Going from hypo to hyper with Hashimotos- what’s going on?
1/3/2016. TSH 5.90
28/9/2017 TSH 6.12
6/12/2017 TSH 2.73- evthyrox 88 started this year
26/12/2018 TSH 1.72
17/4/2018 TSH 2.08
25/5/2021 TSH 0.36
FT 4 23.37 pmol/L (10-24)
Anti-TG 8.0 IU/ml(less than 4.5)
Anti-TPO 1086.0 U/ml (less than 60)
PTH 83.7pg/ml (10-88)
Ferritin 133 (13-150)
B12 627.9 (200-970)
D3 30.21ng/ml(30-10)
Have appointment with endo on 17/6 but would be grateful for any comments. Only difference I notice in myself is that I’ve become rather short tempered!! Could be due to lockdown of course - or is lockdown the cause of TSH fluctuation!!!! That’s a thought!!
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Crete
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without having any test results between 2018 and present it is hard to be sure . The most recent is not really 'Hyper' , just shows a high but within range fT4 level accompanied by a lower end TSH result.
This could either be that Levo dose is slightly too high and just needs reducing a little if you have any symptoms of overmedication , or it could be fine at that level if you feel well.
You don't give the lab range used for TSH , but 0.36 is not very low anyway, it will probably be only just below the lab range. and 0.36 is not a level associated with problems.
Low but not supressed TSH (between 0.04 and 0.4) did not have any greater risks than within range TSH(0.4 to 4 ) in a long term study of people taking Levothyroxine.
If you read both of these posts .. and follow the links in them to further posts discussing 'Risks' of LOW TSH.. and evidence.
These should help you have a much more useful chat with the Doctor should the subject of low TSH come up .. (it probably will, with TSH at 0.3)... basically it's all relative ... are the benefits to you re. quality of life /ability to function , worth the (alleged)'risks'
.... and once you've seen the evidence , do you even agree there is much of a 'risk' ...
The other possible explanation, (given your high level of TPOab confirming Autoimmune thyroid disease) is that you have recently had an autoimmune attack on the thyroid and this has caused a temporary rise in fT4 as it is dumped from the thyroid to the blood all at once.. as it gets used up the fT4 would lower naturally and the TSH would rise again.. but without seeing your results since 2018 it is not possible to say whether this latest result is just a recent and temporary rise in fT4 level due to an autoimmune attack, or a longer term level of fT4 due to your dose of Levothyroxine.
Was thyroid tested as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
These results don’t suggest over medication
There’s no Ft3 result
High TPO antibodies confirms autoimmune thyroid disease also called Hashimoto’s
Have you had coeliac blood test done
Are you on strictly gluten free diet
Vitamin D might be better nearer 40ng/ml (that’s around 100nmol in U.K. units )
Yes I always test first thing in the morning and without my thyroid meds. Have tried gluten free in the past but noticed little difference . I am lucky not to have any serious symptoms so I’ve lapsed into being low gluten instead of gluten free
I’ve never been tested for coeliac so will check that when I see the endo(first visit to a new one)
The last FT3 I had was 4.83 pmol/L (2.4- 6.4) 26/10/2018
The FT4 was 21.77 pool/L (10-24) then and incidentally Anti -TG at its lowest 298 IU/ml
The endo didn’t ask for FT3 to be tested this time- I wonder why she only wanted FT4?? Anyway I will ask when I go...
Do you feel worse in the colder seasons and better in the warm months or opposite way around? Have you lost any weight? Changed brands? I get short tempered, easily irritated and annoyed by everything when my T4 is high and T3 low. I'd recommend you try to get your FT3 tested.
Since I have arthritis I always feel better when it’s hot- and here it’s hot for most of the year!God I wish I could lose weight- list nearly 20 kilos the year before last with a dietitian but 15 has gone back on and I must start to try again- my weight has been yo-yo ing
all my life.
I was started on Euthyrox 88 and have never changed.
Yes I should get T3 tested as well - wish I’d thought of it at the lab and I could have paid a bit extra and added it on the list!! Duh!!!
I worked in the Hawaiian islands for a few years and had not one hypo symptom, although at the time I didn't know I had a problem. Came back home and it swiftly went downhill. I thrive in warm climates. I took 88mcg for ten years and labs looked optimal and I was functional but I still had symptoms like a stomach that looked like I was 6 months pregnant, hoarse voice, vertigo, vision loss etc. I'd always get mysterious illnesses that lingered and started getting sinus infections with my colds. I'd travel and the next day end up ill. It's all these symptoms that started to add up. To lose weight you'll most likely have to add T3 to your treatment and depending on how high your FT4 levels are you may have to lower that a little. Check sex hormones and I've read something about leptin and insulin resistance making it difficult to lose weight.
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Taking meds with "Normal : TSH
Any medication for Hashimoto?
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advise on what I should do about symptoms?
