Advice ahead of GP telephone apt on 19.06 following private blood test results.

[Michelin]

I’ve now had medichecks results following ongoing symptoms following diagnosis in Oct 2018 despite medication titration from 50mcg initially to 100mcg currently and wondered if you can share your thoughts to help me with the pending conversation, as results indicate I’m over treated currently. I had vitamins tested too as thought it could be low B12 issue but my levels are well within range for all tested. Typically though I feel much better this last few days and the joint and muscle aches that have plagued me for the last couple of months seem much better, 🤞. I think as Hashimoto seems to be the underlying cause of my hypothyroidism I might have had a ‘flare’ that has now settled so don’t want them to reduce the Levo if things now back on an even keel, but equally don’t want to create other issues if i am overmedicated. ?!? Thoughts welcome, with thanks.

So for comparison:

19.10.2018

TSH 37.25 (r 0.35-5.5)

Free T4 11.1 ( r 10-19.8)

TPO antibody 443 (r 0-60)

Now:

TSH 0.558 ( 0.27-4.2)

Free T3 4.42 (3.1-6.8)

Free Thyroxine 23.6 (12-22)

TGO antibody 227 ( less than 115)

TPO antibody 41.4 ( less than 34)

Ferritin 68.5 (13-150)

Folate 7.22 ( Less than 3.89)

Active B12 107 (37.5-188)

Vit D 89.5 (50-175)

CRP HS 0.4 (less than 5)

[greygoose]

Your FT4 is over-range, yes. But, that doesn't mean you're over-medicated. If you look at your FT3, you will see it's much lower in its range than the FT4, indicating that you have a conversion problem. So, I don't think this was a Hashi's 'flare', just poor conversion.

Your nutrients are in-range, but your ferritin and vit D could be a bit higher.

[Michelin in reply to greygoose]

Thanks so much for your reply, that’s why I told them I wanted to do the private testing as I thought I may have a conversion issue. Still learning all the time but knowing GP’s don’t always know best in these situations or are resistant to other potentially more appropriate treatment, what do you feel I should e aiming for in my conversation as after following lots of posts I’m not sure a referral to endocrinologist will be more helpful either. Probably haven’t helped myself as I’ve taken copy to gps for them to scan into my records so they can look at results and talk from that position and the medichecks GP has said I may be over medicated?!

I’m supplementing appropriately to help myself, as discussed in my previous posts, but I’ve not yet tried gluten free /diet - I’m presuming that might be my next step?! Fills me with dread tbh as love my gluten / grain and dairy rich food, 🙈, but sounds like a necessary evil!

[greygoose in reply to Michelin]

It might be useful to see an endo if you are allowed to chose your endo - Dionne at Thyroid UK has a list of helpful endos. But, if it's just any old bog-standard NHS endo, then no, it probably wouldn't be helpful. What you need is a little T3 added to your reduced dose of levo.

It just isn't worth getting the comments from the medichecks doctor. He's just another bog-standard NHS GP with a bog-standard NHS training. He has no special knowledge of thyroid, and just goes by the TSH, like all the rest. He knows nothing about T3.

Try gluten-free and see if it helps (if you can bear it!). If it doesn't, then return to your beloved gluten. lol I know how you feel. I bit the bullet and tried a gluten/dairy/sugar-free diet for three months and it did nothing for me. So, I went back to eating all three, with relish! However, I think I might have been rather stupid to try all three at once. Had anything helped, I wouldn't have known which it was. I would advise trying gluten-free first, and then dairy, then sugar-free, one at a time.

[Michelin in reply to greygoose]

Thanks again, also for your understanding re exclusion diet, and I know if things much worse again I’d do it as you’ll try anything to feel better but hard to do it to when things have improved somewhat. Can see from other related posts that there is no point in doing low gluten/diary/sugar etc, it has to be all or nothing, which is the scary bit! Think I’ll try to negotiate staying on current level and keep up my supplements for another three months and keep log of symptoms, then retest T3 and vitamin levels again via medichecks. If symptoms remain problematic or get worse I’ll try diet route and consider private referral to Endo recommended by Dionne at Thyroid UK. This forum is so helpful in helping me to help myself! Much appreciated. 😀👍

[greygoose in reply to Michelin]

You're welcome.