I am very new to this, but have found some good information and great suggestions here. I decided to go ahead and order a private thyroid test (finger prick). I did all that was recommended on the patient-to-patient suggestions of not taking my levothyroxine prior to the test and to do the test as early as possible. I don't do any supplements that contain biotin and the collection was done in a fasting state. My new results:
TSH: 1.8 (range .5-3) μU/mL Normal
FT4: 1 (range .7-2.5 ng/dL) Normal
FT3: 2.7 (2.4-4.2 pg/mL) Normal
TPO Antibodies 1855 (<70 normal, 70-150 elevated, >150 high) High
I did this test as my physician tested me after 4 weeks of levothyroxine treatment (this was in May) - and from my understanding it should have been after 6 to 8 weeks. Here are those May results:
TSH2.090 uIU/mL (0.450 - 4.500 uIU/mL)
FREE T4 (REF)1.18 ng/dL (range 0.82 - 1.77 ng/dL)
So, the ranges are different for the two components that were tested in April. I did the calculations for % in range and the FT4 dropped 38% to 19% of range, while my TSH went from 40% to 52%, ). This tells me that I am not going in the right direction. The FT3 number is sad. I really wish I could convince my dr. to increase my medication... Or maybe the finger prick tests are different?
What I don't know about is the antibodies - I did this test about four weeks after coming down with Covid in early June. Do you think that made this test so wild (or is this even a wild number? I have no experience in this). Is this something that needs to be addressed by my dr.? Should I ask the dr to get tested for this when I see him in August? (I sense he may dis the private tests, but I may be wrong). He wouldn't do any other tests and he shrugged off my request to increase my levo from 50mg to 75mg - because I am "in range" when I saw him in May. I attempted to put forth a good argument to increase, but I failed.
Any advice or support appreciated. I am in the US (but my best friend is British )
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Don't be fooled by the 'normal' comments. It just means 'in-range'. But being 'in-range' is not the same as optimal, and not even good for everyone.
Your TSH is too high, and your FT4 is too low, and your FT3 is much too low. You do need an increase in dose - 50 mcg is just a starter dose - but I don't know how you persuade your doctor of that, because he won't have the slightest idea about how being on too low a dose would affect you. All he knows is that your results are in-range, and that's good enough for him - he doesn't have to live with them!
The high antibodies mean that you have Hashi's - Autoimmune Thyroidistis - where the immune system slowly destroys the thyroid. But, I doubt he would know anything about that, either. There is no treatment for the Hashi's itself, just the resulting hypothyroidism. But it's good that you know, because results can swing wildly with Hashi's. And your doctor won't understand why.
He wasn't enthusiastic about testing FT3 because he probably doesn't even know what it is, wouldn't understand the results and doesn't know what it does. But, in fact, it's the most important number, because it's low T3 that causes symptoms. T3 is needed by every single cell in your body to function correctly, which is why we can have such a wide variety of symptoms when there's not enough to go round.
I'm afraid you're just going to have to keep going on at him to increase your dose if you want to get well. Did you get your nutrients tested, too? Vit D, vit B12, folate and ferritin?
thanks, greygoose. The lab the I went to doesn't do all the vitamins - I did order the Vitamin D and Inflammation test, which I can send back to them (it seems like it takes forever). I also just found another lab where I can order tests without a doctor - that will actually do a draw and it has a number of things listed - like the b12, iron, ferritin(?) that I see others test for. I will look into what it will take for that to happen (financially). If you were to say which was the most important ones to look at, what would they be?
Vit D, vit B12, folate and ferritin. Those are the basics, according to the results of which, you build up your supplement regime. Then add in the co-factors, like magnesium and vit K2-MK7. Apart from those, the second most important are zinc, copper and selenium.
Thank you - it looks like I can get the B12, Folate and Ferritin from the other company (funny, they don't have the Vit. D, but that's okay since I have this at home kit from Everlywell). Onward!
Obviously you need next dose increase in levothyroxine
50mcg is only a starter dose
If your current doctor doesn’t understand that you need new doctor
Dose levothyroxine is increased slowly upwards in 25mcg and blood retested 6-8 weeks after each increase
you have high antibodies this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
ESSENTIAL to regularly retest vitamin D, folate, ferritin and B12
Frequently necessary to supplement to maintain optimal vitamin levels
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
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.
Eliminate Gluten. Even if you don’t have Hashimoto’s. Even if you have “no adverse reactions”. Eliminate gluten. There are no universal rules except this one.
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