I was diagnosed with Hashimoto’s over a year ago. After a dose of 50 mg, I developed hyperthyroidism and my TSH levels varied for a number of months. I am currently not taking any medications and back to an underactive thyroid.
Here are my recent lab results along with vitamin levels:
There are many on here more knowledgeable than me who I’m sure will be along soon, but I would be interested in the results that made them think you were hyper. Also 50mcg is quite a small dose.
My TSH is usually less than one and my results always say ‘low’, however the doctor never queries it and they keep my dose at 100mcg. I feel well.
You are now hypothyroid again and need restarting on 50mcg Levothyroxine
Bloods should be retested 6-8 weeks later
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).
The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 in top third of range and FT3 at least half way in range
All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels
NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.
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
Would a gluten free diet mean that it’s strictly products labelled as gluten free? Or is eating products that are naturally gluten free okay too like oats for example?
Slightly strange results. TSH is the body's message it needs more hormone, and yours is pretty high, which means you're pituitary wants more.
But levels of freeT4 and freeT3 for a healthy person are right in the middle of the range and yours are quite close to that. Which should mean things are fine.
The two sets of measures don't match. I think Slowdragon's suggestion may be right, that you have Hashimoto's and are experiencing swings. As the thyroid gets nibbled away extra hormone is dumped into the blood. This means even though thyroid function is low, there are short term normal or high levels. Unfortunately some people can have this very badly and its not really a short term spike, but varying levels all the time. Doctors often know nothing about this.
There are a few things you can try, for most people gluten free helps and for some dairy free. You've also got a couple of low vitamins, improving those will improve thyroid function. Vitamin D is low, and ferritin might be, although I don't know enough to be sure.
I’ve been at 50 for more than two years and my T-SH has been at 1.5. I have more of the hyper symptoms than hypo. Something has never felt right to me. Hate to say this but I would love to feel tired and sleepy sometimes.
Some of my undermedicated hypo symptoms are the same as the symptoms I had when I was hyper. I wish I had known that symptoms can be the same for both as I kept myself undermedicated for years because I thought I had hyper symptoms. You need to have your t4 and ideally your t3 tested as well as your tsh. It is the only way to get optimal. I have a faster heart rate and I have lost weight because I am under medicated.
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