TEST RESULT HELP NEEDED: Further to my earlier... - Thyroid UK

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TEST RESULT HELP NEEDED

Leccybill profile image
11 Replies

Further to my earlier post, full ( controlled ) test results enclosed for your advice/comments. Other relevant conditions to consider, Eosinophilic Asthma, Psoriasis and Vitiligo.

CRP HS 0.7 RANGE 0-5

FERRITIN 257 RANGE 30-400

FOLATE 13.7 RANGE <2.9

VITAMIN B12 51 RANGE 25.1-165

VITAMIN D 76 RANGE 50-200

TSH 0.87 RANGE 0.27-4.2

FREE T3 3.8 RANGE 3.1-6.8

FREE THYROXINE 17.8 RANGE 12-22

THYROGLOBULIN ANTI 150 RANGE 0-115

THYROID PEROXIDASE 184 RANGE 0-34

MANY THANKS

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Leccybill profile image
Leccybill
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11 Replies
SlowDragon profile image
SlowDragonAdministrator

Looking at previous post

You’re on 100mcg levothyroxine

Which brand of levothyroxine

Do you always get same brand at each prescription

What vitamin supplements are you currently taking

Did you know that high thyroid antibodies confirms autoimmune thyroid disease also called Hashimoto’s diagnosed by high thyroid antibodies

TSH 0.87 RANGE 0.27-4.2

FREE T3 3.8 RANGE 3.1-6.8

FREE THYROXINE 17.8 RANGE 12-22

Ft4 is only 58% through range

Ft3 a very low 19% through range

Helpful calculator for working out percentage through range

chorobytarczycy.eu/kalkulator

Vitamin D, folate and B12 are all too low

Aiming for vitamin D at least around 100nmol

Active B12 at least over 70

Getting all four vitamins optimal may help improve conversion rate

If not already on strictly gluten free diet

Have you had coeliac blood test done yet

If not get this done

Very high percentage of Hashimoto’s patients benefit from strictly gluten free diet

SlowDragon profile image
SlowDragonAdministrator

How much do you weigh in kilo approx

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

NICE guidelines on full replacement dose

nice.org.uk/guidance/ng145/...

1.3.6

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.

Also here

cks.nice.org.uk/topics/hypo...

gp-update.co.uk/Latest-Upda...

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.

BMJ also clear on dose required

bmj.com/content/368/bmj.m41

bestpractice.bmj.com/topics...

Guidelines are just that ....guidelines.

Some people need more …..some less

healthunlocked.com/thyroidu...

Leccybill profile image
Leccybill in reply toSlowDragon

No supplements other than a protein drink each day as I have lost a lost of muscle in the last few years and suffered from fatigue. I was just over 12 stone and now im just under 11 stone/69.5kilo. I had a telephone appointment with GP and mentioned this and as I had improved somewhat whilst on the protein drink asked if i might not be getting sufficient nutrients from my food, she said mu celiac results were ok, i've just had a look on patient access and the only test I can see are IgA

4.72 g/l

0.80 - 4.00

Abnormal

21 Oct 2020

SlowDragon profile image
SlowDragonAdministrator in reply toLeccybill

guidelines on dose levothyroxine by weight

Your current weight 69.5 x 1.6 =. 112mcg per day

You likely have room to increase levothyroxine to 112.5mcg every day

(100mcg and 125mcg on alternate days)

Ft4 is currently only 58% through range

SlowDragon profile image
SlowDragonAdministrator in reply toLeccybill

Only 5% of Hashimoto’s patients are coeliac A further 80% find strictly gluten free diet helps or is essential

The only way to know if gluten free diet will help you is to try it

SlowDragon profile image
SlowDragonAdministrator in reply toLeccybill

Many protein drinks have soya in …..not recommended for anyone taking levothyroxine

Check out the ingredients

Leccybill profile image
Leccybill in reply toSlowDragon

No Soya, stopped that some time ago. I will get retested for coeliac and add the vitamins see if any improvement. Could you PM me the names of a good Endo in the PR2 area ?

SlowDragon profile image
SlowDragonAdministrator in reply toLeccybill

Coeliac test

lloydspharmacy.com/products...

Email Thyroid UK for list of recommend thyroid specialist endocrinologists...NHS and Private

tukadmin@thyroiduk.org

Leccybill profile image
Leccybill in reply toSlowDragon

Thank you.

Leccybill profile image
Leccybill

Very informative, thanks for that. I’m in the process of getting a coeliac screen I did see an immunologist who confirmed I didn’t have any intolerances but didn’t actually remark on what he had tested me against. Does your private endo send you for the test via your GP ? I did go private originally, just before COVID kicked in but he was somewhat out of my area and all the test he did where also at his hospital which was a pain traveling there and I do not have any of the results on patient access which further complicates matters.

naryshkin profile image
naryshkin in reply toLeccybill

As a patient, you have the right to know what GPs and specialists test you for. You should contact the immunologist's reception or secretary to ask for a copy of the tests done so you can have a copy of it in your own records. This applies to both private and NHS.

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