Please help with blood results

[Cookie83]

I have recently been diagnosed with hashimotos due to high antibodies however, my tsh is 1.03, my t4 is 12.8 and my t3 is 4.4. I feel extremely fatigued so the dr has put me on a trial of eltroxin 25mg. I’ve been on them for four days and have been getting more bowel movements and my resting heart rate is 80. Not sure if these are due to the medication. Not sure what to do?

[Bluespots]

I have Hashis in the UK, what is Eltroxin, please ?

[helvella Administrator Thyroid UK in reply to Bluespots]

Eltroxin is simply a brand name of levothyroxine. Originally registered by Glaxo.

However, and this could be important:

Eltroxin in the UK is from Advanz Mercury Pharma and is absolutely identical to Advanz Mercury Pharma levothyroxine.

Eltroxin in Australia is from Aspen.

The two products are different formulations.

helvella - Thyroid Hormone Medicines

I have created, and try to maintain, a document containing details of all thyroid hormone medicines in the UK and, in less detail, many others around the world.

dropbox.com/s/shcwdwpedzr93...

[Bluespots in reply to helvella]

Thank you for info.

[SlowDragon Administrator]

How old are you?

Standard starter dose of levothyroxine is 50mcg

However as you are getting reactions even at 25mcg suggest you stick on 25mcg dose and get blood retested in 6-8 weeks

Always take levothyroxine on empty stomach and then nothing apart from water for at least an hour after

Always test thyroid levels as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Likely to need several further increases in levothyroxine over coming months. Typically dose is increased slowly upwards in 25mcg steps. Sometimes in smaller steps if can’t tolerate 25mcg increases

Bloods should be retested 6-8 weeks after each dose increase

No other medications or supplements within 2 hours

Some like iron, vitamin D, magnesium, HRT or ppi not within 4 hours

Have you had vitamin D, folate, ferritin and B12 levels tested?

[Cookie83]

I am scared to continue taking medication as I am not fully convinced I am hypothyroid yet. I am underweight and do not want to lose weight and my resting heart rate is 76. My basal body temp is 36.4.

[tattybogle in reply to Cookie83]

"I am scared to continue taking medication as I am not fully convinced I am hypothyroid yet. I am underweight and do not want to lose weight .."

So. if those were your results BEFORE taking any Levothyroxine ?

" recently been diagnosed with hashimotos due to high antibodies however, my tsh is 1.03, my t4 is 12.8 and my t3 is 4.4"

Then yes , it would be unusual for a gp to start a trial of Levo based on those.

The TSH looks perfectly 'normal' (around 1) , but in some circumstances TSH doesn't always rise as it should in hypothyroidism , so we can also look at the fT4 level to see if the thyroid hormone level is too low.

What is the lab range for the fT4 result ? it will be after the result in brackets.

(It might be something like [12-22] , but some ranges are [7.9 -14] so without the range we can't tell how low that fT4 result is.)

"Thyroid peroxidase AB 185.2 (<5.6) "

The raised TPOab do show an increased probability that you would eventually need thyroid hormone.

So the TPOab level, plus symptoms , and (possibly) lowish fT4 is probably why GP has decided to trial Levo.

25mcg is only very tiny amount, and i would say it is highly unlikely that taking this for 6 /8 weeks would have any impact on your weight .

It's also such a small amount it's unlikely to make you feel any better until you are taking a lager dose.

However , the in the first few days / weeks, it is possible that you would notice some changes .. like increased bowel movements /faster heart rate ... this doesn't necessarily mean you should stop taking them .. thyroid hormones take a few weeks for the effects to settle and the body to adjust itself when you increase dose.

So i think it would be best to continue and see how you feel after 6/8 weeks . but not expect to really feel any real improvement in fatigue until you were taking a higher dose .. starting on 25mcg is just done so that it isn't too much of a shock to the system.

[Cookie83 in reply to tattybogle]

The range for t4 is 9-19. Mine is 12.8

[Cookie83]

B12 - 360 (135-650)

Folate - 34.7 (>7)

Ferritin - 73 (15-200)

Vitamin D - 85 (50-140)

[Cookie83]

Thyroglobulin AB 5.1 (<4.1)

Thyroid peroxidase AB 185.2 (<5.6)

[Wired123]

Hi, sorry to hear you’re at the start of the disease. There are some doctors who feel the damage can be contained so the body does not destroy too much of the thyroid gland in the early stages of autoimmune attacks.

You may well want to consider this approach, I don’t know much about it but one Endo I saw claims he has a protocol for this if started early enough. I can message you his name as we can’t share names publicly.