I’ve just had a battle with my GP about testing T3 & T4 alongside TSH! As my last TSH was 1.89 it is ‘beautiful’ and I should be well. There is apparently no further benefit to testingT3 and T4 despite T3 being only just in range at 3.2 (3.1-6.8).
I’ve now got a referral to Endocrinologist, because what I’m asking is outside GPS scope of practice. I’m happy to go privately if anyone can recommend a good knowledgeable endocrinologist.
Please PM your recommendations.
BEFORE seeing any endocrinologist m especially if paying privately you need FULL Thyroid and vitamin testing
Last test no FT4 was tested - looking at previous test result, it looks too low and therefore needed dose increase
FT3 obviously still ridiculously low
Essential to regularly test vitamin levels
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water . 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).
Is this how you do your tests?
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins
thyroiduk.org.uk/tuk/testin...
Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random
Email Dionne at Thyroid Uk for list of recommended thyroid specialists including those that will prescribe T3
thyroiduk.org.uk/tuk/About_...
Thank you.
Yes my thyroid test has been 24 hours after last dose of Levothyroxine. I’ve got a form for B12, FBC, Ferritin, SFOL, and UE. I have had antibodies in the past but they have been refused recently. I do have my last result that I pushed for in July this year TPO 3.46 (<34)
I got a dose increase after my last test when no T4 was tested. The GP believes I don’t need any further tests as TSH is good. I feel unwell still, but she treated me like I was making it up!
I’m so upset right now, I don’t know what to do.
The best way to describe how I feel is walking around with a diving suit on, and when I try to ride my bike it’s like I’m going uphill all the time! My cycling is my social life!
Have you ever had high TPO antibodies test result?
NHS only tests antibodies once
NHS refuses to test TG antibodies unless TPO antibodies are high
So you would need to test privately
You need vitamin D tested and folate as well as B12 and ferritin
Recommend getting full Thyroid and vitamin testing privately
Most important results are FT3 and FT4. TSH is often completely suppressed when on high enough dose of Levothyroxine
Yes I’ve had TPO tested, I’ve never had TG antibodies.
It looks like I better get a private test done!
Thanks for your help
Many people only have high TG antibodies
Because NHS refuses to test, they often struggle to get diagnosed
ncbi.nlm.nih.gov/pubmed/303...
Ever had ultrasound scan of your thyroid?
20% of Hashimoto's patients never have raised antibodies
healthunlocked.com/thyroidu...
Thanks for this I have read the paper. I have raised TPO TG never tested.
I have all my results now and my highest T3 was 3.6 my T4 has only ever been low in the range.
I’ve never had a thyroid scan.
So if you have raised TPO antibodies this confirms that the cause of your hypothyroidism is due to autoimmune thyroid disease (Hashimoto's)
FT4 should be near top of range when on a high enough dose of Levothyroxine. So first step is to get 25mcg dose increase in Levothyroxine. Retesting again in 6-8 weeks.
You may need to see an endocrinologist who will inform GP to increase dose.
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.
Folate and B12 need testing together
Very confused....you have two ID's?
Lorwri-1 and Lorwri12??
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
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
chriskresser.com/the-gluten...
amymyersmd.com/2018/04/3-re...
thyroidpharmacist.com/artic...
scdlifestyle.com/2014/08/th...
drknews.com/changing-your-d...
restartmed.com/hashimotos-g...
I just realised my TPO result has a full stop in the middle the result was 346,
I have been gluten free for nearly four years and I did feel better taking it out of my diet. I eat a very nutritious diet with absolutely no wheat, grains, or sugars. This was before my hypothyroid diagnosis although I think I did have a problem and didn’t know it. I have supplemented vitamin D for nearly four years too, as there is a family history of osteoporosis.
I will get bits and mineral bloods done this week now.
Sorry about the two profiles, can they be merged or should I delete one?
Thank you for your help
I don't think you can combine two profiles
Probably best to delete one
Come back with new post once you get results
Recommended Hospital/Endocrinologist in Derby/Nottingham/Midlands
Worried and confused after Endocrinologist appointment
Very high results again and confused 
Endocrinologist Keeps Lowering my Tirosint Dose
100T4/10T3 or 112.5T4/5T3
