Here’s my full thyroid function results from Medichecks
My thyroid function results : Here’s my full... - Thyroid UK
My thyroid function results
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Adam40
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SlowDragonAmbassador
As per previous post with results from GP
healthunlocked.com/thyroidu......
TSH is still very high
You need immediate 25mcg dose increase in levothyroxine
Bloods should be retested 6-8 weeks after each dose increase
Likely to need further increases in levothyroxine over coming months
Very high thyroid antibodies confirms autoimmune thyroid disease also called Hashimoto’s
Did you know you had Hashimoto’s?
Ask for coeliac blood test at next GP appointment
Vitamin D is insufficient
GP should prescribe 1600iu daily for 6 months
But you may wish to self supplement at higher dose
Aiming to improve to at least around 80nmol and around 100nmol maybe better
SlowDragonAmbassador
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...?
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
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.
SlowDragonAmbassador
What vitamin supplements are you currently taking?
Low folate
supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial.This can help keep all B vitamins in balance
Difference between folate and folic acid
chriskresser.com/folate-vs-...
Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.
thyroidpharmacist.com/artic...
B vitamins best taken after breakfast
Igennus Super B is good quality and cheap vitamin B complex. Contains folate. Full dose is two tablets per day. Many/most people may only need one tablet per day. Certainly only start on one per day (or even half tablet per day for first couple of weeks)
Or Thorne Basic B is another option that contain folate, but is large capsule
IMPORTANT. If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
endo.confex.com/endo/2016en...
endocrinenews.endocrine.org...
I’ve just started on a vitamin D supplement that’s all I take
How much vitamin D are you currently taking
Were you taking this before Medichecks test
Low vitamin D is strongly linked to autoimmune thyroid disease (Hashimoto’s)
pubmed.ncbi.nlm.nih.gov/286...
Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.
pubmed.ncbi.nlm.nih.gov/273...
Vitamin D insufficiency was associated with AITD and HT, especially overt hypothyroidism. Low serum vitamin D levels were independently associated with high serum TSH levels.
pubmed.ncbi.nlm.nih.gov/300...
The thyroid hormone status would play a role in the maintenance of vitamin D sufficiency, and its immunomodulatory role would influence the presence of autoimmune thyroid disease. The positive correlation between free T4 and vitamin D concentrations suggests that adequate levothyroxine replacement in HT would be an essential factor in maintaining vitamin D at sufficient levels.
Most GP’s are completely unaware of the interconnection between low vitamin levels and autoimmune thyroid disease
Similarly most are totally unaware of link between gluten intolerance and Hashimoto’s
4000 iu I’m taking, thanks for all your advice
Hi Adam, I had low vit D3 but gp wouldn't listen when I said that I wasn't depressed, just absolutely lethargic, sent me to mental health dept!! Finally sent my own blood test...result d3 20!!!!! He only prescribed 800iu daily. Did some research, need at least 10,000iu twice weekly to bump up d3 levels. I am an ex midwife and theatre sister and all I can say is; God help the general public!!!
I’ve been get advice from the receptionist when I ring for my results believe it or not, I have to request to speak with a doctor !!
Ludicrous isn’t it
Guidelines for GP’s are quite clear what they should prescribe
NHS Guidelines on dose vitamin D required
ouh.nhs.uk/osteoporosis/use...
When I got online access to historical blood test results few years ago , I discovered my vitamin D was 12nmol. Was never told or treated at the time
It’s disgusting I’m seriously shocked at the things I read when finding out about people’s stories and health, I’ve never really needed the support of my gp so I’ve always been ok with things and just take what they say as they are the professionals or so I thought !!
I’m certainly not the type to just stay quite if I know different to what I’m being told so I’m really looking forward to my conversation with them tomorrow I’m already going to be having a word about the fact I was refused the full function test and as soon as I get the results I’ve posted they jump to suddenly do them, also the fact I’m getting advice from the receptionist when my results come back like I’m important enough for my gp to speak to
Possibly the GP misread TSH as 2.23
But it’s absolutely clear and a comment included say it’s likely under replacement
Results from 9-3-21
Pathology Investigations
Thyroid function test
Serum TSH level 22.3 mu/L [0.35 - 5.5]
Above high reference limit
Serum free T4 level 12 pmol/L [9.0 - 23.0]
Comment: Query clinical evidence of under replacement
All I know or should I say I’ve been told off my GP is I have a under active thyroid is this the same thing ? Forgive my ignorance.
