Hypothyroid without Autoimmune antibodies?

[tamari]

Feeling desperate after 25years on Levothyroxine 150mg then last year reduced to 100mg have all symptoms of low thyroid. Decided to have advanced thyroid medicheck results today😱 not Hashimotos which endo diagnosed years ago can this be possible? What does that mean why am i so fatigued,muscle exhaustion hair falling out? C

[SeasideSusie Remembering]

tamari

Do you have the results? If so please post them along with their reference ranges and we can try and help.

[tamari in reply to SeasideSusie]

Hi SeasideSusie, thanks for replying so fast i will have a go. Ferritin 83 range 13 -150

Folate 14.7 range 2.9 - 15.28

Vit B12 Active 81 range 25.1 - 165

Vit D 82 range 50 -200

TSH 0.35 range 0.27 - 4.2

FREE T3 4.1 range 3.1 - 6.8

FREE THYROXINE 15 range 12.22

THYROGLOBULIN ANT. 14.8 range - 0 - 115

THYROID PEROXIDASE ANT. 9.1

0 - 34

CRP HS 0.3 range 0 - 5

Thank you

[SeasideSusie Remembering in reply to tamari]

tamari

CRP HS 0.3 range 0 - 5

This is an inflammation marker, the lower the better, yours is excellent.

Ferritin 83 range 13 -150

Ferritin is recommended to be half way through range although some experts say the optimal level for thyroid function is 90-110. Yours is pretty good, exactly half way through range!

Folate 14.7 range 2.9 - 15.28

I thought the top of the range was 14.5 but no matter. Folate is recommended to be at least half way through range, so half way to upper part of range is good.

Do you supplement?

Vit B12 Active 81 range 25.1 - 165

Active B12 below 70 suggests testing for B12 deficiency. You are above that which is good, I would want mine 100+.

Vit D 82 range 50 -200

The Vit D Society and Grassroots Health recommend a level of 100-150nmol/L.

Your level isn't bad, if you wanted to improve it then supplementing with 2,000iu D3 along with it's cofactors - magnesium and Vit K2-MK7 - would be about right. If you make Vit D easily from the sun you might top it up naturally without any help during the summer and might just need a boost during the winter months.

TSH 0.35 range 0.27 - 4.2

FREE T3 4.1 range 3.1 - 6.8

FREE THYROXINE 15 range 12.22

The aim of a treated Hypo patient on Levo only, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges.

Your TSH meets this criteria but your FT4 is only 30% through range and your FT3 is only 27% through range, nicely balanced but low. This is why you are experiencing symptoms. You could do with an increase in your Levo, 25mcg now and retest in 6-8 weeks to check your levels and see whether another increase is necessary.

Most doctors only adjust dose by TSH but that's not a thyroid hormone, it's a pituitary hormone. The FT4 and FT3 are the thyroid hormone tests and these are really what they should be looking at, FT3 being the most important one as T4 is a storage hormone which converts to T3 which is the active hormone that is needed by every cell in our bodies.

To support your request for an increase, use the following information:

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the professional publication for doctors):

"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).*"

*He recently confirmed, during a public meeting, that this applies to Free T3 as well as Total T3.

You can obtain a copy of the article by emailing Dionne at

[e-mail]

print it and highlight question 6 to show your doctor.

THYROGLOBULIN ANT. 14.8 range - 0 - 115

THYROID PEROXIDASE ANT. 9.1

These are low at the moment. However, if you were diagnosed with Hashi's originally I expect your antibodies were raised at the time. Antibody levels fluctuate and it doesn't matter that at one test they are raised and another test they are within range, it doesn't change the fact that you have Hashi's, and it doesn't change the treatment because Hashi's isn't treated, it's the resulting hypothyroidism that is treated.

Hashi's is where the immune system attacks the thyroid and gradually destroys it. Nobody knows how long this process takes, it differs from person to person I expect. Maybe there's nothing left of your thyroid now so there's nothing left for the immune system to attack so the antibodies no longer have a job to do (they come along and mop up the mess after an attack), so your antibody level is showing as very low. Or you may be just going through a very hypo episode (when the immune system attacks you will go through a "false hyper" episodes because the thyroid will release a lot of hormone which will cause your FT4 and FT3 to go high). Either way, I wouldn't worry, just take note of your FT4 and FT3 and ask for an increase in your dose based on your current results.

[tamari in reply to SeasideSusie]

Thank you so much, i don't supplement Folate or anything else i never mentioned my diet i am meat,dairy and gluten free. Can you recommend a good quality supplement?

[SeasideSusie Remembering in reply to tamari]

As you are meat free your B12 isn't as bad as it might be, and your folate is probably good due to your diet. Maybe try a good quality, bioavailable B complex containing methylcobalamin and 400mcg might be enough to raise your level. Consider Thorne Basic B, it does contain 400mcg methylfolate so I expect it will raise your folate level too. Avoid any B complex that contains Vit C as this keeps the body from absorbing B12 (they need to be taken 2 hours apart).

If you want to supplement Vit D I like Doctor's Best D3 softgels, they are an oil based very small softgel which contains just two ingredients - D3 and extra virgin olive oil, a good quality, nice clean supplement which is budget friendly. Some people like BetterYou oral spray but this contains a lot of excipients and works out more expensive.

For Vit K2-MK7 I like Vitabay or Vegavero brands which contain the correct form of K2-MK7 - the "All Trans" form rather than the "Cis" form. The All Trans form is the bioactive form, a bit like methylfolate is the bioactive form of folic acid.

Magnesium helps D3 to work. We need Magnesium so that the body utilises D3, it's required to convert Vit D into it's active form. So it's important we ensure we take magnesium when supplementing with D3.

Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds if taking magnesium as tablets/capsules, no necessity if using topical forms of magnesium.

naturalnews.com/046401_magn...

drjockers.com/best-magnesiu...

[tamari in reply to SeasideSusie]

Thank you for all the info lots to take in, i doubt my gp will listen to an increase in Levo i shall book an appointment asap. My gp refused prescribing HRT said he didn't agree with it and referred me to Gynea. I will report back, thanks for all your help this forum gived me hope.

[FancyPants54 in reply to tamari]

Bet he wouldn't "not agree" with giving a man testosterone! Supercilious plonker. Go and see a different doctor at the practice and tell them you want HRT. You aren't asking for it like it's a sweet, you want it and you have every right to get it. If there's only one doctor, switch practices. This man is a fool.

[tamari in reply to FancyPants54]

Hi FancyPants54, gp referred me to Gyaenocology and as i had an op to remove ovaries i was suffering early menopause so quite justified.I do think HRT interferes with Thyroid meds?

[FancyPants54 in reply to tamari]

It can do. Tablet HRT is worst. So avoid that and go for transdermal, gel, patch or spray. It might need a slight increase in thyroid dose. It's not a reason not to use it.