Hi all, I was diagnosed with Hashimottos last year and since then been trying to find my optimal dose of Thyroxine. In April my TSH was 6.0 (reference range 0.27-4.20), my GP wanted to keep me on 75mcg but because I was still out of range and symptomatic I asked to be increased so I went up to 100mg. I had another blood test last week and my result is 0.1, my GP therefore wanted to put me back to 75mg but as this is first time I have had some improvement in symptoms she has agreed to keep me at 100mcg and re-test in another 8 weeks. My questions are:
1. Why have my results swung so dramatically the other way when previously I have only seen small differences in results with each dose increase?
2. I had Covid the week before blood test so could that have had an impact on my results?
3. Is it detrimental to stay on too high a dose of Thyroxine?
4. I was thinking of getting a private test in about 4 weeks to see what my FT3 and FT4 are doing as I thought that might be helpful on deciding treatment dose, is that a good idea?
Thank you for you any advice you can give.
Written by
mle121
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It could very well be a hyper phase of Hashimoto's. Presumably you know that with Hashi's levels and test results fluctuate with Hashi's activity.
Was TSH all that was tested? You really need FT4 and FT3 tested as well. Don't let GP reduce dose based on TSH alone, refuse unless FT4 and FT3 are tested.
If it's a hyper phase of Hashi's and you get symptoms and raised FT4/FT3 along with your low TSH, then reducing your dose temporarily during this phase may help, but don't have your prescription altered because once it's reduced you may find it very hard to have it increased again.
Also acute infection can mess with thyroid levels so Covid might have something to do with it.
Thank you for your speedy response. I did not know that Hashi levels could fluctuate so that is very interesting to hear. How do I know if I am having a hyper phase when have no hyper symptoms? Yes TSH was all that was tested. I am aware that it isn't always easy getting an increase in dose hence why I was resistant and for first time symptoms improved.
Supplementing with selenium l-selenomethionine 200mcg daily is said to help reduce the antibodies, as can keeping TSH suppressed.
Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies. It's essential to test Vit D, B12, Folate and Ferritin and address any problems.
How do I know if I am having a hyper phase when have no hyper symptoms?
I don't have Hashi's so have no personal experience.
Hashi's is where the immune system attacks and gradually destroys the thyroid. After every attack, the dying cells release their stock of thyroid hormone into the blood stream, causing the levels of thyroid hormone to go well over range - depending on reference ranges FT4 maybe to around 30 something and FT3 around 11/12 and the TSH reduces to suppressed. I would imagine that you would get hyper type symptoms or symptoms of overmedication when this happens.
However, you can still have a low/suppressed TSH with in range FT4/FT3 if the pituitary isn't working correctly so it's very important to test TSH, FT4 and FT3 all together, although doctors don't seem to understand this.
Thank you very much indeed for all this info. My diet is already quite restricted so trying to eliminate gluten as well is going to be tricky but it will be interesting to see the results of a coeliac screen and maybe trying a short spell of elimination to see if it makes a difference. I will do some research from all the useful links you have sent me. Thank you again.
Hi, thank you for such a quick reply. I have no idea what brand I was on before or if same as now. I have always had my bloods done before 9 and last dose 24hrs before. I have never had anything else tested except FT4 and antibodies at diagnosis and when I asked for more my GP said TSH is all that was required, but I have read enough posts to know that this is a common occurrence and that private testing is probably only way to go to get all the results I need. Thank you for info re FT3 result to know if over medicating. I will get a private test done then in a few weeks and post results then I can see where to go from there.
Suggest you always make a note of what products you get.
Despite the official line being that all levothyroxine products are equivalent (at the same dosage, of course) that is simply not true for all patients across all products.
May I suggest that in addition to getting Free T4 and Free T3 tests, get a reverse T3 test. In about I believe 15% of thyroid patients, their bodies make large amounts of Reverse T3, which will then fill up Free T3 receptors so you aren’t getting the T3 body needs. I had this problem for years until I did my own research. I was so sick my prayer was, “God fixing or take me. Either was ok with me.” Hopefully you won’t have to go through years of the wrong medicine like I did. My doctor for years only did the TSH test.
There’s a website and a book with the same name that helped me tremendously. I am not in any way affiliated with it but heard about it from the patient advocate in the thyroid specialist office I was in. It’s called, “Stop the Thyroid Madness”. I wish the same kind of miracle I have had. I have been on Time Released T3 medicine for years. Keep doing your research; trust your gut; and don’t quit 5 minutes before your miracle happens! Feel free to check my bio. There is more info there.
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