Hello! I've just had the results of a Medichecks blood test and I'm a bit concerned about my rapidly increasing TSH.
A bit of background – I was diagnosed with hashimotos/underactive thyroid and PCOS when I was 17 (I'm now 29). I've been taking thyroxine ever since and my dose has risen over the years. I'm now on 175mcg.
My partner and I were hoping to start fertility treatment next month, but given these results it may look like it's going to take a while longer...
Results:
TSH 8.28 (0.28-4.2)
T3 4.32 (3.1-6.8)
T4 19 (12-22)
Thyroglobulin antibodies 503 (<115)
Thyroid peroxidase antibodies 117 (<34)
For reference, I did a test last November and results were...
TSH 2.19 (0.28-4.2)
T3 5.14 (3.1-6.8)
T4 20.7 (12-22)
Thyroglobulin antibodies 460 (<115)
Thyroid peroxidase antibodies 97.6 (<34)
I'm going to book an appointment with my GP, but obviously I need to get these results in normal range ASAP in order to move forward with our planned IUI.
Any advice? If I was to up my thyroxine, how long would it take for it to reflect in my bloods? Thanks in advance!
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bananahammock2
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Hi! Thanks for your reply. I changed my dose a year ago from 150mcg to 175mcg, and my results six months ago were pretty good and I thought that was a result of that change.
I have been taking 2000mg a day of Metformin for PCOS (on the advice of the fertility consultant). I've been taking this for around a year though, although I have recently upped my dose from 1500mg to 2000mg.
I had vitamins tested, the results were all good for ferritin, folate, vit B12 and vit D.
Samples taken under same conditions – after breakfast and medication.
Please add actual results and ranges on vitamin levels
As you have Hashimoto’s have you had coeliac blood test?
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
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
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
I could be wrong, but no one seems to have picked up on your comment about having your breakfast and taking your medication BEFORE you do the blood test.
Most of us on here avoid breakfast and only drink water, have the test and then take the medication afterwards.
Your blood results will be skewed by taking the blood test AFTER you have had your levothyroxine!
Many people find Levothyroxine brands are not interchangeable.
Once you find a brand that suits you, best to make sure to only get that one at each prescription.
Watch out for brand change when dose is increased or at repeat prescription.
Many patients do NOT get on well with Teva brand of Levothyroxine. Teva contains mannitol as a filler, which seems to be possible cause of problems. Teva is the only brand that makes 75mcg tablet. So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results
Why do you want your results in ‘normal range’? The ranges don’t always reflect how well you feel or your optimal replacement dose. You may have read many comments on here about GPs (and endocrinologists) who are wedded to the idea that tests should be ‘within range’ while keeping their patients severely unwell.
What is ‘normal’? The problem with getting bloods ‘within range’ is that this may well leave you unwell and under-medicated which has implications for conception and pregnancy, from what I have read.
I think that crimple’s comment is a valid one and perhaps a new lot of tests before food and medication would give a better picture; that’s a FULL range of tests as outlined on this site. Good luck.
Sounds strange, I bet angelofthenorth and SeasideSusie will know the score, they both really helped me work out what was happening to me. Good luck, the people on this forum really know their stuff!
Thanks for your comments – they're super helpful. I have a gut feeling there's something wrong with the results, as it's a steep hike in TSH after not very long and very few changes.
Will retake test under conditions set out above and see what happens.
For reference, I cut out gluten a year ago and only slip up every once in a while. It did reduce antibodies to begin with but not significantly and they've since risen slightly. I also avoid dairy, but could probably do more to stay away from cheese...
SlowDragon my vitamin levels...
Folate - serum >19.8 (ug/L >3.89)
Vitamin B12 - active 125 (pmol/L >37.5)
Vitamin D - 98.6 (nmol/L 50-175)
Does anyone have any advice for a more comprehensive test I can order online?
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