I was eventually diagnosed as hypothyroidism August 3rd 2022.
My GP put me on 50mcg Levo and referred me within 2 weeks to see an Endo because he was bit confused by my symptoms (including persistent ear ache) and suppressed TSH/ lowish T4 and T3 in May then 2 sets of hypo results in June and July. My last post has specific details of results.
Before my appointment the Endo/ Hospital requested lab results:
TSH 4.20 ( 0.35 -4.94)
FT4 9.5 ( 9 -19.1)
FT3 3.2 (2.4 -6.0)
At the time I took these tests, I had been on 50 mcg Levo for just over 2 weeks.
The Endo said he could feel a slight goitre, I was still having symptoms even though my results had now 'come back into range' (as above) and because my TPO ab were over 600 he increased my dose to 75mcg and said he wanted to re-test in 6 weeks and get the TSH to about 2.
Yesterday I took the blood tests 6 weeks after above meeting (following protocol advised on this very useful forum) Results:
TSH 2.21 (0.35 -4.94)
FT4 10.7 ( 9 - 19.1)
FT3 3.3 (2.4 - 6)
The blood was drawn at my local surgery and I was surprised when the results were put up on my account. Not so surprised though by the "No action needed". I was hoping for an increase to 100mcg as I still have aches and pains and fatique but not as bad as is was. Any thoughts on these results welcome! The T3 and T4 haven't gone up much was my thinking.
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Noona123
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Hi Sofie007, Not sure where my reply has gone!! Will try again! My antibodies went up from 534 on a Medichecks test to greater than 600 three weeks later with NHS test. NHS didn't retest these again.
Thanks Sofie, I believe cutting out gluten may help, which I've tried but think I'll have to do it thoroughly for it to be effective! Have just read slow dragon's post to me! Any additional tips would be gratefully received. I'm training to be a sound healer so might find something there - will let you know!
The NHS will not re-run antibody tests as once you have returned a positive level this simply confirms the condition you have. In your case you have autoimmune hypothyroidism caused by Hashimoto's, which you will always have, and once this is confirmed the antibody level is irrelevant. Some people try an anti-inflammatory diet to bring down their antibody levels, but unless you are actually reacting to the foods you eliminate from your diet, this will make little difference, and you risk cutting out vital food groups. Concentrate on optimising vitamin and mineral levels, which will help to make effective use of your levo. Vit.D will need to be supplemented with a maintenance dose once you have reached optimal level, which often takes some time. An increase in levo should hopefully optimise your thyroid levels.
Thanks Partner20. I am hoping for an increased dose and in the meantime will work on my vitamins and minerals, particularly iron which I now realise isn't that great.
I followed all the protocols, my test was at 8.50 am no breakfast, 24hr before last dose, no biotin etc. The Endo actually requested a test for Ferritin as I have been very low in the past. This came back as 49 . He also wanted me to have a 9am cortisol test after the appointment which came back as 281 which he said was "quite re-assuring". My B12 and folate are optimal and my D3 is a work in progress. Have been taking the equivalent of loading doses for about 6 weeks to get it up from 60 to 100!
A ferritin of 49 is not good enough. Should be above 75, closer to 90/100. Supplementing needed with iron.
Both your FT4 and FT3 are low so you really need an increase and no wonder you have symptoms. 50mcgs Levo is really just a starting dose, you need to stress the symptoms you have and not be fobbed off with other reasons for them.
I've been trying to increase my iron but it's a slow process. I'll aim for over 75 as you say. I've got a Medichecks test who 'owe' me a ferritin and folate test that I've got to use by Novemebr so will re-test then. I've actually been taking some liquid iron my mum was prescribed (but didnt get on with) but I stopped that and have pumpkins seeds and even started having lambs liver which for an ex-vegetarian is a bit scary!! I've actually been on 75mcg Levo last 6 weeks (50 for a fortnight beforehand ) so I was hoping for higher T4 and T4. But I'm beginning to understand that that Hashimotos takes a while to settle down.
Oh no, must be awful for an ex vegetarian, poor you. Chicken liver pate is recommended here as well if that appeals at all. Keep chipping away at it though and you will get there.
I have a GP appoint booked for 2 weeks time to discuss ongoing symptoms, but technically I'm still under the Endo so have also emailed him saying I still have symptoms. Vitamin levels okay, don't have problems with digestion and have also been eating 2-3 Brazil nuts which I read on here help the conversion of T4 to T4. I eat really well as we have an allotment so grow lots of veggies and I've mostly cut out gluten. Maybe I need to give the Levo a bit longer?
In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.
The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).
The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.
……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.
The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.
Thanks SlowDragon. I weigh about 70kg so 100 mcg would be good . I've learnt alot from these forums about optimising nutrients etc which I've been doing so the ft4 and FT3 results were a bit surprising. My 75 mcg comes in 2 lots: 50 is accord and 25 is Teva which I've read can upset people but I seem to be okay on it - I'm not lactose intolerant though. If I had 100 I could just have accord which would be better perhaps rather than mixing them.
You do need an increase. Your TSH has been lower than expected and even near zero in the past. Sometimes with autoimmune hypothyroidism there can be a period of high hormone levels which can suppress TSH. TSH can then remain low for a long time even though hormone levels are not high. So, they need to go by your symptoms and fT3, fT4 rather than TSH.
The Endo wrote to me and said if my levels came back 'normal' in 6 weeks he'll 'discharge me back to the care of the GP' - no option for talking further about results or symptoms. I havent got a direct email address for the Endo but have sent an email for his attention via a general dept email address. Might send it snail mail too. Are you able do you contact your Endo between appointments if needed?
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yes i am open to anything.
6 week test results
latest results . On T4/T3
Latest test results after Levo increase
tests show breathlessness due to being under medicated :)
