TSH dropped. Hashimoto's on thyroxine

[Flashgirl]

Good evening all. Any advice on the following blood test results (latest at bottom) please?

Hashimoto's diagnosed Jan 2020.

Currently on levothyroxine 100. T4 rising slightly but TSH has dropped. (Didn't get T3 or vit D this time).

Many thanks!

1 May 20

SERUM TSH - 0.66mu/L (0.35-5.00mu/L)

SERUM FREE T3 - 3.80pmol/L (2.60-5.70pmol/L)

SERUM FREE T4 - 13.3 pmol/L (range 9-22.00pmol/l)

FERRITIN - 23ug/L (range 10/200)

9 July 20

SERUM TSH 0.41mu/L (0.35-5.00mu/L)

SERUM FREE T3 - 4.6pmol/L (2.60-5.70pmol/L)

SERUM FREE T4 - 11.7pmol/L (range 9-22.00pmol/l)

FERRITIN - 31ug/L (range 10/200)

SERUM FOLATE- 8.2ug/L (range 3.00 - 20.00ug/L)

VITAMIN B12 - 869 ng/L (range 200.00 - 910.00ng/L)

VIT D - 119 n/mol/L (range 50.00 - 200.00nmol/L)

4 Sept 20

SERUM TSH 0.07mu/L (0.35-5.00mu/L)

SERUM FREE T4 – 13.6pmol/L (range 9-22.00pmol/l)

FERRITIN - 36ug/L (range 10/200)

SERUM FOLATE- 17.7ug/L (range 3.00 - 20.00ug/L)

VITAMIN B12 - 1036 ng/L (range 200.00 - 910.00ng/L)

[SlowDragon Administrator]

How do you feel?

Do you always get same brand of levothyroxine

Are you on strictly gluten free diet or dairy free diet or tried either?

Ferritin still needs improving, though it is rising very slowly

Obviously you need Ft3 as well at next test

[Flashgirl in reply to SlowDragon]

Hi there. Thanks for replying.

Feel tired and run down. My Endo (from healthunlocked list) has suggested I do 75/100 alternate days as he doesn’t want to suppress the TSH. But I’m not exactly sure what a low TSH means (he hasn’t explained as was just an email? Do you have any clarity on that?) Also I’m on accord.

With diet it’s so difficult. Trying GF where possible but dairy free I find so hard as we don’t eat meat. Will try as I know there are so many books and recipes out there.

Ref Ferritin, I’ve been on ferrous sulphate for a year once a day and it’s still low, but apparently my iron studies are ok and sometimes the ferritin level is not a true reflection (?!).

I’ve been suffering from thyroid pain like strangulation since jan this year. I’ve had prednisolone (2 courses) and finally got to see an ENT who was able to examine it and claimed it’s thyroiditis so now I need to have another ultrasound and FNA and also try a nerve suppressant!!

Will ask for T3 next time.

Many thanks.

[SlowDragon Administrator in reply to Flashgirl]

As a vegetarian with Hashimoto’s low ferritin is almost inevitable

Likely to need to increase iron supplements. Are you taking iron with orange juice or vitamin C. Helps improve absorption

Need to do full iron panel test to check iron doesn’t go too high. You can have low ferritin and high iron...

Eating iron rich foods like pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/Websites/...

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.

healthunlocked.com/thyroidu...

Thyroid disease is as much about optimising vitamins as thyroid hormones

Helpful post about iron supplements and testing

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post about iron supplements

healthunlocked.com/thyroidu...

Post discussing just how long it can take to raise low ferritin

healthunlocked.com/thyroidu...

Steroids tend to lower TSH

ncbi.nlm.nih.gov/pmc/articl...

When adequately treated TSH is often low

Low TSH can reduce conversion of Ft4 to Ft3.....but low TSH when on high enough dose levothyroxine is common