Can someone please help explain my thyroid antibody results? I have been on Levothyroxine for 8 years. I am currently on 150mg a day. I feel awful every single day. I paid for private bloods as my doctor would not test for FT3 and antibodies. I had really hoped that these results would show me some reason why I feel so unwell but as usual, as I am in range, it is deemed I am ok. I am at my wits end. My family all want me to go on anti depressants as does my doc. I only feel sad because I feel so unwell and not because I am depressed. Stop me feeling so exhausted, then I am happy! It is like no one believes me! I am at the point where I feel like just stopping my tablets and seeing what happens as I am sure the levo makes me feel worse. Please help~:
I had the blood taken venously. I did fasting and did not take medication that morning.
Many thanks for reading x
Range for Thyroid peroxidase antibodies is 0 - 34
Written by
kezzabird30
To view profiles and participate in discussions please or .
High thyroid antibodies confirms autoimmune thyroid disease also called Hashimoto’s
Presumably you knew that cause of your hypothyroidism is autoimmune thyroid disease?
Did you do this test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
Do you always get same brand of levothyroxine?
Your results show you are under medicated and need dose increase in levothyroxine
Ft4 is only 38% through range
Ft3 at 40% through range
Helpful calculator for working out percentage through range
Most people when adequately treated will have TSH well under one
Ft4 should be in top end of range....typically at least 18-20
Request GP increase levothyroxine by 25mcg and retest in 6-8 weeks time
Approx 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
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.
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.
So at 150mcg you are on relatively high dose levothyroxine already for your weight
Guidelines on dose by weight is approx 132mcg.
So likely poor absorption or different brands upsetting you
Do you ALWAYS take levothyroxine on empty stomach and then nothing apart from water for at least an hour after. Ideally no calcium rich foods within 4 hours
Many people find it more convenient and possibly better absorption to take levothyroxine at bedtime
Do you have weekly pill dispenser so that it’s easy to see if you have missed a day
Ask GP for coeliac blood test BEFORE considering trial on strictly gluten free diet
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
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
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
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.
As already mentioned.....Lactose intolerance is also very common with Hashimoto's
I had really hoped that these results would show me some reason why I feel so unwell
Well, they do show you a reason. Your TSH is too high - should come down to 1 or under when on thyroid hormone replacement - and your Frees are too low. Frees should be up in the top third of the range, or wherever you need them to be to feel well. It's a very personal thing. But, you are under-medicated, whatever your GP may say.
The high antibodies are saying that you have Hashi's. I take it you didn't know that. But, it's not the antibodies making you feel unwell. It's the low thyroid hormones. There's not much you can do about Hashi's - except try a gluten-free diet to see if it helps with some of your symptoms. Hashi's people very often have Coeliac disease - have you been tested for that? - or are gluten-sensitive. But, if you want to be tested for Coeliac, don't give up gluten until after the test.
I was thinking that I wanted to stop my medication but it appears I am not on enough? I really struggle to get my doctor to take me seriously without trying to get me to take Anti depressants.
Difficult to say for certain, while you are under-medicated, but it doesn't look as if you have a conversion problem. So, that's one less battle you have to fight.
I'm afraid you really can't stop the levo, because with Hashi's, things are just going to get worse, not better, I'm afraid. It's for life.
What vitamin supplements are you currently taking ....if any
Your vitamin levels are pretty good
You also have good conversion of Ft4 to Ft3.....but just not on high enough dose levothyroxine
If you are lactose intolerant you will need lactose free levothyroxine
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 is also boxed as Almus via Boots, and Northstar 50mcg and 100mcg via Lloyds ....but doesn’t make 25mcg tablets
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
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
REMEMBER.....very important....stop taking any supplements that contain biotin a week before ALL BLOOD TESTS as biotin can falsely affect test results - eg vitamin B complex
So I take Berroca daily as well as Selenium 200ug and Vitamin A-C-E . The doctor from medichecks has said my iron levels are too high but i do not take any Iron supplements
Do you ensure vitamin supplements are at least 2 hours away from levothyroxine
High ferritin is common with Hashimoto’s, this due to inflammation
Are you post menopause? This also tends to increase ferritin levels
GP could do full iron panel test to see if iron is also high. (Unlikely) Ferritin is not considered high for hemochromatosis unless it’s up over 800 plus
I usually take levo at 7am then I do not eat or take supplements until 10am. I am 46 and not yet in the menopause stage I do not think! Although i do feel like i am 90 years old with the bone aches and tiredness
You're wasting your money with Berroca. That won't do you any good. Cheap ingredients, and not enough of them. Best to spend your money on supplements you know you need rather than taking pot-luck with a multi.
I am on 150mg at the min made up of 100mg and 50mg so will ensure I stick with accord and like you say, cut a 50mg in half if they increase my dose. thank you for your advise x
Replacement therapy with levothyroxine should be initiated in all patients to achieve a TSH level of 0.5-2.0pmol/L.
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
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.
Most patients will feel well in that circumstance.
But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
(That’s Ft3 at 58% minimum through range)
You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor
I’d be asking for a small (25mcg) increase to try to alleviate your symptoms but keep your t3 and t4 in range. I doubt your doc/Endo will fight too much about it but to keep them on board try asking ‘for their support to trial a small increase to see if it will help symptoms’. After 6 weeks on the new dose test again and go back for a further increase.
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
Ok had ran out of berroca anyway, so will give other supplements a try. Lots to read and take in but appreciate everyone's comments. Helps me feel not so alone x
Just to say you are not alone - most of us with Hashi's have been where you are now. Many of us felt awful and were ignored by the medical profession who for some reason seem to think if we are in range, we should feel well. And if we still say we feel ill, we are sent away with AD's. It is shameful the way we are treated.
I found this forum, and I think it literally saved my life. You have been given a lot of information so just go through it slowly, and give yourself "thinking time" to take it all in. Keep reading and take your own power back.
It can be an upward and slow journey, but worth it on the day you wake up and think "what job shall I tackle today" instead of "I just want to go back to sleep". It will happen.
Oh, and here is a tip to get your GP to give you the increase you need - ask about him prescribing T3 (liothyronine), and he will be so scared he will give you the increase to make you go away!
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Please help with Thyroid results
New Results, please help
Thyroid results help please!
Thyroid Results 
