Hi. Attached are my labs from June. When I went to go see the Endo ( I budgeted to see Private one) He seemed like a wonderful Dr . However after walking out there - I believed that the 4.5 Stone / 28 kg's of weight that I had picked up since being diagnosed in Nov 2017 was due to my "emotions"/stress/trauma - not related to my Hashimoto's. I hear some people call it " brain fog" not sure if it is the same as I still experience , I start sentences and then just go off la la land. Frustrating my partner much. The whole of summer I slept in socks & fully covered. My hands and feet still get so cold. I get a ridiculous amount of headaches. ( My fiance thinks I am addicted to head ache tabs - FYI I am not - i try drink water most time). Trying to get up in the am is like a mission of note!!! I drag myself out of bed. I could go on. I was prescribed VITAMIN D + FERRATIN in February and was still taking when I had the tests done.
I am currently on 100 mg of Levothyroxine. He wanted me on 75mg . So I am due to get to see the Endo again. Not sure If I should change.
I know next test I should get my REVERSE T3 done? Is that correct? Is there anything that jumps out to anyone. He was totally NOT interested in adding T3 into the mix. I may "Appear" normal - but I sure ain't feeling normal!!!
Thanks for listening!!
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Quest2019
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I know next test I should get my REVERSE T3 done? Is that correct?
No. Reverse T3 is a bit of a red herring. There are many, many reasons why we may have high rT3, thyroid just being one of them. Conditions that contribute to increased Reverse T3 levels include: Chronic fatigue, Acute illness and injury, Chronic disease, Increased cortisol (stress), Low cortisol (adrenal fatigue), Low iron, Lyme disease, Chronic inflammation. Also selenium deficiency, excess physical, mental and environmental stresses. Also Beta-blocker long-term use such as propranolol, metoprolol, etc. Physical injury is a common cause of increased RT3, also illnesses like the flu. Starvation/severe calorie restriction is known to raise RT3. Diabetes when poorly treated is known to increase RT3. Lyme disease. Cirrhosis of the liver. Fatty liver disease. Any other liver stress Renal Failure. A fever of unknown cause. Detoxing of high heavy metals.
If rT3 is high due to a thyroid problem, it would be because we have too much T4 and it was converting to rT3 rather than FT3 and that would show in our results - we'd have a high, possibly over range, FT4 and a low FT3.
You are undermedicated to have such low FT4 and FT3 - 13% through range and 21% through range respectively. As your TSH is 1.2, I don't understand why it was suggested you reduce your dose of Levo, your TSH isn't even below range. The aim of a treated hypo patient generally, when on Levo, is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their reference ranges, if that is where you feel well. So you need an increase in dose, not a reduction.
Your ferritin could be a bit higher - it's recommended to be half way through range.
B12 and Folate are good.
Vit D is low, the Vit D Council recommends a level of 125nmol/L and the Vit D Society recommends a level of 100-150nmol/L.
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
NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.
Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)
All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels
As you have Hashimoto's are you on strictly gluten free diet?
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
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