I finally have T3 results :
I ended up going private this time so finally have a FT3 result ,I know I need to increase my eltroxin based on these results ,currently on 100mg but I’m wondering how do I check my conversion ability Based on results and for the antibodies what’s the difference between TPEx and TGab .i know I have Hashimoto’s.thanks guys .
Tsh : 24.2 ( 0.27 -4.2)
FT4: 14.6 (12 - 22)
FT3: 3.8 (3.1 - 6.8)
T4: 89 (59 - 154)
TPEX:331 (0 - 34)
Tgab:750 (0-115)
See GP for 25mcg dose increase in levothyroxine
Also insist on testing of vitamin D, folate, ferritin and B12 plus coeliac blood test (if not already on strictly gluten free diet)
Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten intolerance. Second most common is lactose intolerance
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find strictly gluten free diet reduces symptoms, sometimes significantly. Either due to 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 strictly gluten free diet for 3-6 months
If no noticeable improvement, reintroduce gluten and see if symptoms get worse
chriskresser.com/the-gluten...
amymyersmd.com/2018/04/3-re...
thyroidpharmacist.com/artic...
drknews.com/changing-your-d...
restartmed.com/hashimotos-g...
Come back with new post once you get results of vitamin testing
Thanks slow dragon ,I already have the extra 25mg ready to increase from tomo I knew this tsh was going to be high .all vitamins have been tested and high in ranges due to supplement except ferritin it’s low in range -I don’t have these results to hand right now (left them at work)but I’ve checked them and all high in Ranges according to your recommendations except the ferritin .i have been tested for coeliac twice and it’s negative .im gluten free now .What I’m curious about is my conversion ability .
Above link often posted on here as useful to work out where you lie in you range.
FT4: 14.6 (12 - 22). 26%
FT3: 3.8 (3.1 - 6.8) 18.92%
I agree with you, this is too low.
Your Ratio 14.6 / 3.8 gives you a ratio of 3.8:1
I believe 3:1 & 4:1 are acceptable levels.
Are your vitamins optimal?
Can’t advise on TPEX and tgab.
Thanks a million purple nails , ya all vitamins are high in range except ferritin.im going to increase my dose to 125mg tomo and retest again ,seeing a dietician that specialises in thyroid problems on Thursday too (online consultation giving the current CV restrictions) to see what else I can do .
You cannot know if you are converting well when you are so under-medicated. The TSH needs to come down to one or under, which will mean that your FT4 should be at a decent level. Then, you get FT4 and FT3 tested at the same time and compare the results. If you convert well, the FT4 will be just slighter higher in-range than the FT3. If the FT4 is at the top and the FT3 at the bottom, then you will know you're a very poor converter.
Once you know that you have Hashi's, there is no point in retesting the antibodies. They fluctuate, but it doesn't make any difference to the Hashi's, it doesn't go away, even if the antibody levels go low.
By TPEX, I imagine you mean TPO antibodies? TPOab and TgAB have different jobs, that's all, but they both indicate Hashi's when they are very high. Thyroid Peroxidas and ThyroGlobulin are both proteins found within the thyroid. If they get into the blood, as they are likely to do during a Hashi's attack on the thyroid, that will activate the immune system to release the relevant antibodies to clean them up. 
Thanks grey goose .i thought as much about my conversion until I get my tsh down .i had my tsh go down to 0.01 in Dec on 125mg and I went hyper so my doctor freaked out and had me off everything for a few weeks now I’m back here again trying to lower tsh again ! About to go to 125mg again tomo and I’m freaked at going hyper again and my heart palpitations and passing out :(((( but I think I’m so underactive at this stage at tsh 24 I can’t imagine an extra 25mg pushing me hyper .i think the doctor” fupped “ me up taking me off meds for over a week but I was freaked out after passing out . This was the doctor that I had high hopes in !! I’m on my own now cause I’ve spend €1000 since December and she’s only made me sicker !
A low TSH doesn’t necessarily mean over treated. Only above range Ft3 would mean over treated
These hyper symptoms could have been due to a temporary Hashi flare
How long have you been gluten free?
This can help reduce swings in levels
My heart rate was out of control and I’d chest pains and passed out ,I’ve never fainted in my life and my tsh was at 0.01 so as you can imagine I had to get help my T4 was way over too but t3 wasn’t checked .i had to do something and when I reduced eltroxin it did reduced hyper symptoms.i couldn’t do nothing and stay on my dose my heart was pounding out of my chest I thought I was having a heart attack ,I’m 45 and have 3 children I had to reduce . But maybe coming off the meds was a bad idea
Levothyroxine dose can need extremely fine tuning....and essential to have optimal vitamin levels too
Strictly gluten free diet helps or is essential for thousands of Hashimoto’s patients
Low Ft3 can cause high heart rate
What would you have done in that situation?
Knowing what I know now I would have got full private thyroid and vitamin testing ASAP before considering changing dose .......then tweaked dose down a very tiny bit while I waited for results
But hindsight is wonderful thing
I had similar experience to you over 20 years ago...I stopped taking levothyroxine for 10 days...became extremely unwell. So unwell medics thought I had MS/brain tumour/MND etc ......and took months to recover. I never ever stopped levothyroxine again! (More on my profile)
I won’t be ever be stopping again !! I thankfully didn’t get that sick just extra tired ,depressed and constipated but that might be down to the fact that my vitamins are all in a great place and I’m gluten free.
I was too scared to not stop because I would have had to wait at least for 4 days for results and prior to that episode it was only a week since my previous results with all vitamins great but tsh 0.001 and T4 at 27.9 and actually i did have Ft3 that time of 6.9.
So you perhaps needed tiny dose reduction..
perhaps just 25mcg reduction one day per week.....
or it could have been a Hashimoto’s flare
Honestly my gut is saying a flare but I know better now ,I’ll going to manage myself from now on .
Hopefully now you are strictly gluten free levels will be steadier
I think I’m very strict very tough with a family if 5 but I’m fairly sure I’m 100% last 3 months no cheating but I think I need to go AIP too to see if I need to take soya and fairy out too .
Probably every thyroid patient needs to cut soya....including soya lecithin
Lactose intolerance can improve once gluten free
Here are the vitamins:
B12 -1022 (200-1100)
Folate - 20 (3-14)
Vit D -120 (50-125)
Ferritin -35(6.9-282.5)
Ferritin still needs improving a bit
Vitamin D...is that nmol or ng/ml?
You could perhaps reduce vitamin D supplement a little ...especially with summer arriving
I'd say get your zinc checked its commonly low with hypothyroidism and even hyperthyroidism in autoimmune aka gaves and hashim too. Zinc balances cortisol and thyroid levels, low zinc lets cortisol rise which suppresses thyroid lefels hence the high pounding heart rate. But ideally needs checking to verify, otherwise its trial and error time... I'd sooner test myself...
Hope that helps
Its nmol/L .Ya I reduced the D already will get it tested again next time .
You can test vitamin D here ...if not doing full testing
I can get it done here in Ireland,I’m using private testing now and it’s extensive and was very fast and easy so will up to 125mg and full test everything in a month again .
High antibodies is this serious
Blood results
Latest TSH FT3 FT4 results
Latest fT3 result
