Advice is needed please on Latest labs

[JannSimpson]

Hi

I appreciate any help with deciphering my latest lab work.

Here is a bit of history: I was Diagnosed with Hashimotos in 2014. I've been on anti-inflammatory diet since then. No gluten, dairy, grains, sugar or processed foods. I'm currently on a low Histamine diet for Histamine Intolerance. And I don't know what is driving that

I do take 13 mcg of Tirosint. However, I did not take any biotin or my thyroid medication the morning of the test and I was fasting. I'm talking kelp for low Iodine and have lowered my dose of Vitamin D

My TSH was tested again yesterday and is now at 6. But I think there is still an error here as I feel ok. However, My FT4 & FT3 are still not converting. My TPO is down to 17 from 600 which is wonderful. But my TSI & TRAB is still a bit high.

My cholesterol is elevated according to the doctor and I know low thyroid is the culprit, but I'm not going to take Statins. How can I get it all under control? 🤷‍♀️

Total 299

Triglycerides 88

HDL 74

LDL 211

[PurpleNails Administrator]

Were your diagnosed with Hashimotos as you had positive TPO & TG antibodies?

Have you always had low FT4 & FT3? Do your levels fluctuate a great deal?

Positive Trab or TSI are usually antibodies associated with continuous hyper - (Graves).

There’s a cross over with antibodies. Or you may have both conditions - TED is associated with both autoimmune -although most medics say TED is hyper Graves.

“I do take 13 mcg of Tirosint”

Is Tirosint levo? - 13 mcg very very low. Was this 135 mcg?

FT4 is at 40% of range so there’s lots of room for increase. Usually this is 25mcg per day and retest in 6 weeks.

Your test was done as recommended (tick)

FT3 only 4.17 % of range. Very low. Raising Levo dose will rise FT4 and enable the FT3 should rise too.

You are deficient in iodine, and I don’t have much advice about helping this. How is your diet? Do you have diet low in iodine sources?

If you raise level of FT4 & improved iodine, hopefully that will be sufficient to raise both FT4 the FT3 (and better conversion).

Treating high cholesterol should be delayed until thyroid status better. Then it likely won’t be necessary to treat.

Edit. Forgot to add. TSH is high. It could have antibody interference & be incorrect - but I wouldn’t focus on TSH I would look at your FT4 & FT3.

[JannSimpson in reply to PurpleNails]

@PurpleNails Thank you for your reply!

"Were your diagnosed with Hashimotos as you had positive TPO & TG antibodies?"

Im not sure. I think my Doc was simply going by TSH. She may have tested more but Its been so long I cant remember. Plus I wasn't as "lab work savvy" as I am now. 😉

I do know that at one point my TPO was 600. I was put on Armour Thyroid and then Natur Throid and soon after starting feeling HYPER and ended up with Thyroid Eye disease. 😑

I believe I do have a little of both Hashi and Graves or Hypo & Hyper as my TSI and TrAb continue to be slightly elevated, although not as high as they used to be! My doc is very open to doing lots of tests as you can see.

As far back as I know my Free T3 &4 have been low but I cant be sure.

Yes Tirosint is Levo with out gluten or other fillers that may cause a reaction. At first I took 50 MCG nd it made me feel Hyper, as did 25 mcg, so we started low at 13 micrograms with no reaction. I will talk to her about possibly raising it then?

Will just increasing my Tirosint perhaps raise booth my ft3 & ft4?

"If you raise level of FT4 & improved iodine, hopefully that will be sufficient to raise both FT4 the FT3 (and better conversion)". IM ON BOARD WITH THIS!!

Im currently dealing with Histamine Intolerance issues so I have to be careful with Food sources of Iodine. But I do take kelp and a supplement called T-150 by XYMOGEN. It has a natural source of iodine in it.

However all of this madness prompted me to do Tons of research on natural solutions and healthy ways to bring down inflammation, heal leaky gut, address adrenals etc... . Even though I did have lid surgery to bring one eyelid down to normal, both of my eyes look normal now and I continue on my health crusade!

Now I just need to see what is driving this histamine problem.

😜

[tattybogle]

Hi JannSimpson ... have you tried again to increase your Levo dose yet from 13mcg ? What happened if you did ?

on previous post , tsh was 5 ish . ( way to high) and now it's even higher, clearly indicating you are not taking anywhere near a large enough dose of thyroid hormone.

