I would be grateful for a little advice following my recent blood tests so that I’m prepared when I return to see the endocrinologist.
TSH 0.35 (0.3-3.6)
FT3 2.0 (2.2 - 4.2)
FT4 0.83 (0.8 -1.7)
I am currently on 100mcg levothyroxine (triosint). When I last saw the endocrinologist she suggest that I may need to have my medication lowered as my TSH was suppressed at 0.03, (FT3 2.21 and FT4 1.06). She didn’t rush to do this without a further blood test , but she did refer to me as having sublinical hypothyroidism, (Hashimoto's TPO 88.74 (1.0 -16 ) , Which I’m not sure is the case. I am concerned that the endo will want to lower my meds although am feeling much better on this dose, although still not quite right, and clearly my FT3 and 4 levels are still pretty low. Is it significant that she says sub clinical, in respect to low fsh levels? I live in Italy (where the health care is actually very good I think) and need to go prepared to help with language etc.
Thank you.
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Aesm
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I cannot imagine what she means by 'subclinical'. The normal meaning of 'subclinical' is a TSH over-range, but no symptoms. How can that apply to a TSH of 0.35 and an under-range FT3? And, I presume that with an under-range FT3, you do have symptoms.
Just looking at the TSH of someone on thyroid hormone replacement tells you nothing. It is the FT3 the most important number and yours is under-range. Therefor you are under-medicated. This woman obviously knows nothing about thyroid and is actually dangerous. She will make you - and keep you - very sick.
Thankyou for your advice. Yes i do still feel unwell, but not as bad as when on lower doses. I was originally diagnosed by an English speaking GP here when my TSH was high end of normal range but my FT3 was below, and was experiencing a lot of symptoms. I have since registered with my local non English speaking doctor who actually is good. She referred me to the endocrinologist straight away, more to do with getting an exemption certificate for everything thyroid related. I do also have multiple nodules and a cyst on which I had a biopsy, luckily benign. I do hope I haven’t got myself on the treadmill that many people on this forum seems to have, that of struggling to maintain adequate doses of levothyroxine with low or suppressed fsh levels. My appointment with the endocrinologist is on Ist August, fingers crossed? X
As you have Hashimoto's you need vitamin D, folate, ferritin and B12 tested regularly
Many Hashimoto's patients find they need to supplement some or all of these virtually continuously in order to keep levels optimal
TSH is often low on Levothyroxine. Most important results are FT3 and FT4....yours are both too low
Your antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
Hashimoto's affects the gut and 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
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
Thank you, that is a lot of information to take on. I did think the FT3 and 4 are too low and certainly didn’t think my levothyroxine should be reduced. I do have indigestion and reflux frequently and saw a ENT specialist who diagnosed it as Laryngopharyngeal Reflux (LPR), is this linked to coeliac? I am currently taking B12 and folate supplements , but haven’t had regular blood tests to check levels. I will look at all those links you provided. Thank you for your support.😀
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