Blood Results - Help Needed Prior to Endo Appointment Please

[TrishG67]

Hi after 20 years on Levothyroxine for Hashis and suffering endless symptoms & constantly being unwell I finally found an Endo who has prescribed Armour NDT. I have been trialling this for 6 weeks now as my blood results have been swinging like a see-saw from Hypo to Hyper then back again. ( I am 53 in menopause so dropping levels of estrogen or previous use of PPIs last year could well have been causing this)? I was taking100mg Levo for years then autumn last year reduced this to 75mg daily of Levo. I have only been taking 1 grain of NDT so far. My bloods this week from Thriva are below:-

TSH = 5.85 ( high) range is (0.270 - 4.2)

Free T3 = 3.1 range is ( 3.1 - 6.8)

Free T4 = 9 (low) range is (12 - 22)

TGAB = 1417 (high) range is ( 0 to 115)

TPOAB = 120 (high) range is ( 0 - 34)

Total thyroxine T4 = 69 range is ( 59 - 154)

Vit D = 129 range is (75 to 175)

Ferritin = 113 range is ( 13 - 150)

Active B12 = 114 range is (37.5 - 188)

Folate Serum = 38.5 range is ( 8.83 - 60.8)

Other recent bloods from GP =

Serum Cortisol = 512 range is (140 to 700)

Red blood cell count = 3.79 range is (4.2- 5.4)

FBC Haemoglobin = 117 range is (120 -160)

TSH bloods prior to switching to private Endo were Oct 19= 0.08, Jan 2020 = 2.18, May 2020 =3.86, July 2020 =12.24.

So my current reading with Thriva this week of 5.85 is not great I know but at least heading back in the direction it needs too. I guess I will need to increase the NDT from the 1 grain but if anybody can give me any other advice before my follow up Endo appointment in September I would be so grateful. 👍

[SlowDragon Administrator]

Results show you are under medicated

On NDT or any dose of T3 you would expect TSH to be well under one, when adequately treated

Vitamins are good ..presumably you supplement?

As you have Hashimoto’s are you on strictly gluten free diet or dairy free?

TG antibodies may lower as dose of Armour increases and TSH drops

TPO antibodies often lower on gluten/dairy free diet

[TrishG67 in reply to SlowDragon]

Hi Slowdragon many thanks for reply. Yes I do supplement. Since March this year I have been taking Selenium amongst other vits/supps and have been gluten free. The TGAB antibodies were almost 3000 back then.! So I gather taking the selenium and going gluten free has helped bring these down? I have been getting some advice from a nutritional therapist. Tried dairy free but dont follow this strictly just cut it out as much as possible and always use coconut milk. I just long for the day to be symptom free and less anxious. 🙏🤞

[Marz in reply to TrishG67]

Your bottom of the range FT3 is the cause of your symptoms ... when that is higher I am sure you will feel stronger.

[TrishG67 in reply to Marz]

Cheers I hope so. Do you think I should be ok to Increase my dose to 1.5 grains until I see Endo on 7th Sept? Just seems daft waiting until appointment if I know I will deffo need to increase dose when I get there and speak with him. I could be in progress of stepping up dose in meantime but dont wish to cause any problems? Also does anyone know should I be addressing the FBC /low red blood cell count at all with anything? Manu thanks in advance

[SlowDragon Administrator in reply to TrishG67]

Normally dose is increased in 1/4 grain increments

[Marz in reply to TrishG67]

I would ask for a Full Iron Profile - your Ferritin is fine but the FBC results posted suggest iron anaemia and should be treated. Thyrod hormones will work better too ...

[TrishG67 in reply to Marz]

Ok thanks guys I only have 1 grain tablet and a pill cutter to chop in half. TBH they are not easy to cut as they crumb up so would be difficult to measure a quarter grain. Maybe I should wait for Endo appointment then to see if he prescribes quarter tablets? I just thought I could have gone up half grain to get into my system. But best hold off I suppose. I will follow up with GP re iron levels. Thanks so much 👍