Thyroid Results after 2 months: Good Morning... - Thyroid UK

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Thyroid Results after 2 months

revitalise profile image
14 Replies

Good Morning Everyone

I had my thyroid bloods taken on Mon 24th Jan 2 months after reducing from 100mcg to 75mcg due to being overmedicated. My Dr cannot speak to me until Monday. As always any advice would be greatly appreciated. I was fasting and within the 24 hour period since I had taken my last dose of Teva Levothyroxine.

Serum Free T4 18.4 pmol/L (10.8-25.5)

Serum TSH 0.12 mu/L (0.27-4.20)

Thyroid Peroxidase Antibody 243 ku/L <35 Negative, 35-50 Equivocal, >50 Positive

Wishing you all a good 2022!

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revitalise
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14 Replies
greygoose profile image
greygoose

So, how do you feel with those results?

revitalise profile image
revitalise in reply togreygoose

Hi greygoose actually feel a lot better no more fatigue, muscle weakness or acid reflux. Do you think the TSH will come back to within normal range or would I need a slight increase. Does it mean much that the Thyroide Peroxidase is increased from 2 months ago. Hope you are well?

greygoose profile image
greygoose in reply torevitalise

One can never tell with the TSH, what it's going to do. But, worth waiting longer to see.

In any case, the low TSH is not the problem, because TSH doesn't make you feel anything. If you were feeling bad on your previous dose, it could have been because your FT4 was too high. But, it would be nice to know what your FT3 is doing

No, it doesn't mean much that your antibodies have raised. They fluctuate all the time. :)

revitalise profile image
revitalise in reply togreygoose

Thank you for advice still waiting to speak to my GP next week.

greygoose profile image
greygoose in reply torevitalise

You're welcome. :)

tattybogle profile image
tattybogle in reply torevitalise

. Do you think the TSH will come back to within normal range or would I need a slight increase.

An increase (in levo dose ?) would make you TSH go lower, not bring it back up into range.

Depending on GP , they may still say you are overmedicated with these new results, and may ask you to reduce Levo further because TSH is still below range, but hopefully they won't , because it's not all that low and your fT4 is well within range

(TSH 0.01 would be really low ... 0.1 isn't)

See my reply to this post (3rd reply down) healthunlocked.com/thyroidu... feeling-fine-but-tsh-is-low for link to a study and other posts discussing low TSH /risk.. This should be helpful if they want to reduce Levo further and you don't want to ,( or you agree to try and it makes you feel worse.)

revitalise profile image
revitalise in reply totattybogle

Many thanks for your advice will see what GP says when I finally get to to speak to her next week.

SlowDragon profile image
SlowDragonAdministrator

Are you taking Teva brand levothyroxine because you are lactose intolerant?

When were vitamin D, folate, ferritin and B12 last tested

What vitamin supplements are you currently taking

High thyroid antibodies confirms autoimmune thyroid disease also called Hashimoto’s

Have you had coeliac blood test done, are you on strictly gluten free diet

revitalise profile image
revitalise in reply toSlowDragon

Hi SlowDragonI am not lactose intolerant its the brand that the GP prescribed to me last June. I take Vitamin D. My coeliac test was negative. I take B12 oral spray and vitamins were tested in October. Hoping to speak to my GP next week.

SlowDragon profile image
SlowDragonAdministrator in reply torevitalise

Have you ever had different brand levothyroxine

Suggest you consider trying different brand

Many people find Levothyroxine brands are not interchangeable.

Many patients do NOT get on well with Teva brand of Levothyroxine.

Teva contains mannitol as a filler, which seems to be possible cause of problems. Teva is the only brand that makes 75mcg tablet. So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half

But for some people (usually if lactose intolerant, Teva is by far the best option)

Teva, or Aristo (100mcg only) are the only lactose free tablets

Most easily available (and often most easily tolerated) are Mercury Pharma or Accord

Mercury Pharma make 25mcg, 50mcg and 100mcg tablets

Accord only make 50mcg and 100mcg tablets

Accord is also boxed as Almus via Boots, and Northstar 50mcg and 100mcg via Lloyds ....but Accord doesn’t make 25mcg tablets

beware 25mcg Northstar is Teva

List of different brands available in U.K.

thyroiduk.org/if-you-are-hy...

Posts that mention Teva

healthunlocked.com/search/p...

Teva poll

healthunlocked.com/thyroidu...

Once you find a brand that suits you, best to make sure to only get that one at each prescription.

Watch out for brand change when dose is increased or at repeat prescription.

New guidelines for GP if you find it difficult/impossible to change brands

gov.uk/drug-safety-update/l...

If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient. If symptoms or poor control of thyroid function persist (despite adhering to a specific product), consider prescribing levothyroxine in an oral solution formulation.

academic.oup.com/jcem/artic...

Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).

Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after

Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime

verywellhealth.com/best-tim...

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

(Time gap doesn't apply to Vitamin D mouth spray)

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

REMEMBER.....very important....stop taking any supplements that contain biotin a week before ALL BLOOD TESTS as biotin can falsely affect test results - eg vitamin B complex

SlowDragon profile image
SlowDragonAdministrator in reply torevitalise

Refuse to reduce dose levothyroxine until had TSH, Ft4 and Ft3 tested together

Likely to need to test privately

Test early Monday or Tuesday morning and last dose levothyroxine 24 hours before test

cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

SeasideSusie profile image
SeasideSusieRemembering

revitalise

I was fasting and within the 24 hour period since I had taken my last dose of Teva Levothyroxine.

Can you clarify what you mean by that. Last dose of Levo should be 24 hours before test, not within a 24 hour period.

revitalise profile image
revitalise in reply toSeasideSusie

Morning SeasieSusieJust to clarify my last dose of levo was 24 hours before the blood test.

SlowDragon profile image
SlowDragonAdministrator

you have high antibodies this confirms autoimmune thyroid disease. Technically it’s Hashimoto's (with goitre) or Ord’s thyroiditis (no goitre).

Both variants are autoimmune and more commonly just called Hashimoto’s

Poor gut function with Hashimoto’s can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but a further 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal

As coeliac result is negative you can consider trialing strictly gluten free diet for 3-6 months.

Always worth trying…..Likely to see benefits. Can take many months for brain fog to lift.

If no obvious improvement, reintroduce gluten see if symptoms get worse.

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

ncbi.nlm.nih.gov/pubmed/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

ncbi.nlm.nih.gov/pubmed/300...

The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

restartmed.com/hashimotos-g...

Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.

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