodine. Pregnant women who develop hyperthyroid problems after giving birth, are more likely to have a deficiency. For hypothyroid conditions selenium zinc and vitamin C are essential to help thyroid metabolism. If your tests show too high iodine, then diet might be a factor with too much shell fish or salmon, so you might be advised to cut these down, and avoid iodine supplements. If you have a good milk supply when breastfeeding, then I guess your baby will be thriving. With post partum thyroid illness which can turn to Hashimotos in 50% of mothers who have had post partum thyroid problems. many women find it difficult to produce enough milk.
Thanks so much, knowledge is power. I can obtain my results with a little persistence. I have a telephone appointment with the doctor on Thursday so we'll see what happens and i will update
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