Help to decipher readings

[Henson1980]

Morning Everyone,

I have just received my blood test results for my Thyroid Function. My readings show: TSH 1.46miu/L and T4 13.3 pmol. My question is, at 100mcg of Levo per day am I on the right track or undermedicated? I also have Hashi's. Feeling pretty awful at the moment, ie body aches and pains, headaches/tiredness etc, if the results are normal then I guess its just a case of having to bite the bullet go Gluten Free

[SeasideSusie Remembering]

Henson1980

Who did your test?

What is the reference range for FT4?

Was FT3 done as well?

Any other tests (i.e. vitamins) or just the very basic thyroid function test?

Did you do the test no later than 9am, nothing to eat or drink but water before the test and last dose of Levo 24 hours before the test?

[Henson1980 in reply to SeasideSusie]

Hello, My Dr done the test. FT3 wasn't tested just very basic thyroid function test.

Test was done at 9.30am and I had eaten, I was advised I didn't need to fast the FT4 Ref range is 7-14

[SeasideSusie Remembering in reply to Henson1980]

Henson1980

Was your last dose of Levo 24 hours before the test, if not when did you take it?

[Henson1980 in reply to SeasideSusie]

No, it was that morning. It was a last minute blood test but by that point I had already taken my dose

[SeasideSusie Remembering in reply to Henson1980]

Henson1980

So you have a false high FT4, it's measured the dose of T4 you'd just taken rather than the normal circulating hormone level you'd get if you left 24 hours.

You really can't tell if you're under (or over) medicated unless FT3 is also done at the same time as TSH and FT4, as it's the FT3 result that tells us this.

It might be a good idea to do a full thyroid/vitamin panel following the advice we always give here about an early, fasting test with last dose of Levo 24 hours before test. Doutbtful if your GP will do that so you might want to consider using one of our recommended private labs.

[SlowDragon Administrator]

Strongly recommend getting FULL Thyroid and vitamin testing

What vitamin supplements are you currently taking?

Which brand of levothyroxine are you currently on

Do you always get same brand

Essential to test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

For full Thyroid evaluation you need TSH, FT4 and FT3 important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially as you have Hashimoto’s

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

If you can get GP to test vitamins then 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

Come back with new post once you get results

[SlowDragon Administrator]

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

healthcheckshop.co.uk/store...?

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

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

ncbi.nlm.nih.gov/pubmed/296...

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

ncbi.nlm.nih.gov/pubmed/300...

The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease

nuclmed.gr/wp/wp-content/up...

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

restartmed.com/hashimotos-g...

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.

Why gluten intolerance can upset cortisol levels

kalishinstitute.com/blog/gl...