Improving your thyroid hormone levels should improve the cholesterol.

" My T4 and T3 are still not converting "....

T4 converts to T3 , but it's not possible to judge how efficient you are at converting T4 to T3 until you are taking enough T4 to get the TSH down to a reasonable level .

[Andie222]

Hello. I think I have read that it's best to avoid taking biotin for a week before blood test, as it can skew results. Just wondering if you did that.

[JannSimpson in reply to Andie222]

Yes, I did not take any B Vitamins for more than a week before my blood tests. Thanks!

[turningthepage]

An LDL of 211 is extraordinarily high, and it’s unlikely to be the result of low thyroid function alone. This is diagnostic for familial hypercholesterolemia, and should be treated now! This is particularly salient for you, as you have maintained an excellent diet/lifestyle for years (awesome job, btw!). I’m familiar with this as an internal medicine PA x 17 years, and my husband has FH also (most of the men in his paternal lineage died from heart attacks before the age of 55). I understand you don’t want to take statins, but if you can’t be persuaded, please consider another intervention such as Repatha. Please research this further and consider referral to a lipid specialist if you aren’t happy with your GP, as you have an markedly high risk of suffering a serious cardiovascular event within the next 5–10 years without treatment. Take care and be well!

[JannSimpson in reply to turningthepage]

Thank you for responding. Yes, I will definitely look into it. However, I'm looking into natural remedies to lower it all. I once lowered it ( by about 10 points) by eating roasted beets, carrots, and apples every day for breakfast. I may start that again. 😊

[JannSimpson]

tattybogle Thank you for the reply!

No I haven't yet tried to increase my Tirosint but Im definitely WILLING to as I've been on this dose for a while and nothing is really happening. I'll let you know how it goes.

Some people at Hashimoto's 411 on facebook have recommended that I also start a T4 medication like Ctyomel. But Im scared to. What do you all think?

[tattybogle in reply to JannSimpson]

Sorry for late reply , i didn't get a notification for some reason so i only found it by chance ,we've got some gremlins in the site i think ...

"recommended that I also start a T4 medication like Ctyomel. But Im scared to. What do you all think? ........... presumably you meant to write 'T3 ' (cytomel is a brand of T3)

I think it would be more sensible to stick with the usual option (gradually increase levo dose in stages and test...until on adequate dose of Levo , ie: enough to get TSH back into range and probably below 2) and see if that makes you feel better , before getting into the complexities and expense of prescribing/ sourcing and adding T3.

"i've been on this dose for a while and nothing is really happening" on just 13mcg Levo ... i'm not surprised .. that's a really miniscule dose

[JannSimpson in reply to tattybogle]

Thanks tattybogle ! Yes I meant to say Cytomel was a T3 medication. And I am going to have my Tiroisint bumped up to 25 mcg this week. I'll let you know how it goes!

About 8 months ago my TSH lab test came back at 15! I told my doctor that there was no way. I didn't feel bad at all. Actually, I felt better than I had in years. She retested and it came back at 12. I was still perplexed. So I made an appt with my Endo and he checked it again from a different lab and it came back as 3. 🤷‍♀️ So, we felt like there was an error with the previous lab.

We have retested my current TSH and now it came back at 6. So, I'm hoping this is the SAME problem that we had last time. I'm seeing my Endo next week to get another TSH test done.

[JannSimpson in reply to tattybogle]

tattybogle and PurpleNails . I believe I have successfully gone up to 25 mcg of Tirosint without any reactions. I do feel like I have more energy but I wasn't really fatigued before. Anyway, I seem to be doing well on it.

How long should I wait to get blood re-tested to see if it's helping?

[tattybogle in reply to JannSimpson]

Hi , after any dose change you need 6 weeks before testing will be representative of the new dose .. and at least 6 weeks , more like 8 really, to know how that dose will feel symptom wise.noting the previous discrepancy between your TSH results, i suggest you also get endo to do next bloods again to see a comparison of TSH. (some people have certain sorts of antibodies which can cause interference in results when TSH is tested using lab methods that use those antibodies in their process,... perhaps endo used lab which uses different test method)

As the dose increase was very small , i don't expect it to make much difference to your Blood results, but since you have had previous difficulties with larger doses, it's a good idea to only increase very slowly and give each increase time to settle, and see how it feels .