Test results advice please

[Bookworm63]

Hi all I’ve been getting confused just recently with my thyroxine medication because I’m not sure if the excipients in the meds make me feel tired and bloated or if I’m just under medicated. I’ve just done a basic Medichecks blood test as I’ve never been able to pluck up the courage to do it before. Not good at blood very squeamish had to have nurse do it in the end. Bearing in mind that I was only just back on 50mcg a day for just over week prior to test. The test was taken at 10.15 am (earliest I could get,) and I hadn’t taken any Levo in 24 hours before test. I did continue with my b complex supplement as it doesn’t contain biotin. Because of tummy troubles I stopped levo for a week near the end of July because I was feeling full up bloated and sick but by the end of the week I felt totally exhausted and extremely nauseous! So went back on the levo again. Now starting to feel much better. I now take 25mcg Aristo tab first thing and 25mcg liquid thyroxine at about 12 after not eating for about 2 hours and then leave it an hour before having lunch. This seems to working well for me. Digestion still feels a bit slow after eating but it is actually moving better and touch wood no nausea! Energy levels improving also. Sorry for the long explanation but thought it was relevant to the results.

TSH - 2.46 (0.27-4.2)

Free T3 - 4.09 (3.1-6.8)

Free Thyroxine- 17.7 (12-22)

Thyroglobulin Antibodies 13 (<115)

Thyroid Peroxidase Antibodies <9 (34)

My feeling is that I carry on with the liquid/tab regime for the next few weeks until I’m about 6-8 weeks in and then retest with a more comprehensive test. Vitamin and iron levels etc. I’m beginning to feel more uncertain about the excipients in the medication and more convinced it was low medication that was causing my problems. However I’m reluctant to change my new regime at the moment as it seems to be working and at last I do have more of an appetite and less nausea. Also starting to put on a bit of weight, which for me at the moment is good. Anyones thoughts please would be much appreciated, thank you 🙏

[greygoose]

I would say those labs are pretty useless, given that you hadn't been on the 50 mcg for 6 weeks straight. I wouldn't have done them an wasted the test, personally.

[Bookworm63 in reply to greygoose]

I take your point Greygoose. I had the blood test because I had a free consultation with a private functional GP. I have been struggling with Levo ever since I have been on it. Never really felt well but mostly because of tummy troubles, nausea and bloating. Slow digestion. If I stop taking it I initially get my appetite back and my digestion feels more normal but then I start to feel so tired and exhausted and nauseous if I do any exertion that I have to go back on it. I got in touch with private GP as he was able to prescribe NDT and I thought it might be an idea to give it a go. At least it would be prescribed and monitored. He obviously needed me to do a blood test before going anywhere with it so that’s how I ended up having the test under these uphazard circumstances. Once I received the test I realised I couldn’t do it myself, too squeamish so I had to make an appointment with a nurse which was nearly a 2 week wait. I did get there this Monday but in the meantime I have been struggling to get 50 mcg in me so that’s why it got so sketchy. It’s not been and easy few weeks with the weather and having child care commitments for my granddaughter. I’ve been trying to do the best I can to feel the best I can with continuing my life to the best of my ability. It’s very difficult looking after a 4 yr old when your exhausted and feeling sick. I went ahead with the blood test because I was curious about my T3 level and because no one has ever sat down and analysed my antibodies with me. Although they seem to be ok. I have no idea why I’m hypo, I seem to only go back to borderline if I stop Levo but I can still feel quite poorly. My levels so seem to improve quite quickly once I go back on it. I just don’t seem to be able to stomach the stuff.

[greygoose in reply to Bookworm63]

Yes, I understand. But, have you ever considered that low stomach acid might be a huge part of your problem? It often happens when T3 is low - and yours is low. And causes the symptoms you describe.

You cannot completely rule out Hashi's on the basis of one negative antibody results, because antibodies fluctuate all the time. Also, not all Hashi's sufferers ever have over-range antibodies and are diagnosed by ultrasound when the damage becomes visible. So, you could still have it. But, there are many, many possible causes of hypothyroidism. And, in the end, it doesn't really matter what caused it, it's rarely reversable, you just have to deal with the resulting low levels of thyroid hormone.

[Bookworm63 in reply to greygoose]

That’s interesting so you are saying my T3 is low, which I thought it was but did come up as within range. So now can I pick your brains some more please. If it’s low do you think I should try the NDT route or just try and address my stomach acid issue. I think you may well be right with that too, it does seem Gerd related. If addressing the low stomach acid what do you think works best?

[Bookworm63 in reply to Bookworm63]

Also I do have problems with certain fodmaps. Anything with an “ol” on the end of it, xylitol etc will give me tummy ache and wind and bloat. If I get those symptoms badly there’s usually a formap at the root of it. I think I’ve had IBS for years but it’s never been diagnosed and since being hypo it’s got worse.

[greygoose in reply to Bookworm63]

Just being in-range isn't always good enough. It has to be at the right level within the rang to make you well - something which is different for everyone.

I think, to start with, you should concentrate on the stomach acid, because low stomach acid will affect absorption of whatever thyroid hormone replacement you take. Have a look at this article, and try the home test at the end:

healthygut.com/3-tests-for-...

I'm afraid I can't help much with solutions, because it isn't a problem I've ever had - not to my knowledge, anyway.

Then, it's always a good idea to try NDT, if you have the oppertunity. It might not suit you - it doesn't suit everyone - but it might be just the thing you need. And, if you never try, you'll never know.

If you have IBS, being hypo will make it worse. But, raising stomach acid might help with that. Stomach acid is far more important than we realise!

[Bookworm63 in reply to greygoose]

Thank you so much for the info Greygoose it’s much appreciated 😊. I have got some HCL betaine so I can get started with trying that out straight away. Think I will go back to the private GP and give NDT a go as you say it might just do the trick. Many thanks for your time 🙏

[greygoose in reply to Bookworm63]

You're very welcome.

[Lalatoot]

Bookworm going gluten free even though I am not celiac helped the bloating for me. Then being on a high enough dose of levo also helped.I had all sorts of symptoms - weightloss, nausea, bloating, tiredness, insomnia. I blamed the levo so I cut my dose right down to 25mcg daily and I felt great!! THAT LASTED 3 MONTHS. Then I was very ill and very, very hypo. It turns out that my symptoms were not the levo - it was because I was undermedicated. The endo was happy because my tsh was in the 4s just in range and my ft4 was 15 (10 - 25). I spent 4 years feeling awful because I didn't know any better and I thought the endo would!

[Bookworm63 in reply to Lalatoot]

I did go gluten-free a few years back and I felt great for about a month and then symptoms began to return. I went back to eating against as I felt I was missing out on a food group and I wasn’t feeling any benefit from it. I while later I found a lot of my bloating and acid reflux disappeared once I gave up lactose. Big blow for me, I loved dairy! I’ve remained off it and I notice the difference if I try to go back to it. I think I’ll ask dr for a celiac test and if negative still try gluten-free again and see how it goes. Thank you for the suggestion Lalatoot.