This blood test was done privately. I am feeling dreadful. I am depressed, have put on weight and am exhausted. My life is very stressful at the moment so the symptoms may be due to this.
I have asked my GP for another blood test to see if I need to increase my thyroxine but they have refused because the last blood test they did was “fine” and I can only have one a year. I am on levothyroxine 50/25 on alternate days.
One thing that does puzzle me is that my T3 higher in the range than my T4. As you need the T4 to convert it to T3 how is this happening?
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Mouse
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Mouse the body adapts to survive. The cells need t3. The thyroid produces a little T3 as well as T4 - it doesn't all come from conversion. Also TSH stimulates conversion. So your body is doing its utmost at the moment to give you enough T3 to function.
You are not fine. TSH is high, ft4 is near the bottom of range and you are having symptoms.
Someone hopefully will come along with the NICE guidelines (or do a search for them) which says to GPs that on levo TSH is best kept 2 or under. We on here know it should really be around 1.
Armed with that I would insist on an appointment. It is only through being pushy, proactive, coming from a position of knowledge backed by fact that we thyroids seem to get the treatment we need.
One thing that does puzzle me is that my T3 higher in the range than my T4. As you need the T4 to convert it to T3 how is this happening?
You are obviously very undermedicated to have such a high TSH and low FT4 whilst on Levo. Despite there being inadequate amount of thyroid hormone replacement your body is doing it's very best to ensure that you get enough life giving hormone (T3), this is why your FT3 is showing higher in range than FT4. Eventually this may start to fall too.
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.
Blood tests should be every 2-3 months UNTIL all symptoms resolved
I am 62 and have been on Levothyroxine since 2003. I am very sensitive to any increases. A previous GP tried to get me up to 75 a day but I couldn’t cope on it. I couldn’t sleep and felt anxious all the time. I probably need to increase more slowly. My initial dose was 25 on alternate days.
My vitamin levels were checked in September and are ok. I take vit D, Iron and B12. Folate is always high, probably because I am vegetarian
Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule)
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IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate methyl folate supplement and continue separate B12
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months.
once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to stop the B12 and just carry on with the B Complex.
But as vegetarian likely to need separate B12 3-4 days week ongoing
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron
yes, I have Hashimotos. Thyroid Peroxidase Antibodies we’re 217 (<34) in September. They are fairly stable. Have them checked by Medichecks every couple of years
Are you on strictly gluten free diet or dairy free diet
Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances.
Most common by far is gluten.
Dairy is second most common.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's test positive for coeliac, but a further 80% find strictly gluten free diet helps or is essential due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first
Assuming test is negative you can immediately go on strictly gluten free diet
(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)
Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
I have been gluten free for 5 or 6 years now and I am very strict about it. I am almost dairy free, just have a small amount of hard cheese occasionally
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T4 to T3 conversion troubles 
SWITCHING FROM T3 TO T4/T3
test results - on T3 and T4
Rundown of TSH, T3, T4
Change of T4/T3 dosage?
