Please help me with my latest blood results - confused and disappointed

[BelfastGirl83]

Please can someone help me get to the bottom of what's going on with my latest blood results?

I had a thyroid test 2 days ago:

Current dose: 75mcg mon-fri and 50mcg at the weekends

TSH: 10.1 (0.4-4.2)

T4: 14.2 (12-22)

I was advised by an Endocrinologist to tweak the dose to 75/50 as I would like to get pregnant. He wanted to keep TSH nice and low but a little higher than TSH 0.27.

February blood test:

Dose: 75mcg

TSH: 0.27 (0.4-4.2)

T4: 22.1 (12-22.1)

January blood test:

Dose: 50mcg (this was my starter dose when i was diagnosed in November)

TSH: 5.67 (0.4-4.2)

T4: 16 (12-22.1)

I have hashimotos with raised TPO levels (around 140).

I've been getting acupuncture for the last 6 weeks or so and I started taking Chinese herbs in the form of a tea in the evenings. Would these be interfering? Its hours away from taking levo.

I've been more slack about the time between levo and ingesting yogurt/milk - I leave a two hour window but perhaps this isn't enough? Before I was leaving around 3-4 hours.

I started taking vit D, selenium and zinc all around 3/4 hours after levo. I don't take iron or calcium supplements.

I had all my vitamins checked approx 5-6 weeks ago and they all came back optimal/well within range except vitamin D which is why I'm supplementing. I've gone gluten free too around 6-7 weeks ago.

As far as how I am feeling, it's hard to tell. I have been struck down with a couple of nasty viral infections over the last few months - a really bad chest infection and I'm just getting over a bad cold (neither were Covid) so I have been more tired overall as a result.

These latest results bring me back to where I was in November when I wasn't on levo. How can this be?

Help!

[BelfastGirl83]

I got the my first Covid vaccine last week - the Astrazeneca one. Would this have contributed to any of this? My immune system has obviously been working over time in recent months!

[DippyDame]

This might help

thyroiduk.org/having-a-baby...

I wish medics would get over themselves and stop focusing on TSH alone!TSH is a pituitary hormone, not a thyroid hormone, it reacts to the level of thyroid hormones in the blood

Low hormones = high TSH

High hormones = low TSH

But that's not the whole story, and diagnosing and dosing by TSH alone does not give a clear picture of what is going on.

For full thyroid function evaluation the following should be tested

TSH, FT4, FT3, Folate, Ferritin, Vit D Vit B12 and antibodies

It looks as if your endo is a diabetic, not a thyroid, specialist and not exactly conversant with the subject either! Not unusual I'm afraid.

Current dose: 75mcg mon-fri and 50mcg at the weekends

TSH: 10.1 (0.4-4.2)

T4: 14.2 (12-22)

TSH is far too high because your dose is too low

"He wanted to keep TSH nice and low but a little higher than TSH 0.27."

Well, he's going the wrong way about it, by reducing your levo he is raising your TSH

Also, TSH can fluctuate with Hashis's ...even during a day so not a reliable diagnostic tool!

It looks as if he dropped your dose from 75mcg because your FT4 was top of range... but your TSH was fine! How did you feel on 75mcg?

If he had tested FT3 he would probably have found that was low because it is possible that you are not adequately converting T4 to T3

High FT4 with low FT3 indicates poor conversion

There can be several reasons for this, one being low nutrients.

First optimise nutrients!

If all relevant nutrients are optimal then you possibly need a little T3 added to the T4.

I'm not a medic , I can only speak from my own experience of a long very bumpy thyroid journey but I suggest that you are almost back to where you were at diagnosis because like then , you are undermedicated!

You need a full thyroid test ( as above) if your endo will not do this then you can test privately....many of us do for that reason.

You can find details here but feel free to come back and ask as many questions as you like after you have read the links

thyroiduk.org/help-and-supp...

Good luck

DD

[BelfastGirl83 in reply to DippyDame]

Thanks DD! I actually was feeling great on 75mcg-energetic, mentally sharp etc. I know I was at top end of T4 on this dose. I was reluctant to decrease the dose at this stage but I thought the Endo knew better but it’s come back to bite me! I’m just concerned that the 75 won’t do the trick and I’ll have to increase it again in a months time with still no sniff of a pregnancy because of the fluctuations. 😔

In the last couple of weeks I’ve felt kind of sad and low-tearing up for no good reason and it wasn’t my time of the month so it must be because of the drop in thyroid hormone. I’ve never had T3 tested-if my T4 is good and I feel good, would that mean my T3 conversion is fine?

My vits were done a month ago and they were good/optimal though I’m supplementing with vit D.

[DippyDame in reply to BelfastGirl83]

Feeling low is a typical hypo symptom

There's a fair chance that if you feel well on the higher dose then you are on the correct dose! I wasn't sure how you felt on 75mcg, it's not a huge dose and some people feel better at the top of the range or very slightly over.

The real key is how you feel. I'm T3-only on a high dose which freaks my GP out because my TSH is in orbit but that is where I can function. I self medicate and she now accepts that. The endo I saw was as good as a chocolate tea pot. I found the most knowledgeable people here, they, and much reading helped me out of very poor health.

You know your body better than anyone, listen to it. It will tell you more than tick boxes/lists on a surgery computer screen!!

Sounds like 75mcg it is! Try that for 6 weeks and see how you feel...better I guess!

Stick with Vit D, weneed a lot of it.

Correct dosage should reduce anxiety, ergo, less anxiety and more levo can help with conception. You might need to be patient just a little bit longer until thyroid hormone level rises.

Please keep us posted.

Take care

DD

[BelfastGirl83 in reply to DippyDame]

Thanks DD, will keep you posted. Fingers crossed 75mcg does the trick xx