Hi all, me again. I have a dilemma, My recent issues regarding extreme hypo symptoms which were resolved by stopping HRT.
I also stopped taking a very high dose of flaxseed too at the same time and am now thinking which one was the culprit or was it both.
I had been on HRT for seven months with no hair loss.
I had been on flaxseed for approx one month.
Any suggestions or experience on this I would appreciate it.
More hypo symptoms when taking HRT and Flaxseed in a high dose, not sure which caused elevation of hypo symptoms or both.
As you're not sure which one may be the cause maybe stopping one for a few weeks might resolve the quandry. If there's no change, then add it back in whilst stopping the other for a few weeks.
HRT frequently requires increase in levothyroxine dose
Bloods should be retested 6-8 weeks after starting HRT
Suggest you organise FULL thyroid and vitamin testing privately yourself
Do you have Hashimoto’s?
What vitamin supplements are you currently taking?
cheapest option for just TSH, FT4 and FT3
£29 (via NHS private service ) and 10% off if go on thyroid uk for code
thyroiduk.org/getting-a-dia...
monitormyhealth.org.uk/thyr...
Medichecks - JUST vitamin testing including folate - DIY finger prick test
medichecks.com/products/nut...
Medichecks often have special offers, if order on Thursdays
Thanks slowdragon, All bloods ok, no alterations detected.
What are your actual results and ranges
TSH, Ft4, ft3, vitamin D, folate, B12 and ferritin
Just told they are good no changes needed, still no received a printout so really not sure.
Never ever accept an opinion...always get actual results and ranges
You are legally entitled to printed copies of your blood test results and ranges.
The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results
UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.
Link re access
healthunlocked.com/thyroidu...
In reality many GP surgeries do not have blood test results online yet
Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.
Important to see exactly what has been tested and equally important what hasn’t been tested yet
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
Vitamins need to be at optimal levels ....not just bumping along bottom of range
Come back with new post once you get actual results
If you have started back on HRT ....get FULL Thyroid and vitamin testing (privately if necessary) 6-8 weeks later
I have been requesting blood results for over a month repeatedly but being ignored. I will ask for enhanced access as will make things much simpler.
Only ever been tested once for TPO, they only test once to confirm. Usually FBC, TSH, FT3, FT4. liver function.
Thousands of members only make progress when organising own FULL thyroid and vitamin testing
NHS testing is frequently completely inadequate
Essential to always get test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
I always take my meds before test as i thought it important to know how high the thyroid hormones would be at there highest concentrations so i know im not doing my body harm by being overmedicated. I know they wear off but maybe we should alternate, say first blood draw after taking morning dose and the next blood draw not taking our medication until after blood draw to see how much or blood results change.
Leading Endocrinologists always recommend testing as we say ...
Levothyroxine is a storage hormone....it lasts 7-10 days in body. What you don’t want is to get false high Ft4 if testing after too soon after taking levothyroxine
Always tests as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test ....because you need to see lowest level
Median TSH graph of healthy population
healthunlocked.com/thyroidu...
TSH daily variation
healthunlocked.com/thyroidu...
Very important what time of day you test TSH ....
researchgate.net/publicatio...
“According to the current TSH reference interval, hypothyroidism was not diagnosed in about 50% of the cases in the afternoon.”
“Further analysis demonstrated inadequate compensation of hypothyroidism, which was defined in 45.5% of the morning samples and in 9% of the afternoon samples”
ncbi.nlm.nih.gov/pubmed/252...
TSH levels showed a statistically significant decline postprandially in comparison to fasting values. This may have clinical implications in the diagnosis and management of hypothyroidism, especially SCH.
When i discuss my results with my endocrinologist he knows i take my medications prior to being tested, i always do. I f they are different i tell him i missed a dose if i have, or if i have started to take HRT etc . I guess your TSH will tell regardless if you take in the morning or not it will only be FT3/FT4 that will be high but I'm sure they can tell who has and has not take before the test by results .
TSH takes at least 4-6 weeks to respond to dose changes
Ft3 is unaffected by when you take levothyroxine (and very rarely tested unfortunately)
A common scenario
Results - taking levothyroxine before blood test
TSH 0.98 (0.2-4.8)
FT4 20 (12-22) - 80% through range
Ft3 3.8 (3.1 - 6.8) 19% through range
Results taking levothyroxine 24 hours before blood test
TSH 0.98 (0.2-4.8)
FT4 15 (12-22) - 30% through range
Ft3 3.8 (3.1 - 6.8)
Clearly in both sets of results Ft3 is far too low and patient needs dose increase
But in first set of results GP likely to look at Ft4 near top of range and say “no room for increase”
In second set of results Ft4 shows there’s lots of room for dose increase
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.
Most patients will feel well in that circumstance.
But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor
please email Dionne at
tukadmin@thyroiduk.org
I thought it might look something like that, with taking levo and then without. My endo told me it takes weeks for TSH to change. I have just received my results with ranges so ill post them on here. My TSH is usually a lot lower but i started HRT and was on it for seven months. My TSH was in the 0s but now very high for me.