I spoke to my gp regarding my results of this test as some are literally off the charts provided by Medichecks, I was asked to go straight down to the surgery for them to do a full thyroid function blood test themselves, I had previously requested this before using Medichecks but GP refused, unless it’s COVID related my surgery don’t seem interested, I’m still yet to feel any improvement if anything I feel worse and it’s really starting to get me down, I’m never like this EVER !! I’m always a positive person yet I slowly feel myself changing it’s so frustrating
12 days ago you posted these results done by GP
Results from 9-3-21
Pathology Investigations
Thyroid function test
Serum TSH level 22.3 mu/L [0.35 - 5.5]
Above high reference limit
Serum free T4 level 12 pmol/L [9.0 - 23.0]
Comment: Query clinical evidence of under replacement
These results CLEARLY SHOW you were EXTREMELY under medicated
GP should have IMMEDIATELY increased levothyroxine by 25mcg as soon these results were done
Sorry to say this Adam but I was sure that I had hypothyroidism but gp wouldn't listen TSH upper limit of normal and I had all the symptoms. In the end it cost me £400 to go to an Endocrinologist privately. He prescribed thyroxin 50mcg daily and within 2 weeks all muscle aches went plus all other symptoms plus lost 17lbs in a month without trying!! As I said; God help the general public!!
Hi Adam40.. ❤️
I certainly know what your going through regarding doctors ect, I lost my thyroid to my gp ignoring several below range and suppressed TSH.. Over a period of 2 years, he at no time did T3 or T4 tests,, on 2 it said SEE DOCTOR! he never followed up on those requests, my vitamin D was 29..no follow up on that either he didn't even inform me!!, it took a endo who took over my case to find the out of range TSH and low vitamin D, he also found several high calcium levels going back to 2015 to the present and 2 high parathyroid levels, I have now been diagnosed with hyperparathiyroidism and still my gp and endo are dragging their heels in treating me😠.. I have ostioporosis, ostiopein, ostio arthritis, passed several kidney stones over the years all linked to hyperparathiyroidism, I've kicked the last endo to the curb and no longer accept appointments with that crap gp.. Thank god a new gp has joined our practice, he has done a full investigation in to my records and is now getting the ball rolling, 🙏.. First port of call is an ECG this Sunday, then some in depth blood tests on Monday, but it shouldn't be like this!! Every turn my surgery have put covid first, getting appointments was like climbing everest 😠 and receptionists have to much say as to when you can see the gp😠.. I can only say through me loosing it a bit with the surgery and complaining did I get anything done, again why should it have to be like that, the way I feel at the moment fighting with receptionists and the GP is the last thing we need,
Keep fighting its your health after all good luck❤️❤️👍👍
Thank you so much for taking the time to share that with us, it is sad we have to be like that but nobody seems to any type of accountability or responsibility anymore, I shouldn’t say nobody as I’m sure people could share some stories of GPs going above and beyond, I’ve got one calling me this morning so will be a very interesting conversation
Buddy195Administrator
Hi Adam40, just wanted to reassure you that you will feel massively better once your thyroid medication and vitamin D are optimal. For me (and many others with Hashimotos) going Gluten Free also helped reduce overall inflammation.
I’ve learned so much from this forum; do keep posting if you need further advice or support!
Thank you for your encouraging words 👍
I look forward to even getting a 10% lift in myself, is Hashimotos different from having a under active thyroid ?
Hashimotos is an auto immune condition & the reason why your thyroid is under active.
One thing I’ve learned on my thyroid journey is not changing too many things at once (in a quest to feel well). I tried going gluten free & dairy free at the same time, then couldn’t work out which was beneficial. The same is true with trialing new supplements- you need to make notes of dates & monitor changes. I always ask forum members for advice too, as there is so much experience on this site!
I’m so grateful I found this site and the everyone who comments and advises me !! I genuinely don’t know what stage I’d be at without you all, I certainly would of even known about hasimotos as I wouldn’t of done the Medichecks test, although GP hasn’t mentioned Hasimotos to me at all yet
About 90% of primary hypothyroidism is caused by autoimmune thyroid disease also called Hashimoto’s diagnosed by high thyroid antibodies
U.K. medics only ever call it autoimmune thyroid disease. Never Hashimoto’s
They only treat the subsequent hypothyroidism.
Not interested in cause of autoimmune aspects of the disease
Roughly 5% of Hashimoto’s patients test positive for coeliac disease
But approx additional 80% Hashimoto’s patients find absolutely strictly gluten free diet helps or is essential
A high percentage of gluten intolerant patients are also dairy intolerant (often as compilation of gluten intolerance)
Low vitamin levels are a result of Hashimoto’s
Sounds like I should expect them to after the full function tests they’ve done today
Yes, you clearly need more meds with TSH at 25. And the antibodies are showing that it is the autoimmune version of hypothyroidism as others have commented. Those vits are ugly too, but I note someone else has mentioned them, so that is good. Low vitamin d can cause a lot of issues similar to hypo: tiredness, joint pain, etc. But your thyroid numbers are truly dire. The GP must look at those and if they insist, do their own blood test, but they cannot let you carry on like that. Phone up and get a telephone appointment ASAP. Tell them you will increase your meds yourself as you have a TSH of 25 and free T4 below range, unless/until they get on to it. They won’t like that at all, so they’ll have to do something 
I requested the full function test a couple of months ago now and they refused !! Sad I’ve had to get these results externally but at least I can hopefully move forward
Grr! It would be nice to think that they will see it and then remember the next time someone else asks. We can but hope. Good luck with getting more medication and help.
