Help please

[dylandolly]

Hi everyone, looking for a bit help please from my routine blood test results.my TSH 12.8h....(0.23-5.6 mu/L .last one was in 2020 was..0.33

Free T4....8L..(9-28 pmol/L) LAST ONE WAS 14.

Also cholesterol has shot up to 11.0h and also said my liver reading was a bit on the high side too.so I have been struggling to lose any weight what so ever so went on a Keto diet about 2 months ago and have lost about 8lb.so I'm just wondering if the Keto diet has made everything go haywire or was my Thyroid already playing up before that's I have been saying for a whileI dont think I'm medicated enough.Also feel the symptoms of my Hoffmans is back as I can feel my muscles getting stiff and sore.My GP has written to a cardiologist because of my high cholesterol, but I remember just after I was diagnosed Hoffmans/Hypothyroid my cholesterol was up to 13.Thanks in advance if anyone might have any advice and sorry for the long winded post😃

[SlowDragon Administrator]

How much levothyroxine are you currently taking

Dose needs immediately increasing by 25mcg and bloods retested in 6-8 weeks

Keto diet can significantly reduce conversion rate of Ft4 (levothyroxine) to Ft3 (active hormone)

High cholesterol levels are directly linked to high TSH and being hypothyroid

nhs.uk/conditions/statins/c...

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

[Astridnova in reply to SlowDragon]

Gee, SlowDragon, that's very interesting what you say about Keto diet reducing conversion rate of T4 to T3. Can you give us your references please?

[SlowDragon Administrator in reply to Astridnova]

ncbi.nlm.nih.gov/pmc/articl...

This study has shown that despite the two diets (KD and HCLF) being isocaloric, and despite no difference in physical activity, a greater reduction in body mass occurred on the KD in healthy weight participants, despite no change in RMR. The change in concentration in thyroid hormones (particularly, active T3) suggests that nutritional ketosis may induce metabolic changes that warrant further investigation.

virtahealth.com/blog/does-y...

even when energy is not restricted, a ketogenic diet is associated with sharply reduced blood levels of active thyroid hormone. In this case, even when energy is plentiful and body weight stable, either the low intake of carbs or the presence of ketones reduces circulating concentrations of active thyroid hormone.

deliciouslyorganic.net/step...

Make sure you are eating enough carbohydrates. While a low-carb diet is all the rage right now, going too low carb can inhibit the conversion of T4 to T3 in the liver. A minimum of 100g of carbohydrates a day from foods such as properly prepared legumes, lentils, potatoes and other starchy vegetables is a good place to start

[Astridnova in reply to SlowDragon]

Thanks very much.

[SlowDragon Administrator]

meanwhile get Vitamin D, folate, B12 and ferritin levels tested via GP

What vitamin supplements are you currently taking

TSH should be under 2 as an absolute maximum when on levothyroxine 

gponline.com/endocrinology-...

NHS England Liothyronine guidelines July 2019

 

sps.nhs.uk/wp-content/uploa...

Page 9 

Test for Deficiency of any of the following: Vitamin B12, Folate,  Vitamin D, Iron

See page 13 

1. Where symptoms of hypothyroidism persist despite optimal dosage with levothyroxine. (TSH 0.4-1.5mU/L)

Graph showing median TSH in healthy population is 1-1.5

web.archive.org/web/2004060...

Comprehensive list of references for needing LOW TSH on levothyroxine 

healthunlocked.com/thyroidu....

[dylandolly in reply to SlowDragon]

Hi SlowDragon thanks so much for the reply.My GP upped my Levo by 25mcg the day I went to see her, so I am now on 150mcg,I went to see Dr Toft years ago and he had me on 175mcg but was reduced some time later as my GP thought my TSH was to low.I currently take vit D3 and vit B12, zinc and Magnesium

[SlowDragon Administrator in reply to dylandolly]

GP should not meddle with dose that Thyroid specialist has specified

Never agree to dose reduction based just on low TSH

Most important results are ALWAYS Ft3 followed by Ft4

Insist GP test vitamin levels now

B12, folate, vitamin D and ferritin

[eeng in reply to SlowDragon]

... I think you mean Ft3 followed by Ft4

[SlowDragon Administrator in reply to eeng]

yes…well spotted

Now corrected

[dylandolly in reply to SlowDragon]

I knew what you meant 😀