Advice on latest blood test results please

[Wired123]

Hi all,

I'm a 40 year old male with Hashimoto's since I was diagnosed at the age of 26 - though probably Hypo for many years before that.

I've had my latest bloods and attach to this message.

I've lost about half a stone/few kilos in the last few months by following a lowish carb diet and cut out wheat, focussing on meat and veg with little dairy. This is the advice from this forum to cut out wheat and dairy, it really does work so we should all try it for a few weeks and see if it helps.

I feel much better and my mind is sharper as well as much more energy which has allowed me to start exercise as well.

My question is that despite no change in meds my T3 and T4 have crept up but still within range - perhaps due to better diet or is this just general fluctuation?

My worry is that TSH is too low now and the doctor will look to reduce my T3 or T4 which I am reluctant to do as I feel pretty good at the moment.

Any advice would be gratefully received.

[SeasideSusie Remembering]

Wired123

Presumably you always do your tests under the exact same circumstances so that they can be compared accurately? Also that you leave the correct time gap for last dose of Levo (24 hours) and last dose of T3 (8-12 hours) before testing?

Fluctuations in results do happen with Hashi's, but there is no suggestion with your current results that you are experiencing a hyper swing.

My worry is that TSH is too low now and the doctor will look to reduce my T3 or T4 which I am reluctant to do as I feel pretty good at the moment.

Taking T3 is known to lower TSH and often suppresses it and one wishes that doctors prescribing T3 know this. TSH is useful for diagnosis of hypothyroidism but once on thyroid meds it has no real use, it should not be used to adjust dose, it's the FT4 and FT3 that show our thyroid status.

Your FT4 and FT3 say it all, they are both well within range, you feel good, there is no need to alter your dose. If your doctor mentions your TSH being low you have your answer above

[Wired123 in reply to SeasideSusie]

Thanks Susie

Yes I always follow the same protocol, same lab, same time, always fasting. 24 hours since T4 and about 18 hours since T3 (my last dose is c2.30pm each day).

I guess FT3 would be marginally higher if I delayed my T3 dose to be 12 hours, but we are probably splitting hairs.

A previous private Endo used to tell me to take T3 at 7am and then test at 9am - and then would tell me I’m over medicated and need to reduce the dose. Idiot!

My concern remains that the TSH is “too low” for a doctor to allow me to remain on this dose, although I’m in range for FT3 and FT4.

Several Endos use TSH to determine dosage.

Even progressive and sensible Endos who advocate T3 treatment still err on the side of caution if FT3 goes too close to zero.

Let’s hope he doesn’t try to push me to reduce my dosage of anything as I don’t want to upset the happy balance I have.

[radd]

Wired123,

I found after the introduction of 20mcg T3 (raised slowly) I was able to reduce both hormone doses after several months.

Your dietary changes and being optimally medicated will both be contributing to making everything just work better, hence higher hormone levels. Other things I found helped was liver & gut support which are ongoing.

Re TSH, this is always going to be a bone of contention until the medical establishment recognise that TSH can not be universally used for dosing. You have acquired the right amount of meds for a cumulative approach to wellbeing but now it will be the keeping of these amounts that becomes a battle for many. Hence, why so many of us self-medicate with sensible amounts most suited for our individual needs.

Your bloods look great although I personally wouldn’t want FT4 to go any higher when medicating both hormones. If these were mine I would keep testing every few weeks/months to keep an eye until you reach a plateau as you may need a slight dose reduction. However, a dose reduction would be only to keep thyroid hormones at 'your' optimal levels and not to appease TSH.

Well done 😊

[Wired123 in reply to radd]

Thanks Radd, it’s been a journey and I’ve seen over 10 private Endos most of whom were useless!

Will keep testing as you suggest.

What gut and liver support do you use? I’m tempted to try Symprove again.

[radd in reply to Wired123]

Wired123,

Symprove always looks so convenient, but I myself don't need any additional probiotics, just more acid. I have warm lemon juice every morning, ACV or Betaine HCL + pepsin with protein heavy meals. For my liver, sometimes a bit of milk thistle, dandelion root, berberine, etc. I prefer less pill taking now a days so choose combos or green powders. I also like Twinnings Detox Tea, even if it is pretty weak it's preventing excess coffee consumption.

Be aware I only take small amounts of milk thistle as it's actually a prohibitor of thyroid hormone transporters.

[Wired123 in reply to radd]

How did you diagnose the need for more acid?

[radd in reply to Wired123]

Wired123,

If you have read my previous replies to other posters you will know this was a real break through in my utilising thyroids meds effectively.

I simply took high strength Betaine HCL with pepsin, starting with one tablet and increasing by another every few days with protein rich meals. One is suppose to establish a maximum dose by a warm feeling in the gut & then reduce by one tablet for a final dose. When I had reached five extra strong strength tablets and still felt nothing 😳 my nutritionist told me not to go any higher. I stayed at five tablets for about a six months and slowly my own gastric acid started improving own production. Now I only need one or two tablets every few days with a protein rich meal.

I also used to take digestive enzymes and ox bile, as when food enters the stomach it not only releases HCL but this triggers a sequence of events that includes the small intestine releasing pancreatic enzymes and the gallbladder releasing bile that emulsifies fats. However, years of low thyroid hormone may inhibit these happenings but it is these functions that ensure good nutrient/med absorption, prevent bacterial overgrowth & promote a healthy gut microbiome.

Be aware that HCL is a powerful acid and although freely available in UK, the US FDA have banned its use in OTC products. Also, it is wholly incompatible with PPI's or if you have stomach ulcers.

I have found Doctor's Best are the best value for money dolphinfitness.co.uk/en/doc...

[Wired123 in reply to radd]

Thanks Radd, I will look into that as I journey towards optimum. A lot of sense in what you’ve described.

Thanks again

[Wired123]

Interesting, I’m also getting to the point where I want to do less pills.

I’m due to try Berberine as it’s supposed to reduce blood sugars and insulin, both of mine are higher than they should be.