TSH of 25 should have immediately been flagged up and GP should have immediately increased levothyroxine
Utterly outrageous that they did nothing
The aim of levothyroxine is to increase the dose levothyroxine slowly upwards in 25mcg steps until TSH is ALWAYS under 2
Oh, you must be feeling really poorly with those results 😞 I’m so sorry and hope you get your dose increase ASAP!!
I’ve been given a 25 increase so will see how that goes within the 6 weeks until my next test
Good news! 😊
SlowDragonAmbassador
TSH should be under 2 as an absolute maximum when on levothyroxine
gponline.com/endocrinology-...
Replacement therapy with levothyroxine should be initiated in all patients to achieve a TSH level of 0.5-2.0pmol/L.
New NHS England Liothyronine guidelines July 2019 clearly state on page 13 that TSH should be between 0.4-1.5 when OPTIMALLY treated with just Levothyroxine
Note that it says test should be in morning BEFORE taking levothyroxine
Also to test vitamin D, folate, B12 and ferritin
sps.nhs.uk/wp-content/uploa...
Aim is to bring a TSH under 2.5
UK guidance suggests aiming for a TSH of 0.5–2.5
gp-update.co.uk/SM4/Mutable...
Roughly 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
Gosh, Adam, I’m shocked but sadly not surprised that you have been so let down by your GP here.
As well as getting our heads round a thyroid problem, I think many of us who hang out on this forum have had to come to accept that the medical profession at large is not going to come to our rescue. Meaning we have to become our own best advocates. So I’m glad to know that you’re doing your own testing and are taking things in hand for yourself.
They’ve up by 25 I picked them up today but still awaiting to speak with a doctor
Pleased you got the increase - nice work!
Agreed that it would be good to speak to someone. They should be booking the next blood test for 6 weeks time. Maybe you can chase that as 25 mcg probably won’t do it longer term, in my inexperienced opinion!
Likely to need further increases in levothyroxine
Make sure you get same brand of levothyroxine
Get follow up blood test booked in for as early as possible in morning in 6-8 weeks time
I’ve been given different brands 🤷🏻♂️ the 25 new prescription is different than my 100
Which brands?
Many people find Levothyroxine brands are not interchangeable.
Many patients do NOT get on well with Teva brand of Levothyroxine.
Teva contains mannitol as a filler, which seems to be possible cause of problems. Teva is the only brand that makes 75mcg tablet. So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half
But for some people (usually if lactose intolerant, Teva is by far the best option)
Teva, Aristo and Glenmark are the only lactose free tablets
Most easily available (and often most easily tolerated) are Mercury Pharma or Accord
Accord don’t make 25mcg tablets
Accord is also boxed as Almus via Boots, and Northstar 50mcg and 100mcg via Lloyds ....but beware 25mcg Northstar is Teva
List of different brands available in U.K.
thyroiduk.org/medications-f...
Teva poll
healthunlocked.com/thyroidu...
Once you find a brand that suits you, best to make sure to only get that one at each prescription.
Watch out for brand change when dose is increased or at repeat prescription.
academic.oup.com/jcem/artic...
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
verywellhealth.com/best-tim...
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
Pathology Investigations
THYROID PEROXIDASE AB'S
Thyroid Peroxidase Antibody > 1300 ku/L [0.0 - 59.0]
Above high reference limit
Thyroid Peroxidase Antibodies - Positive.
There is a very high likelihood of
developing autoimmune thyroid disease.
Suggest repeating thyroid function tests
initially at 3 monthly intervals.
So this is what came back from the new test, I also spoke to a GP who is going to be dealing with me moving forward after our conversation today, I expressed my overall disgust in the lack of duty of care shown and lack of information provided, I asked him to just be completely honest regarding what’s going to be available to me and I was told to expect my dose to move up to around 175 but should feel some improvement in the coming months once my vit D improves and my TSH level gets to between 1 & 2. Only word I can use to sum it all up is frustrating!!
It’s a bit of a move from keeping me on the 100 like they recommended before my private test 🤷🏻♂️ sad when we literally trust these people with our health and life
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