What you think of these result

[Blueskyyy]

Hi

Can someone check these result (TSH, FT4 and FT3) ?

Thx

[Lalatoot]

Are you on any medication? We need to know that to be able to realistically comment.

[Blueskyyy in reply to Lalatoot]

Yes of course

I take 125 mcg T4 + 12.5 mcg T3 daily

What you think of these result. ?

[Lalatoot in reply to Blueskyyy]

I'm am no expert on complicated issues and not a medic. Your tsh is high and as you are also taking t3 your ft4 is high. If I were you I would go back and look at your whole history and review how you ended up on your current dosages. How were you on t4 only? Why did you add t3? Are vitamins optimal?

Are you on any other medication or natural products that could be affecting you? Failing that I would be wondering what is going on with my pituitary gland that it is continuing to stimulate my thyroid so much even when my blood levels suggest it doesn't need to. This is all hypothesis on my part. All the best

[Blueskyyy in reply to Lalatoot]

Thx

The first three tests were done while taking only T4 (75, 100 and 112.5 mcg T4).

While the last test on 09.09.19 has been done while I was taking 125 mcg T4 + 12.5 mcg T3.

Regarding pituitary gland, I have hashimoto and my TPO antibodies are high, Doctor said that in case of autoimmune thyroid disease, the pituitary gland is not the cause of high TSH.

As you can see my FT3 and FT4 are great, I dunno what should I do next

[Lalatoot in reply to Blueskyyy]

Why did you start taking t3?

[Blueskyyy in reply to Lalatoot]

I started taking T3 in hope that my TSH gets suppressed, the other option was to add more T4 but I couldn’t support more T4 as my body started to react to the T4 overdose

[Lalatoot in reply to Blueskyyy]

What do you mean that your body started to react to t4 overdose? What were the symptoms?

[Blueskyyy in reply to Lalatoot]

Headache, migraine etc

[Lalatoot in reply to Blueskyyy]

Why if your body could not take any more t4 when you were on 112mcg did you end up on 125mcg plus t3?

[Blueskyyy in reply to Lalatoot]

Yes because symptoms occured while I tried to up my T4 from 112 to 137.5 (by adding 25 mcg T4 )

So then I knew the limit is roughly 125 mcg T4

[Lalatoot in reply to Blueskyyy]

Personally I think that your body must be wondering what on earth is going on you have changed doses and meds so much since April. The body needs time to catch up with the blood results and we need to take things slowly. Since April this year you have been on 4 different doses of thyroxine plus started t3. You need to give your body time to adjust to each change and sometimes this means waiting a little longer than 6 to 8 weeks. Have you thought about gluten free and have you had vitamins tested. You need to have optimum vitamin levels.

[Blueskyyy in reply to Lalatoot]

Well that’s a good point, thx

By the way, In June I started taking glutamin which helped me lots but pushed the TSH to 14, then I stopped taking it and started combi T4 + T3.

Last test revealed that my tsh went down from 14 to 7, however I think this dip is because I stopped taking glutamine.

It can be that my body is already settling the tsh down and it’s taking some time, so first dip is achieved and now working on the second dip.

I am already on gluten free diet

I take also supplements for vitamin D3, selenium and zinc

Do you think i am on the right track ? Are you ok with adding more T3 ?

Please suggest

[Lalatoot in reply to Blueskyyy]

Sorry but I don't know what to suggest.

[Angel_of_the_North in reply to Blueskyyy]

Well, I don't see how the pituitary can NOT be the source of high TSH as it is the pituitary that produces it (I suppose it could be hypothalamus shouting at it too much). You can have "false" high TSH because of monoclonal antibodies interfering with the assay(test). Those are NOT the Hashis antibodies but are related to mice (really, but people have them). How do you feel?

[Blueskyyy in reply to Angel_of_the_North]

I feel very well.

I will in the next days follow a strict plan to suppress tsh with T3, I will overdose with T3 and test tsh, if it gets suppressed I can exclude any other causes that relate to pituitary gland, otherwise I will ask for pituitary check.

[Angel_of_the_North in reply to Blueskyyy]

If you feel well it more likely to be a problem with the assay and antibodies than a "real" high TSH. I wouldn't risk making yourself feel worse just to prove a point. I have central hypo, but my TSH does react a bit (although it rises when FT4 rises, not when it falls)

[Blueskyyy in reply to Angel_of_the_North]

The bad thing is that when I go next month to the fertility specialist with my partner, he would suspend any diagnosis until the tsh is within range.

[Angel_of_the_North in reply to Blueskyyy]

You could have a TSH-producing adenoma. That could be tested for. Or try to find out what assay was used and get a test done that uses a different one. Cpould try giving endo these articles: ncbi.nlm.nih.gov/pmc/articl... and clinchem.aaccjnls.org/conte... (which mentions the mouse antibodies)

[Blueskyyy in reply to Angel_of_the_North]

I have hashimoto as i made a thyroid ultrasound and it confirmed hypothyroidism.

So the question is it possible for someone with hashimoto to have pituitary adenoma?

In addition, my TSH is getting lowered with hormones however it is not getting normalized, I guess in case of adenoma, tsh doesn’t react at all to hormones therapy, or ?

Regarding assay, that can be the cause however I just reviewed old tests (year 2016) and saw that my tsh was 5.4 at the Time

By the way, in Germany where I live, most laboratories use same assay which is called „ECLIA“ from roche

[Angel_of_the_North in reply to Blueskyyy]

"So the question is it possible for someone with hashimoto to have pituitary adenoma?" I don't see why not, but I'm not a doctor - it just means that the adenoma pumps out TSH whether you need it or not and yours seems to be way too high for your thyroid hormones. If you felt hypo, it could be thyroid hormone resistance, but as you feel well, that's unlikely.

[NWA6]

Hey Blueskyy. Have you got ranges?

TSH is ofcourse too high. T4 might be high or middle of the range but don’t know without the range. T3 is possibly low, if your range is 3.5-6.5

What was your FT4 when you started to feel ‘hyper’ (this happened to me also at about 20 (12-22)) even though my T3 was low.

Without knowing the ranges I’m guessing that you need more T3. A score of FT4 17 on combo treatment would be about right. So up your T3.

[Blueskyyy in reply to NWA6]

The ranges are shown in the table under the column “Norm”

Dates of each test is also shown, last test on 09.09.19

[NWA6 in reply to Blueskyyy]

Fab! Then what I said still stands 🤗

[Blueskyyy in reply to NWA6]

Hi Paula

Well I am adding more t3, i am taking now 20 mcg T3 (before I took 12.5) and keeping T4 same (125 mcg)

Honestly I don’t see any reason why my tsh is still high despite normal FTs levels

Btw, FT4 stands by 112% of the range

FT3 is at 59% of the range.

I don’t think these are bad levels !