Was wondering if anyone could offer advice on my latest test results?
I was also being tested for diabetes at the same time so unsure if some of the results are from that test.
T3, T4 and TSH all look within normal ranges to me but Sodium and Potassium are out of normal range and don’t know whether I should ask more questions?
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ALW198
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Was your test taken early morning appointment after fasting & delaying dose until after draw.
What other medication and supplements do you take?
Your Sodium and Potassium are fractionally out of range but dr isn’t concerned & marked as no action required.
You FT3 is slightly low end of range. Do you have hypo symptoms or are you feeling well?
HbA1c is the diagnostic measure for diabetes. It measures the sugar attached to the haemoglobin, so it gives an average reading from past few months. Doesn’t show spikes or low. it’s considered more accurate than a snap shot reading. Yours is 33 when it approaches 41 it’s considered pre diabetes levels so yours is fine.
Taking dose before draw may lower TSH and show a higher FT4 than if you left until after draw,
Your results may look different if tested in recommended way and would likely show a lower FT4.
The aim when on replacement if for TSH to be around 1 always under 2 and FT4 in higher part of range eg 75% or range FT3 at least 50% your results with a recent dose are:
FT4 Is 59.5% of range
FT3 is 19% of range
So your dose of levothyroxine (T4) could be raised, by 25mcg per day & retested in 6 weeks. 125mcg is a fairly high dose. A guide is often said to be 1.6mcg per 1kg per body weight.
How do you take your medication? Away from food/drinks other medication? Do you always have same brand?
Your doctor may say as TSH in range this isn’t necessary but if you have symptoms it may be because your FT3 is low, this is the more active hormone.
Raising the FT4 levels should also raise the FT3 but it looks like your not converting FT4 to FT3 very well. Which you can see from a higher level of FT4 compared to a lower percentage of FT3.
Ask doctor test folate, ferritin, B12 & Vitamin D. Once optimal this will help FT4:FT3 conversion. Optimal is not same as in range which is what a Doctor will consider acceptable.
Private companies are an option if Doctor refuses to test everything.
There are some foods and drinks that are known they do not mix well with levothyroxine:
* drinks containing caffeine, like coffee, tea and some fizzy drinks, can reduce the amount of levothyroxine your body takes in. Leave “at least 30 minutes” after taking levothyroxine before you drink them. (An hour or more should be ok)
* calcium-rich foods, such as milk, cheese, yoghurt and broccoli, can reduce the amount of levothyroxine your body takes in. Leave at least 4 hours between taking levothyroxine and eating calcium-rich foods.
* soya in food and supplements may stop levothyroxine working properly. If you regularly eat soya or take soya supplements your doctor might need to do extra blood tests to make sure you're getting enough levothyroxine.
* kelp (a type of seaweed) can contain high levels of iodine, which sometimes makes an underactive thyroid worse. Do not take supplements containing kelp if you're taking levothyroxine.
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
Have you every had thyroid antibodies tested? TPO or TG ? This will show if your hypothyroidism is due to autoimmune. Autoimmune thyroiditis or Hashimoto’s. Hypothyroidism is treated the same no matter the cause. For those who have autoimmune many find gluten free diet beneficial.
Before considering a trial on gluten free diet get coeliac blood test done first just to rule it out. Do you have stomach issues?
If GP unhelpful and refuses test, this test recommended (requires spot of blood) in home kit.
If positive you have a strong argument for GP to repeat unless GP accepts private result. (Depends on GP).
If result is negative still consider trialing strictly gluten free diet to see if there is an intolerance (which a test would not detect). Changing to a strictly gluten free diet may help reduce symptoms, help gut heal. If after a few months or so no improvement try to reintroduce.
Last post mentioned vitamin D deficiency. What was last result?
I don’t think I’ve ever had antibodies tested, I asked my Doctor about it previously and didn’t get much response. I am now at a new practice though so maybe I’ll ask again.
I’ve never had any stomach issues so no raised concerns in that department.
It doesn’t look like they tested for vitamins etc this time. It’s my first test in 10 months and first at new practice so ‘learning the ropes’ again!
You are under-medicated. Yes, the results are within range but the ranges are so wide that the important thing is where your result falls within the range. Your TSH is too high for someone on thyroid hormone replacement, and your Frees are too low, and if you took your levo three hours before the blood draw, you have a false 'high' FT4, there. Your FT4 would have been much lower if you'd left the recommended 24 hours.
Taking your levo too close to the blood draw will not have affected your TSH, but the time of day will have affected it. What time was it, exactly?
Your potassium is ever so slighly over-range, which is not a problem. But, your sodium is under-range, and that's a different kettle of fish! Are you on a low/no-salt diet?
OK, so the TSH would have been higher at 8 am, but it's too high, anyway. And your FT4 was a false result.
I'm not a fan of diets of any kind - unless they make the person feel better in some way. If you are hypo, your size and shape has little to do with what you eat. That's just the way being hypo affects you: to 'thin' or too 'fat', but your metabolism is messed up and diets are unlikely to help that. So, don't go thinking you 'should' be on a 'diet'. By all means experiment with ways of eating - gluten-free, paleo, whatever - but not low-calorie. That will just make things worse.
Do you have Hashi's? Gluten-free is often helpful for people with autoimmune diseases because they often either have Coeliac Disease or are gluten-sensitive. You can test for Coeliac but the results are unreliabel. To find out if you have gluten-sensitivity the only way is to stop gluten 100% for a few months and see if you feel better. If you don't feel any better, start eating it again and see if you feel worse.
It doesn't help everyone. I have Hashi's but gluten-free did nothing for me. I didn't feel any different when I stopped it and I didn't feel any different three months plus later when I started eating it again. But, it is worth a try because some people find it gets rid of a lot of their symptoms.
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