Result has been acknowledged by Prof <redacted doctor name> on 02/07/2020 15:28. Urea And Electrolytes, (UE)
Sodium
143 mmol/L
133-146
Potassium
4.5 mmol/L
3.5-5.3
Urea
3.8 mmol/L
2.5-7.8
Creatinine
65 umol/L
50-90
Result has been a8. Liver Function Tests, (LFT)
Total Protein
78 g/L
60-80
Albumin
48 g/L
35-50
Bilirubin (Total)
12 umol/L
4-20
Alkaline Phosphatase
57 U/L
35-105
ALT
24 U/L
5-38
Result has b. Bone, (BNE)
Calcium
2.48 mmol/L
2.10-2.58
Adjusted Calcium
2.32 mmol/L
2.10-2.58
Albumin
48 g/L
35-50
Alkaline Phosphatase
57 U/L
35-105
Result has been acknowledg. Full Blood Count, (FBC)
WBC
6.28 x10^9/l
4.00-11.00
Rbc
4.54 x10^12/l
4.10-5.10
Hb
138 g/L
120-150
Hct
0.430 l/l
0.360-0.460
MCV
94.7 fl
80.0-100.0
MCH
30.4 pg
27.0-32.0
MCHC
321 g/L
315-345
Plt
247 x10^9/l
140-400
Neut
3.99 x10^9/l
2.00-7.00
Lymp
1.71 x10^9/l
1.00-3.00
Mono
0.43 x10^9/l
0.20-1.00
Eos
0.11 x10^9/l
0.02-0.50
Baso
0.04 x10^9/l
0.01-0.10
Thyroid Stimulating Hormone, (TSH)
TSH
2.39 mU/L
0.27-4.20
N.B. Please note the new TSH reference range from 1st April 2015
Result has beenT4, (T4)
Free T4
18.0 pmol/L
9.0-26.0
N.B. Please note the new TSH reference range from 1st April 2015
Result has b
Free T3
4.4 pmol/L
2.8-7.1
N.B. Please note the new TSH reference range from 1st April 2015
Estimated Glomerular Filtration Rate, (GFR)
eGFR
> 60 mL/min/1.73m2
Creatinine
65 umol/L
50-90
Normal kidney if no proteinuria, haematuria, or abnormal kidneys on USS.
UK CKD guidelines are available at renal.org/CKDguide/ckd.html
EGFR calculated using parameters for white female. (If black multiply
result by 1.21)
FBC, (SFC)
Interim Report: Please check Full Blood Count (listed separately) before making clinical decisions.
WBC
6.28 x10^9/l
4.00-11.00
Hb
138 g/L
120-150
Hct
0.430 l/l
0.360-0.460
MCV
94.7 fl
80.0-100.0
Plt
247 x10^9/l
140-400
Neut
3.99 x10^9/l
2.00-7.00
Warning: These results are provisional, and
Please remove all reference to your doctors name ASAP ..click edit bottom right
TSH 2.39 mU/L (0.27-4.20)
Free T4 18.0 pmol/L (9.0-26.0)
Ft3 4.4 pmol/L (2.8-7.1)
Ft4 43% through range
Ft3 39% through range
Helpful calculator for working out percentage through range
Both Ft4 and Ft3 likely too low for someone on levothyroxine. TSH clearly high as well
Extremely common to need dose increase in levothyroxine on HRT
There’s no vitamin D, folate, ferritin or B12 results
Should be removed now, thanks i thought admin would have done it before it posted. I did need a dose change by these results and i really did feel unwell thats why i did the test early as my GP did not check after 8 weeks of HRT. I agree i think I need to up T4 to 150mcg everyday rather than every other day.
My GP has not given me results with ranges, i have been onto them for a long time so not sure about VitD, folate, ferritin or B12. Im guessing Vit D still low or they would not still prescribe me D3. I will get onto them again, they do not respond to e mails and i do not use phones or own one so i will call in and knock the window and ask.
Admin do NOT see your posts before they appear on the site.
If you realise the name should not appear, and have been told it should not appear, why not remove it yourself? There are only very few admins, and we do not always see everything.
i did remove the name didnt i ?
No!
I went in and edited it to read: Prof <redacted doctor name>
Come back with new post once you get vitamin D, folate, ferritin and B12 results and ranges
Most people are forced to test privately
Vitamin results
Will only be reported as abnormal if below range ...but we need optimal vitamin levels (though NHS not obliged to treat to bring to good levels, that’s down to the individual)
Ferritin range typically 14-150
Optimal results need to be over 70
GP would only say Ferritin is too low and needs treatment with supplements if result under 14
drhedberg.com/ferritin-hypo...
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Vitamin D
GP will often only prescribe to bring levels to 50nmol.
Some CCG areas will prescribe to bring levels to 75nmol
leedsformulary.nhs.uk/docs/...
GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)
mm.wirral.nhs.uk/document_u...
NHS Guidelines on dose vitamin D required
ouh.nhs.uk/osteoporosis/use...
Good B12 at least over 500
Folate at least half way through range
Thyroid disease is as much about optimising vitamins as thyroid hormones
Such a huge range?
What’s such a huge range?
Sorry ferritin. LOL xx
My GP put me on HRT. I developed Shingles a fortnight later and went Hypo. I later worked out that it was the Estrogen x
I have been trying to get feedback and test results with ranges since my latest panic of fatigue, hair loss, burning scalp, acute constipation from either the GP or the Endo but you have to go through the secretaries and i think they ignore my constant e mails. I stopped my HRT as i thought it might be that that was making me ill and today i finally got my results and my TSH had gone up to 2 which is still in range but i can not get out of bed with TSH at 2 but they say no change so now I'm back on HRT and have been for a bout a week . I thought also maybe as i have been on T3 for a good while now i thought i may have been over medicating but now i know as i was about to stop T3 in case it was that being to high and causing hair loss which happened to my son who is hyperthyroid, he lost all his hair.
HRT and hypothyroidism 
Thyroid meds and HRT 
Advice on metavive or hrt
T3 or HRT
Hypo / Hashi's and HRT! Any success stories please! 
