Low TSH plus High Free Thyroxine

[Slosh]

I have just done a Medichecks blood test:

TSH = 0.19mlU/L (Range 0.27 - 4.2)

Free T3 = 3.78pmol (Range 3.1 - 6.8)

Free Thyroxine = 22.6pmol/L (12 - 22)

Thyroglobulin antibodies = 28.5kU/L

(Range 0 - 115)

Thyroid Peroxidase antibodies =20.7klU/L

(Range 0 - 34)

Am I over medicated?

I presently take 100mcg Levothyroxine daily.

Thanks in advance.

[SeasideSusie Remembering]

Sslosh

Am I over medicated?

Technically, because your FT4 is 0.6 over range your GP could say you are. However, what your results do show is that you are a poor converter of T4 to T3 because your FT4 is high and your FT3 is low at only 18% through range.

Good conversion requires optimal nutrient levels. Did you also have Vit D, B12, folate and ferritin tested?

[Slosh in reply to SeasideSusie]

Not Vit D

ACTIVE B12 high > 300pmol/L (Range 37.5 - 188)

Folate Good

Ferritin High - 225 ug/L (Range 13 - 150)

[SlowDragon Administrator]

Bloods should be done as early as possible in morning and fasting and last Levothyroxine dose 24 hours before blood test

Is this how you do your tests?

This gives highest TSH and lowest FT4

Your conversion of FT4 to FT3 is very poor

Do you supplement vitamin D?

As you have Hashimoto's low vitamin D is extremely common and maintaining optimal levels can improve symptoms

Can test here

vitamindtest.org.uk

ncbi.nlm.nih.gov/pubmed/286...

Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.

endocrine-abstracts.org/ea/...

Evidence of a link between increased level of antithyroid antibodies in hypothyroid patients with HT and 25OHD3 deficiency may suggest that this group is particularly prone to the vitamin D deficiency and can benefit from its alignment.

Are you on strictly gluten free diet?

Or tried it?

While still eating high gluten diet 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

ncbi.nlm.nih.gov/pubmed/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

ncbi.nlm.nih.gov/pubmed/300...

The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

Research into fasting or non fasting tests

ncbi.nlm.nih.gov/pmc/articl...

[Slosh in reply to SlowDragon]

Thank you for you detained response.

I took it early morning before Levo dose.

I am in an autoimmune Paleo diet - no gluten or dairy.

[SlowDragon Administrator in reply to Slosh]

Have you seen improvement on AIP?

Recommend Getting vitamin D tested

[Slosh in reply to SlowDragon]

I don't know - my TSH has come down - but since the NHS doesn't test FT3 - I wouldn't now.

I went on the AIP more for histamine intolerance.

[SlowDragon Administrator in reply to Slosh]

Suggest you get vitamin D tested, improve levels if need be (aiming for at least around 80nmol and around 100nmol may be better

Then retest thyroid levels in another 2-3 months

If FT3 still remains low then look at getting small dose of T3 prescribed

Email Dionne at Thyroid Uk for list of recommended thyroid specialists who will prescribe T3

Getting DIO2 gene test can help persuade endocrinologist to prescribe T3....but more likely on private prescription than NHS in many English CCG areas.

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

CCG areas prescription rates

openprescribing.net/analyse...

[Slosh in reply to SlowDragon]

Thank you so much for your advice