22 years Hypo but recent changes - help with test results v much appreciated

[Meno56]

Hi I have been diagnosed Hypothyroid for 22 years follwoing 1st pregnancy and have been fortunate to be fine on high dose of Levothyroxine T4 (currently 125mcg/day)

Recently HRT changes & increased aches and pains, as well as gallstones diagnosed (with 5/6 biliary colic attacks) which I'm convinced is due to a 3 mth reduction in my Levo dose by overzealous GP (Feb down to 100mcg/day). Luckily it is now back up to 125mcg by most recent GP helping me with HRT issues. Not sure if gallstones will ever disappear, but not keen on idea of surgery to remove gall bladder.

So I have had some private tests done (1st time ever) and would really appreciate some insight into what they suggest. When I saw Endo 20 yrs ago he never mentioned Hashimoto's as cause - just as consequence of pregnancy and suggested Thyroid gland attacked by virus!

I'm wondering whether to try for T3/Liothyronin to supplement T4? Any thoughts?

TSH 0.66 mU/L

Free T3 4.56 pmol/L

Free Thyroxine (T4?) 19.9 pmol/L

Ferritin 58.2ug/L

Folate - Serum 4.93 ug/L

Vit B12 active 64.5 pmol/L

Vit D 66.90 nmol/L

Thyroglobulin Antibodies 12.9 IU/mL

Thyroid Peroxidase Antibodies 27.5 IU/mL

[PurpleNails Administrator]

Hello welcome to the forum.

Please could you add ranges. Ranges vary between labs so we need ranges to accurately interpret.

How long had you been back on 125mcg when test was taken?

What time did you test & how long after taking dose?

The virus doesn’t attack the thyroid, it’s your own immune system (with Hashis) Although it can be set off by a virus. (Or pregnancy) Usually antibodies are high when diagnosed but the fluctuate and can lower later on.

[Meno56 in reply to PurpleNails]

Hi thanks for the welcome PurpleNails. ;)Sorry I didn't include Medichecks test ranges - just thought they would all be the same.

TSH 0.66 mU/L (0.27-4.2)

Free T3 4.56 pmol/L (3.1-6.8)

Free Thyroxine (T4?) 19.9 pmol/L (12-22)

Ferritin 58.2ug/L (13-150)

Folate - Serum 4.93 ug/L (>3.89)

Vit B12 active 64.5 pmol/L (37.5-188)

Vit D 66.90 nmol/L (50-200)

Thyroglobulin Antibodies 12.9 IU/mL (<115)

Thyroid Peroxidase Antibodies 27.5 IU/mL (<34)

I've been back on 125mcg since end July 2021. I tested at 10am having taken previous dose 8am the previous day (have been doing some research!)

I don't remember any antibody testing when I was diagnosed, but I did have a young baby at the time so was pretty pre-occupied.

[shaws Administrator in reply to Meno56]

If you need to add or change something in your post, just click the down arrow next to 'more' and select edit.

[Meno56 in reply to shaws]

Thanks for the tip 👍🏻

[fuchsia-pink in reply to Meno56]

How do you feel?

I'd say your thyroid bloods show you don't convert very well: free T4 is good at 79% through range; free T3 is languishing at only 39.4%.

Nutrients all need a bit of a boost. Hopefully SeasideSusie , the nutrients queen, will pop up in a bit with her always-excellent advice on how best to do this.

If you don't feel great, I'd try and build up your nutrients first, and if you really feel rough, maybe try for an increase in levo - which may take T4 over-range but should help with T3, with the aim of getting an endo referral for a lio trial if nothing improves x

[PurpleNails Administrator in reply to Meno56]

TSH 0.66 mU/L (0.27-4.2) ok ✅ Free T3 4.56 pmol/L (3.1-6.8) 39.46%

Free Thyroxine (T4?) 19.9 pmol/L (12-22) 79%

Ferritin 58.2ug/L (13-150) this is low, should ideally be above 80

Folate - Serum 4.93 ug/L (>3.89) unsure

Vit B12 active 64.5 pmol/L (37.5-188) below half way through range

Vit D 66.90 nmol/L (50-200) 80 or above nearer optimal.

Both antibodies are negative.

Thyroglobulin Antibodies 12.9 IU/mL (<115)

Thyroid Peroxidase Antibodies 27.5 IU/mL (<34)

Your FT4 Is good at 79% or range, but your FT3 is 39% which shows conversion could be improved.

As some of your nutrients are below optimal you should work to improve these. Hopefully a member with expert knowledge will add specific advice.

[Meno56 in reply to PurpleNails]

Brilliant - thanks so much for the response. I feel ok, but not as good as I used to. Very achy joints and tired. When you highlight ranges and where my results sit, it seems very clear what I should start with, so will crack on with Seaside Susie's recommendations from another post I've seen for B12 and Vit D. Having seen all of the comments about TSH and GPs I realise that I have really not paid enough attention to my Hypothyroidism for some time and can remember being switched from Thyroxine to LevoThyroxine with very little explanation of the difference (some time ago!) I reckon that some recent menopause changes have affected the way I feel, so with Menopause and Hypothyroidism - two conditions that few GPs seem to be on top of, it feels like it's a double whammy of bad luck. Hey ho...!

[shaws Administrator]

I think many doctors only adjust dose due to the TSH alone whereas they should be enquiring if the patient felt well and is symptom-free on the existing dose. If not he should test both Free T4 and Free T3.