These were my latest results after coming off 75 mcg of Levo. Waiting on results for a retake of T4. Any suggestions or tests I should ask the doctor for? Do I need to be remedicated?
TSH 3.38 [.450 - 4.500]
T4, Direct <.10 [.82 - 1.77]
TPO 441 [High]
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Mommy_of_2
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I stopped Levo because due to insurance issues I had to see a new endo. I was having IBS issues and thought possibly I was over medicated. So we stopped my medication for 6 weeks and those were my results. I just went in to retest my T4 as the doctor thought it was a possible lab error since it dropped so much.
Vitamins weren't tested and im not taking any supplements.
IBS and/or gluten intolerance are extremely common symptoms of being hypothyroid
Essential to test vitamin levels, especially after stopping levothyroxine inappropriately.
Vitamin levels frequently collapse when levothyroxine is stopped
When hypothyroid we frequently have LOW stomach acid, this leads to poor nutrient absorption and low vitamin levels, poor gut function, acid reflux, other issues gut issues can be SIBO, H Pylori and slow gut motility
Replacement therapy with levothyroxine should be initiated in all patients to achieve a TSH level of 0.5-2.0pmol/L.
NHS England Liothyronine guidelines July 2019 clearly state on page 13 that TSH should be between 0.4-1.5 when OPTIMALLY treated with just Levothyroxine
Note that it says test should be in morning BEFORE taking levothyroxine
“According to the current TSH reference interval, hypothyroidism was not diagnosed in about 50% of the cases in the afternoon.”
“Further analysis demonstrated inadequate compensation of hypothyroidism, which was defined in 45.5% of the morning samples and in 9% of the afternoon samples”
TSH levels showed a statistically significant decline postprandially in comparison to fasting values. This may have clinical implications in the diagnosis and management of hypothyroidism, especially SCH.
Very informative! I think I will push to go back on my medication and also get proper blood tests.
One more thing I'd like to ask - it could be unrelated. But the last 2 blood tests I took, my eGFR was almost abnormally low for my age. It was 74, and then 69. I'm supposed to retest in January. Is there any kind. of link between hashis and decreased kidney function?
Your TSH is higher than in a euthyroid person and free T4 is so far below range as to be almost undetectable. Your high antibodies show you have Hashismoto's, which is by far the most common cause of an under-active thyroid, and means your thyroid can't be "cured".
You are not making anywhere near enough thyroid hormone naturally so need to take your thyroid medication - and in a big enough dose to make you properly well. Why did you stop?!
ps I understand that some people get some sort of "high" when they stop taking the thyroid hormone they need - before crashing down afterwards. If you took at Lalatoot 's post of a year ago, you can see the dangers of stopping when you shouldn't ... healthunlocked.com/thyroidu...
Thank you for the response and the link as well. The doctor thinks my T4 dropping could be some lab error so I went Friday to retest and will be calling my doctor next week for the results.
Would you consider that TSH hypo even though it is in the labs range?
Yes. As SlowDragon says, once you're on thyroid meds it shouldn't be more than 2 - and prob less than 1 ... and free T4 and free T3 both need to be good and high in range [at least 2/3 into the range] x
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