I've just received my Medichecks results. In January 2020 (via GP surgery) my TSH was 5.43 (0.35-5.5), today it is 0.212 (0.27-4.2). The GP Report with test results suggests my Levothyroxine dose may be too high. He also suggests Hashimoto's and asks if I've been made aware of this - no I haven't.
For both tests - surgery and Medichecks I took my meds after the test. My surgery test was 10.45am and I did the Medichecks at 8am. The only difference in meds that I've made is over the last 3 weeks I've taken my Levothyroxine at night together with 1 Metavive 1 capsule, and 2-3 times per week I've taken 2 Metavive 1 capsules. The only other strange thing is that I'm not hungry!!
Any comments/advice greatly appreciated please.
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Maggiesmum
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The only difference in meds that I've made is over the last 3 weeks I've taken my Levothyroxine at night together with 1 Metavive 1 capsule, and 2-3 times per week I've taken 2 Metavive 1 capsules.
How long did you leave between your last dose of Levo and the blood test, and last dose of Metavive and your blood test? It should be 24 hours for Levo and 8-12 hours for Metavive.
As Metavive is a thyroid glandular, although there is no declared hormone content it would still be advisable to take the same amount each day rather that taking extra a few days a week.
Have you been on the same dose for at least 6-8 weeks before the test?
The fact that you have Hashi's probably accounts for the big difference in your TSH. Did your GP test just do TSH or was there an FT4 result as well?
The GP Report with test results suggests my Levothyroxine dose may be too high.
Take no notice of their doctor's comments (not worth bothering with, and you'll get your results back quicker without them). Medichecks doctors are NHS trained so will have the same opinions as GPs, and they all go by TSH. You're being told your dose is too high because your TSH is low. Your FT4 and FT3 are in range so you are not overmedicated.
Folate would be better over 10.
Active B12 of 53.7 is low. A result below 70 suggests testing for B12 deficiency according to Viapath at St Thomas' Hospital:
If you do then list them to discuss with your GP and ask for testing for B12 deficiency and Pernicious Anaemia. Do not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results.
Vit D at 51.4nmol/L is low. The Vit D Council recommends a level of 125nmol/L and the Vit D Society recommends a level of 100-150nmol/L. To reach the recommended level from your current level, based on the Vit D Council's suggestions you could supplement with 4,000iu-5,000iu D3 daily along with D3's important cofactors - magnesium and Vit K2-MK7.
Your raised antibodies suggest that you are positive for autoimmune thyroid disease aka Hashimoto's which is where the thyroid is attacked and gradually destroyed.
Fluctuations in symptoms and test results are common with Hashi's.
Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.
Some members have found that adopting a strict gluten free diet can help, although there is no guarantee.
Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.
You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.
I've taken my meds at night for the past 3 weeks. Have just counted the Metavive and I've taken 26 in total, 1 per night and the other 5 when I felt I needed extra support. I will stick to 1 from tonight.
I took meds at approximately 11pm Saturday night and completed the Medichecks test 8am Monday morning.
In January my GP tested B12 = 397ng/L (190.0-910.0) and Folate = 3.6ng/mL (3.3-99999.0). I presented with foot issues which she thought may be Diabetes - turned out to be Morton's Neuroma!
At my next GP visit I queried B12 and Pernicious Anaemia, to be told NO your tests are fine.
My TSH was tested at annual thyroid test in January. I am now waiting for this to be re-tested and T4 tested, following my last GP appointment.
My GPs have never mentioned Hashimoto's so I'll read up on this.
Your antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
As detailed by SeasideSusie says your folate, B12 and vitamin D are all too low
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, or buy test online BEFORE trying strictly gluten free diet
Assuming test is negative you can immediately go on strictly gluten free diet
If coeliac test is positive you will need to remain on high gluten diet until endoscopy, with 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
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
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
The Gp should have checked your antibodies levels in 2004 when your tsh was 6.96[0.35-5.5] and T4 was 14[9-23] if you were having symptoms at that time. ( Based on nhs guidelines) .
If antibodies were raised at that time you should have been offered Levothyroxine at that point.
I was diagnosed with autoimmune thyroid disease in 2003 with tsh 6.8[0.36-4.1] and mid range t4 ........BECAUSE they found raised thyroid peroxidase antibodies of 2499[0-50],which means .....'Sub clinical hypothyroidism'...... which is likely to progress to ......'hypothyroidism'......... because of the raised antibodies.
So based on that , before you grovel to your Gp , i would ask if your antibodies have ever been tested on the nhs , and if not , why not?
Do you feel better now than you did at your previous test in January ?.
If you do, then do not allow Gp to reduce your medication based on one out of range tsh result alone, which in any case is only just below the reference range 0,212 [0.27-4.2]. your t4 and t3 look good in this latest test.
Of course it will depend on what your next blood tests done by Gp say,( and they will no doubt be a bit different to this one, so you may not be asked to reduce dose anyway) but if you are feeling better than previously be VERY cautious of agreeing to reduce before asking some advise on here first.
If you have managed to do something which makes you feel better you must guard that improvement with your life.......... in my experience ,once you let the Gp change something to keep THEM happy ,you do not always get back to the same level of wellness .....'if it aint broke , don't fix it' as they say!
Best wishes,
Tat
P.s i still have raised TPOab (antibodies) nowadays of 195.4
"do not allow Gp to reduce your medication based on one out of range tsh result alone"... If you have managed to do something which makes you feel better you must guard that improvement with your life...... in my experience ,once you let the Gp change something to keep THEM happy ,you do not always get back to the same level of wellness"
Absolutely!
Maggiesmum , that happened to me, and no doubt to many others here. I was persuaded to take a decrease in thyroxine last year because TSH tested as 0.01, even though T3 and T4 were well within range.
I didn't like it as I still had hypo symptoms, but was unable to convince the person I saw (the practice pharmacists usually deal with thyroid medication). It seemed the only way to prove that what I needed was an increase, not a decrease. 3-4 months later I developed breathlessness and swollen ankles and was finally given the needed increases. Breathlessness improved but swollen ankles didn't. Now TSH is completely suppressed (less than 0.005) and even a slight decrease in Levo (that time it seemed a good idea to me too) didn't help.
Thanks for your response. As far as I'm aware my antibodies have never been checked but I will ask when I'm recalled (after Covid-19) for my cancelled blood test.
Levothyroxine was prescribed by a long-term Locum who had a reputation as being "the best GP in the practice", he left 6mths later. My dose was eventually increased by a GP who I (and many others) had faith in - she left last year!
The relevant antibodies are those at the bottom of your results at the top of this post , under 'autoimmunity' ,in case you were not aware . As others have said in their responses they are both above range now, which indicates your immune system is attacking your thyroid gland .
I'm interested to know how you are feeling since you started adding the metavive , if you don't mind me asking ?
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Differing test results
Blood test results
Test results
My Medicheck thyroid test results
GP won't accept private test results. Why?
