Hi all,
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]
Why have you stopped levothyroxine
Bloods should be retested 6-8 weeks after any change in dose
How long since you stopped taking levothyroxine was this test done
Always test as early as possible in morning before eating or drinking anything other than water (and last dose levothyroxine 24 hours before test )
What vitamin supplements are you currently taking
When were vitamin D, folate, ferritin and B12 last tested
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
would you consider mt TSH hypo even though it is In the labs range?
How long since you stopped levothyroxine before testing
It takes at least 6-8 weeks, if not longer for levels to drop
Essential to test vitamin levels and maintain optimal vitamin levels as low vitamin levels tend to lower TSH
Was latest test done as early as possible in morning before eating or drinking anything other than water
What were TSH, Ft4 and Ft3 when on 75mcg daily
Median TSH graph of healthy population
healthunlocked.com/thyroidu...
I stopped 6 weeks before. Also no, I tested in the afternoon as I had to wait for childcare so I could go to the lab. Good to know for my next orders.
On 75 mcg of levo, a blood test showed my TSH at 2.2 [.450 - 4.500] and T4 at 1.51 [.82 - 1.77] .
So technically TSH didn't jump too much without Levo?
TSH often unreliable with autoimmune thyroid disease as Ft4 and Ft3 levels change so much
Just testing TSH and Ft4 is completely inadequate especially as low vitamin levels tend to lower TSH
TSH over 2 suggests under medicated
TSH should be under 2 as an absolute maximum when on levothyroxine
gponline.com/endocrinology-...
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
Also to test vitamin D, folate, B12 and ferritin
sps.nhs.uk/wp-content/uploa...
Graph showing TSH in healthy population
web.archive.org/web/2004060...
Many people when adequately treated will have TSH around or under one
Most important result is always Ft3 (not tested)
Always test as early as possible in morning before eating or drinking anything other than water
researchgate.net/publicatio...
“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”
ncbi.nlm.nih.gov/pubmed/252...
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?
Absolutely yes….especially low Ft3
academic.oup.com/jcem/artic...
ncbi.nlm.nih.gov/pmc/articl...
Suggests
A) under medicated
B) likely low vitamin levels
C) poor conversion of levothyroxine (Ft4) to active hormone (Ft3)
D) get coeliac blood test done BEFORE considering trial on strictly gluten free diet
How much do you weigh in kilo
Unless very petite, 75mcg levothyroxine is low dose
Yes!
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
Results 
Results
Are these results normal? 
Results 
