Hi, ive looked back on my last 4 TSH results, they went 0.35 in october, up to 1.59, down 0.84, and now 0.48, is this normal?
I'm supposed to be hypo, but doesn't this low level more indicate hyper?
I'm taking 100mg levo, and have Hashimotos
Thankyou to those of you who replied earlier, really trying to understand this thing now.. if anything to do with my thyroid is why i'm having all, or some of my symptoms, it would be good to know
pelakey1
You are hypothyroid, it is impossible to become hypERthyroid. However, you have Hashimoto's and because this causes fluctuations you can have "false hyper" swings but it is not hyperthyroidism, it is the result of Hashi's activity and is temporary.
However, the TSH results that you have mentioned will be within range so don't even indicate a false hyper episode.
But just testing TSH is not enough to give a full picture of your thyroid status, it's the FT4 and more importantly the FT3 results that tell us what we need to know, these are the thyroid hormones, TSH is a pituitary hormone not a thyroid hormone.
However, those variations in your TSH are slight and could be due to difference in time of testing, whether or not you had eaten before the test, etc. Do you always do your thyroid tests as we advise:
* Blood draw no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If looking for a diagnosis of hypothyroidism, an increase in dose of Levo or to avoid a reduction then we need the highest possible TSH
* Nothing to eat or drink except water before the blood draw. This is because eating can lower TSH and coffee can affect TSH.
* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw, if taking NDT or T3 then last dose should be 8-12 hours before blood draw. Adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.
* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (most labs use biotin).
These are patient to patient tips which we don't discuss with phlebotomists or doctors.
This is the only way you can accurately compare your results.
Thanks.. everyone on here suggests getting ft3 test done but endo said there was no point unless I stopped taking levo for 2 months first..
pelakey1
Yes, I've seen your other posts and agree that your endo is an idiot. Absolutely no need to come off your Levo at all. You need TSH, FT4 andFT3 all done at the same time to see what your dose of Levo is achieving.
I would suggest ditching this endo quick smart.
You can also do a private test with one of our recommended labs. Never do FT3 on it's own.
For TSH, FT4 and FT3 only MonitorMyHealth is cheapest at £26.10 when using the code provided by ThyroidUK:
thyroiduk.org/help-and-supp...
For full thyroid/vitamin testing choose either Blue Horizon Thyroid Premium Gold or Medichecks Advanced Thyroid Function Blood Test. Codes available on the same link posted above.
Thankyou.. I'll b back in tomorrow to add further info and I will get tests done now!!
Have you had thyroid antibodies tested
TPo and TG antibodies need testing to confirm autoimmune thyroid disease
If TPO or TG thyroid antibodies are high this is usually due to Hashimoto’s (commonly known in UK as autoimmune thyroid disease).
About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s. Gluten intolerance is often a hidden issue to.
Link about thyroid blood tests
thyroiduk.org/getting-a-dia...
Link about Hashimoto’s
thyroiduk.org/hypothyroid-b...
List of hypothyroid symptoms
thyroiduk.org/if-you-are-un...
Yes.. my thyroid peroxidase are high.. and I was negative for coeliac 5 years ago..
So you can immediately try absolutely strictly gluten free diet, for minimum minimum 3-6 months
Suggest you get thyroid and vitamin D tested first BEFORE going strictly gluten free
Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function with Hashimoto’s 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
healthcheckshop.co.uk/store...?
As your test is negative you can immediately go on strictly gluten free diet
The only way to know if gluten intolerant is to try strictly gluten free diet
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
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.
Watch out for cross contamination. Use separate toaster for GF bread. Separate butter, jam, cutting board etc
Lots of GF options available these days
How much do you weigh in kilo?
guidelines on dose levothyroxine by weight
Even if we frequently don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose
NICE guidelines on full replacement dose
nice.org.uk/guidance/ng145/...
1.3.6
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
Also here
cks.nice.org.uk/topics/hypo...
gp-update.co.uk/Latest-Upda...
Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months. RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.
For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.
For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).
If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.
BMJ also clear on dose required
bestpractice.bmj.com/topics...
I was at 75kg and am now 64kg - I have taken levo for many years at 100mg per day
So 100mcg is roughly correct dose, but often with Hashimoto’s we have low vitamins, poor conversion of Ft4 to Ft3, gluten intolerance and poor absorption of levothyroxine
So may need higher dose or addition of T3 prescribed as small doses alongside levothyroxine
yes, thanks for your input.. i have messaged my gp so will wait to see if he prescribes a different anxiety medication before taking propanolol
i'll stop my b vitamins now for a week then take the ft3 test I have sitting on my desk
Test early Monday or Tuesday morning and post back via tracked postal service
Test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
Tips on how to do DIY finger prick test
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