Meaning of Thyroid test results

[Shkmigmo]

Hi!

Please could you help me interpreat these test results (pic enclosed). I've been diagnosed with Hashi for a year, and taking Euthyrox 100mcg for the last 3 months. I'm bit concerned with my hormonal levels since it seems to me that my pituitary-thyroid feedback isn't working properly. If my Ft3 is low, shouldn't pituitary "shout" ( i.e.release more Tsh) at my thyroid to produce more T3 and T4? What could be the reason for such disbalans?

[greygoose]

The reason could just be that you have Hashi's. More concerning is the fact that you have such low Frees on 100 mcg levo. How long have you been on that dose?

[Shkmigmo in reply to greygoose]

Thank you for the reply! I've been on 100mcg for the last 3 months. Prior to that, I was on 75mcg every day and my blood test showed:

TSH=7.1

FT4=10.67

FT3=2.35

(same range as in picture above).

After that, my endo increased dose to 100mcg every day... 3 months later I'm here with:

TSH=0.605

FT4=13.46

FT3=2.88

...

[greygoose in reply to Shkmigmo]

Well, your TSH is ok, but that's irrelevant. Your FT4 is still much too low and your FT3 is below range! You most certainly need another increase - maybe several. You are still hypo.

[Shkmigmo in reply to greygoose]

Thanks greygoise! I hope my endo will be reasonable enough to make decision in that direction...

[greygoose in reply to Shkmigmo]

Well, do point out that your FT3 is under-range and that that is not normal. And, if he says oh, it's only a little bit under. Tell him that, given it should be nearer the top of the range, it's actually a lot under!

[Nanaedake]

Something is not quite right. FT4 is low and FT3 below range. As you have raised TgAb I think you need further tests as you may have something else besides thyroid disease going on. Autoimmune conditions often coexist. I would follow this up with your doctor and ask for further investigations until you find a reason for your low and under range thyroid hormone blood levels despite taking an apparently adaquate dose of thyroid hormone.

[Shkmigmo in reply to Nanaedake]

Thank you for the reply and suggestion! Next week I have an appointment with endo and hope I'll get some useful insights from her.

[shaws Administrator]

Do you follow this procedure when having a blood test for thyroid hormones:-

The earliest possible appointment - fasting (you can drink water) and allow a gap of 24 hours between your last dose of Euthyrox and the test and take it afterwards.

Due to your very low FT4 and FT3's you're on an insufficient dose of Euthyrox(levothyroxine) or need a T4/T3 combination.

As your own body is not capable of producing thyroid hormones you have to have a sufficient dose prescribed to replace this.

The aim is a TSH of 1 or lower with the Frees in the upper part of the ranges.

If we are hypothyroid it means our thyroid gland isn't working as it should do and doesn't provide adequate hormones for our body to function as normal so we have to have an 'optimal dose' i.e. one that increases the Frees (T4 and T3) to be nearer the top of the ranges.

Also check B12, Vit D, iron, ferritin and folate - everything has to be optimal.

[Shkmigmo in reply to shaws]

Thank you for these instructions! I do follow the recommended procedure when having a thyroid blood test. Vit D is in the middle of the range, and the rest I haven't tested, but I take high doses of B vit complex (Solgar)... Nevertheless, it would be smart to check those too...

[Greybeard in reply to Shkmigmo]

Biotin in B complex (B7) can interfere with thyroid test results. Try not taking your B vits 2 or 3 days before next test.

[Shkmigmo in reply to Greybeard]

You are right! I read that here but I completely forgot about it...Thank you for the reminder!

[Nanaedake in reply to Shkmigmo]

Yes, if taking Biotin you need to leave a week clear and retest. That could be the cause.

[Shkmigmo in reply to Nanaedake]

I will try to retest before my endo appointment! Thanks!

[SlowDragon Administrator]

Request that endocrinologist test vitamin D, folate, ferritin and B12

Plus, as you have Hashimoto's you need coeliac blood test (unless already on strictly gluten free diet?)

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

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...

[Shkmigmo]

Thanks a lot for all these suggestions!

I have never tested for coeliac, but have been on strict AIP for a year now, working hard on my (presumed) leaky gut. Still it seems that my condition is getting worse: I somehow suddenly developed histamine intolerance - so every effort to improve my gut condition is now doomed to failure. I get urticaria rash after eating fermented food and drinking bone broth...I'm telling all this becouse I know that gut is one of the locations in the body where the conversion of T4 to T3 occurs. So poor gut health such as dysbiosis, IBS, or leaky gut may reduce my body’s ability to convert T4 into the active T3 hormone (this was one of my concerns when I received the latest blood test results).

I will definatelly request those blood tests as you recomended, evendough I hate doing it since it requires a good skill of tip-toeing around doctor's vanty when making such requests...