I have received good advice here on vitamin supplementation so I ask for your advice once more. Recent blood results below. Levothyroxine only @ 650mg/week. Dose reduced slightly to try & bring TSH into range. Questions are:-
- Increasing antibody levels - is this a concern or do they always fluctuate?
- High cholesterol - do you think an increase in levo would possibly help to reduce this
My last bloods were taken at 11.15 & I had taken my levo the previous night. I wanted to get a feel for 'normal' TSH level. It was me suggesting the dose decrease as thought I may be over medicated. I feel OKish - my main symptom is sore eyes/puffy eyelids & the one concern I have is the cholesterol. No weight issues & I eat a good diet.
GP is happy to allow slight increase in levo if I request. Would really appreciate your input. I hope results are visible or will find another means to add.
Many thanks
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Will_blue
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Yes, antibodies fluctuate all the time. It's nothing to worry about
Probably increasing your levo won't reduce your cholesterol because cholesterol levels are linked to T3 levels, not T4. It depends how well you convert. And, we can't really tell how well you convert because you didn't leave the full 24 hours between your last dose of levo and the blood draw, so you have a false high FT4.
And, if your blood draw was at 11.15, your TSH was coming up to its lowest point. It was doubtless higher before 9 am.
As said before, your cholesterol is high because your FT3 is too low. Cholesterol has nothing to do with your diet. It is made in the liver and the liver tries to keep the level stable - the more you ingest, the less it makes, the less you ingest, the more it makes. But, when T3 is low, the body cannot process and excrete cholesterol correctly, and it builds up in the blood.
But, that is not a problem, because it doesn't cause heart attacks or strokes, as doctors think. It's a symptom, not a disease.
Always test thyroid early morning, ideally before 9am to get highest TSH
If you took levothyroxine night before test, Ft4 is falsely high
Last dose levothyroxine should be 24 hours before test
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
As you have autoimmune thyroid disease have you had coeliac blood test
Are you on strictly gluten free diet or dairy free diet
Which brand of levothyroxine are you currently taking
What vitamin supplements are you currently taking
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
High cholesterol levels suggests under medicated thyroid wise
If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.
Dose reduced slightly to try & bring TSH into range.
TSH is useful for diagnosing thyroid disease but once on thyroid meds it has no real relevance, it's the FT4 and FT3 levels that tell us what we need to know and it's FT3 that is more important - if this is over range then it suggests we are overmedicated.
Your results from September 2021 and February 2022 both show a reasonable level of FT4 at 75% and 72% but a poor level of FT3 at 32% and 36%. These results suggest poor conversion of T4 to T3 and as all your nutrient levels are optimal you may benefit from the addition of a small amount of T3 to your Levo if you don't feel optimally medicated.
- Increasing antibody levels - is this a concern or do they always fluctuate?
Yes, antibodies fluctuate and your raised levels confirm Hashi's which is what I suspected when I replied to your original post here.
- High cholesterol - do you think an increase in levo would possibly help to reduce this
High cholesterol is a symptom of hypothyroidism, so getting your hormone levels optimal could very well reduce this.
My last bloods were taken at 11.15 & I had taken my levo the previous night.
If you'd tested no later than 9am your TSH would be higher, TSH fluctuates and is higher early morning and lowers throughout the day. Taking your Levo the previous night means that your FT4 is showing higher than your normal circulating level, to get a measure of that it's advised to take last dose 24 hours before test, adjusting time the day before if necessary.
You can see the 'false high' effect from a 'levo only' dose the middle graph here... (top line on middle graph) The biggest 'high' is usually from 2 -5 ish hours after taking the tablet ..... after 12 hours the fT4 result is much closer to the level it would be after 24hours.
So while technically you do have a 'false high' for your fT4 test done at 11.30 am after taking you last dose levo the night before.... your result is probably not very much higher that it would have been after 24hrs.
However you chose to do your testing .. the most important thing is that you find a method than you can do consistently.. so future fT4 results are comparable .
Thanks to all of you. I'm beginning to get a feel for this. I'm going to stay as I am & retest in 6 months - keeping an eye on cholesterol. It has not increased any further in a year & GP happy low risk. I feel OK. I take Accord/North Star & stick with that brand. Will book early am bloods next time & skip levo until after tests.
Will book early am bloods next time & skip levo until after tests.
If you normally take your Levo at night then don't skip the previous night's Levo, change the timing so that you leave 24 hours. If you skip the night before the test and had taken your Levo the night before that then it will be too long, something like 36 hours, and you'll get a false low FT4 result.
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