Mulling over latest results - do they suggest poor conversion?

[sy28]

Just received Medichecks test results (Thyroid Check Plus) and wonder if the following indicate there might be a current conversion problem.

TSH 0.22 mlU/L (Range: 0.27 - 4.2)

Free T3 5.2 pmol/L (Range: 3.1 - 6.8)

Free Thyroxine 21.400 pmol/L (Range: 12

- 22)

Meanwhile:

Thyroglobulin Antibodies 1354.000 kU/L (Range:<34)

Thyroid Peroxidase Antibodies <9.0 klU/L (Range: <34)

I am collecting evidence alongside NHS TSH-only testing.

I'd be really interested to hear what you think, many thanks in advance.

[greygoose]

Well, you're conversion is not brilliant there. But, could be because you're on too much levo. Reducing your levo slightly could improve your conversion.

[sy28 in reply to greygoose]

Thanks, greygoose ... I am currently reducing Levothyroxine by 25 mcgms per month, on instruction from consultant, who wants to achieve either 2 x TSH results above 4.2 or 1 x TSH result above 10 in order to prove original diagnosis, to qualify for T3 trial. NHS is testing TSH only every four weeks, I'm collecting fuller evidence alongside. This test result follows the first reduction from 150 mcgms Levothyroxine to 125 mcgms. I am about to reduce from 125 mcgms to 100mcgms. I noted the antibodies are on the rise already. Many thanks for replying.

[greygoose in reply to sy28]

Oh, lord, another sadistic mad-scientist endo! Can he not just look at your results from when you were diagnosed, instead of making you ill? What he's doing is unprofessional, you shouldn't have to jump through hoops - dangerous hoops - like that just to get T3. Pretty sure he's only doing it for his own amusement. No TSH result will prove you need T3, only a comparison of the FT4 and FT3.

There's no connection between your dose and antibody level, though.

[sy28 in reply to greygoose]

I'm not sure I'll complete the task, all I can do is collect supporting evidence based on my 2017 Hashimoto's diagnosis, which the consultant has recently acknowledged and accepted in writing. Test results gathered now, become crucial. My GP tested cholesterol levels as well as TSH and for the first time, my cholesterol is elevated - a Hashimoto's symptom? Hypertension is elevated, too. My GP is more supportive and sympathetic since reading the copy of 'Time for a reassessment of the treatment of hypothyroidism' I sent her, which she read at home. Convinced, she's following research of her own. I am grateful to diogenes for posting and his collaborative authors, including Dr Toft. I agree with you regarding antibodies ...they were first detected last year, prompting autoimmune thyroiditis diagnosis. I hope your own health is good at the moment. best wishes and thank you for replying.

[greygoose in reply to sy28]

High cholesterol is a hypo symptoms. It's caused by low T3. If your T3 is not high enough, the body cannot process cholesterol correctly and it mounts up in the blood.

High blood pressure can also be a hypo symptom.

People with Hashi's often have a conversion problem.

[sy28 in reply to greygoose]

Thank you, greygoose, for confirming. Previous tests confirm poor conversion issue. Evidence is mounting!

[greygoose in reply to sy28]

You're welcome.

[SlowDragon Administrator]

Essential to regularly test vitamin levels, especially when on inadequate dose of Levothyroxine

What is wrong with these sadistic b******s. Would they cut a diabetic's insulin dose down?

Ask GP to test vitamin D, folate, ferritin and B12

Cholesterol increasing is almost certainly due to being increasingly hypothyroid

nhs.uk/conditions/statins/c...

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

If you have common DIO2 gene variation blood tests won't even show low FT3......but that doesn't mean you don't need it

Have you considered DIO2 gene test?

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

As you have Hashimoto's are you on strictly gluten free diet? Or tried it?

[sy28 in reply to SlowDragon]

Hi SlowDragon, yes, I have had DIO2 gene test, the result being Heterozygous variant genotype TA ie decreased ability of the enzyme to generate the active T3 hormone. This was swiftly dismissed in consultant's first letter: 'this is a common variant and does not in itself signify anything'. That was before a later letter confirmed 'autoimmune hypothyroidism may now have developed.' Meanwhile, my GP offered me statins,this week, for raised cholesterol but understood completely when I declined in favour of receiving optimal thyroid treatment. Meanwhile, second letter from consultant says: 'It may be that she actually feels better without thyroxine.' The GP is testing TSH on monthly basis, I can request B12, Vit D and Ferritin, but there's no guarantee I'll get them included- I'll make sure they're included in the next Medichecks test I'm booking. Overall ... to quote Alan Partridge: Unbelievable. It's definitely not: Back of the net.

[SlowDragon Administrator in reply to sy28]

Roughly where in the UK are you?

Sounds like endocrinologist is trying to deny you trial of T3

Perhaps you need a different one

[sy28 in reply to SlowDragon]

South West ... I'm getting very mixed signals. It's cost related. I'm being encouraged to go private. This is my second NHS referral. GP will deny me a third. I'm hanging on in there!

[sy28 in reply to sy28]

Hi SlowDragon, I meant to add, consultant has confirmed in writing she will be happy to write a letter of support for a trial of combination T4 and T3 if GP happy to prescribe this - however, to confirm hypothyroidism diagnosis, I must first reduce Levothyroxine in 25 mcgm stages with an elevated TSH above the reference range, either on 2 occasions a month apart or 1 reading above 10mu/l. Then, she will be very happy to support T4 and T3 trial. I have Hashimoto's. The final paragraph of her most recent letter confirms this.

[SlowDragon Administrator in reply to sy28]

Very helpful website to look up exactly how many prescriptions per year in each CCG

Plenty of people do get T3 in Kernow CCG

Eg

openprescribing.net/analyse...

Devon areas are less keen

Liothyronine in North, East and Western Devon CCG

openprescribing.net/analyse...

[sy28 in reply to SlowDragon]

thanks, SlowDragon, I've looked at this before and it's helpful. The website's updating at the moment, I'll check back as they advise. As a growing community of patients, we shouldn't have to do this, should we - I don't think it helps that November 2019 Nice guidelines are in people's thoughts.