Do I need thyroid medication?

[butterfly_38]

Hi

I am new here and would really appreciate some advise.

I had my daughter nearly 4 years ago and I was seeing a thyroid/diabetes specialist because I had gestational diabetes. I am British but live in Germany so testing and access to ultra sounds in gp surgeries are different to the UK. She looked at my thyroid via ultra sound and said I looked like I had a thyroid that would develop hashimotos disease. She said my blood levels were ok at the moment and I should just get checked once per year as there was a good chance from looking at the shape of my thyroid that I would develop it. Or if I got symptoms to go back.

Anyway, I moved areas and went to my local GP for a blood test. He also did an ultra sound on my thyroid (although he isn't a specalist like the other doctor) and said yes I looked like I had hashimotos. He said he needed to confirm in a blood test. When the blood test came back he said I needed to start medication. But the results were not that different to when the specialist said I shouldn't start taking them yet.

The results were

TSH 2,70 mU/l (normal being 0.27 - 4.20)

FT3 4.05 pmol/l (normal being 3.6 - 6.4)

FT4 13.2 pmol/l (normal being 12.3 - 20.2)

these are normal right? but he said my MAK TPO-Ak was 293 (normal being <34.0)

So I started taking 25mg of L Thyroxin in MArch 2018 but I started getting palpitations. SO I looked up the MAK to see what this was and it said onthe internet when this is high some doctors but you on meds and some don't. So I stopped taking them.

I didn't previously have symptoms of hypotyhroidsim so I thought I don't need them.

I went back in Dec 2018 and had a blood test. He said he would recommend I started taking them again....

The results were

TSH 1.92 mU/l (normal being 0.27 - 4.20)

FT3 4.13 pmol/l (normal being 3.10 - 6.80)

FT4 12.1 pmol/l (normal being 12.0 - 22.0)

but no MAK results on there...

SO I started taking them.

My next blood test was in April where he said they were great..

TSH 1.90 mU/l (normal being 0.27 - 4.20) (no change ??)

FT3 4.06 pmol/l (normal being 3.10 - 6.80) (no change??)

FT4 14.4 pmol/l (normal being 12.0 - 22.0) (slight higher)

I know a low FT4 can indicate reason for medication if TSH normal but you have symptoms. But I had no symptoms. Do I really need the tablets?

The thing is I am really suffering at the moment with anxiety and nervousness/fast heart rate. I have been prone to anxiety in the past but not this bad for years. I'm worried part of the anxiety is it is because I am taking medication when it is not required? some side effects of the medication is anxiety....

Does anyone have any experience with these types of results... or with anxiety whilst in meds?

If I stop taking L thyroxin after 6 months will that have an effect on me? I never had any symptoms of hypothyroid in the first place.

I only know about this condition, not because i had symptoms but because a doctor decided to check my thyroid in her surgery after I told her I had thyroid meds with my first born in pregnancy so she said to hop on the bed and she'd give me a quick check. I also know I wouldn't have been on thyroid meds for my first born had I been in the UK as the levels of recommendation were different than in the country I was in. I was also not on thyroid meds in my second pregnancy.

I would really appreciate some opinions.

Thank you!

[shaws Administrator]

A number of women after pregnancy can develop a problem with their thyroid gland.

The commonest cause of hypothyroidism is Hashimoto's. Hashimoto's causes us to have thyroid antibodies in our blood and it is the antibodies that wax and wane whilst attacking the thyroid gland until we're hypothyroid. Regardless of blood test results, if antibodies are present we should be prescribed levothyroxine (also known as T4). T4 is an inactive hormone and it has to convert to T3 and it is T3 which is the active thyroid hormone and we have millions of T3 receptor cells in our body, brain and heart containing the most and all need T3 for our body to function normally.

I will state I'm not medically qualified but had to diagnose myself with hypo.

Your results:-

"My next blood test was in April where he said they were great..

TSH 1.90 mU/l (normal being 0.27 - 4.20) (no change ??) - The aim is 1 or lower once diagnosed.

FT3 4.06 pmol/l (normal being 3.10 - 6.80) (no change??) -Should be nearer the upper part of the range.

FT4 14.4 pmol/l (normal being 12.0 - 22.0) (slight higher) - could be nearer the upper part of the level)

thyroiduk.org.uk/tuk/testin...

You are fortunate you were diagnosed with a low TSH as many doctors in the UK make a patient wait until it reaches 10 (it is the guidelines they're given) (but if antibodies are present - you should be prescribed and were prescribed).

Going gluten-free can help reduce the antibodies. You've not had thyroid antibodies checked.

[butterfly_38 in reply to shaws]

Thank you for your advice much appreciated

[shaws Administrator]

I should have said that you need B12, Vit D, iron, ferritin and folate tested. Everything has to be optimal.

[jimh111]

If you have no symptoms with these blood levels you should not take thyroid hormone. The one exception is if you are, or are planning a pregnancy. In pregnancy there are higher demands on the thyroid so you need a little 'headroom'. The recommendation is to keep your TSH below 2.5 in the first part of pregnancy. Taking levothyroxine with these blood levels can actually make you a little worse as it reduces the TSH which reduces your own thyroid secretion giving you less T3 which is the active form of the hormone. I would discontinue the levothyroxine but bear in mind you may become hypo sometime in the future.

It's frustrating that doctors place so much reliance on the numbers, as a consequence many patients who need treatment are denied it and many who don't need it are given thyroid hormone. Ultrasounds are useful when a patient has symptoms but I don't know of any use in healthy people, we all have abnormal tissue here and there.

[butterfly_38 in reply to jimh111]

Thank you for your advice. Much appreciated.

[greygoose]

Are you really sure you had no symptoms? There are over 300 of them. You don't have to have them all to qualify, but are you sure you didn't have any? Anxiety is a hypo symptom.

Once you have a high antibody reading, there's no point in retesting. Antibodies fluctuate, but Hashi's doesn't go away.

[butterfly_38]

Thank you for your reply. Much appreciated. I don't think i had any symptoms. I've always had anxiety on off for 20 years but it got worse after I started taking the medication.

[shaws Administrator]

From Thyroiduk.org.uk

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...