Need repeat bloods, high antibodies but GP doesn't have results.

[Littleschnauzer]

I hoped you lovely people could help advise? Sorry in advance for the waffle...GP called to discuss recent blood results said my antibodies were high and didn't want to be overtreating but then couldn't find my results on the system so having to repeat bloods next Thursday.

My last sample I stopped taking 25mg levothyroxine 24hrs before and appt was before 9:30am.

Background:

25mg levothyroxine for few years after reading on this forum will help with ovulation. Always been subclinical, symptomatic with TSH at around 4.5. Also mother has hypothyroidism.

Eventually GP prescribed and bingo started ovulating.

Levothyroxine upped to 50mg during pregnancy and then pharmacy stopped medication altogether shortly after birth, bloods showed TSH dropped below 1. Not sure of results but I wasn't happy they just decided without asking how I was.

Begged GP to keep me on 25mg, I am symptomatic given 3 months supply. Ran out January. I didn't realise as I had some left over from pregnancy. So called GP for repeat prescription and blood test.

As the GP said my antibodies are high do I come off my 25mg levothyroxine now for my blood test on Thursday or keep taking up until 24hrs before? ??

Sorry I don't know what is best. I've read so much info on this forum my mind is a bit boggled. I take meds at night.

GP knows I'd been taking what levothyroxine i have left over. I've also asked for vitamin D and iron panel.

During pregnancy I had iron infusions and prior to that I've always been anaemic. Never able to give blood and feel exhausted, never rested.

I know 25mg is low dose, I'm very slight 53kg aged 40.

Other than hypothyroid symptoms i try and keep fit and eat well.

Any advice at all will be really helpful. Thankyou. Im just worried they'll stop my lose dose, ill feel lousy and i won't ovulate again xx

[SlowDragon Administrator]

Low vitamin levels, especially low iron/ferritin, will lower TSH

Levothyroxine doesn’t top up failing thyroid, it replaces it. Important to be on high enough dose

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

 

For full Thyroid evaluation you need TSH, FT4 and FT3 tested 

Also both TPO and TG thyroid antibodies tested at least once 

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies 

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis. 

Both are autoimmune and generally called Hashimoto’s.

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

Or when under medicated on inadequate dose levothyroxine

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis 

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended on here that all thyroid blood tests early morning, ideally just before 9am and last dose levothyroxine 24 hours before test 

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Just Thyroid includes BOTH TPO and TG antibodies -£49

randoxhealth.com/at-home/Th...

If you can get GP to test thyroid antibodies and vitamins then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

Only do private test early Monday or Tuesday morning

[SlowDragon Administrator]

Sorry ….missed this

GP called to discuss recent blood results said my antibodies were high 

So you know then that you have autoimmune thyroid disease…..also called Hashimoto’s

Even more reason to be on high enough dose

[Littleschnauzer in reply to SlowDragon]

Thank you so much for your response that's really helpful. Could I just ask one more question? Would it be wise to start taking iron tablets now before my blood test on Thursday, if this would raise my TSH in order to get my levothyroxine prescribed. (Again I have some left over from pregnancy but stopped them after birth)

[greygoose]

GP called to discuss recent blood results said my antibodies were high and didn't want to be overtreating

Trying to make sense of this... Does your doctor really think that high antibodies are an indication of over-medication? Antibodie levels have nothing to do with your dose. They are an indication that you have autoimmune thyroiditis, and are usually at their highest after and immune system attack on the thyroid, when they come along to clear up the mess it leaves in the blood.

Always been subclinical, symptomatic with TSH at around 4.5.

Technically, subclinical means that there aren't any symptoms, just highish levels of TSH. But, is your TSH still around 4.5, even on levo? If so, you are most definitely under-treated. Someone with no thyroid problems has a TSH of around 1 - never over 2. And hypos often need it a lot lower than that. Do you ever get your thyroid hormone levels checked - TSH is a pituitary hormone - FT4 and FT3? TSH is not a very good indicator of thyroid status. Especially not with autoimmune thyroiditis, because levels can jump around.

I know 25mg is low dose, I'm very slight 53kg aged 40.

Dosing by weight is a bit of a nonsense, really. It's only a very rough guide. There are far more important guides to dosing, such as your FT4/3 levels, and the way you feel. And you say you feel lousy, so you're obviously under-medicated. I think what you really need is a new doctor, one that has half a clue about the way the thyroid works - or doesn't work, as the case may be.

[Littleschnauzer]

My TSH had always measured around 4.5. They wouldn't treat through nice guidelines. And yes my weight being slight was also mentioned as a reason.I changed to a female GP to ask about ovulation etc and I was started on 25mg which got my TSH to 2 to 2.5. Honestly I was just so grateful that I was offered some levothyroxine.

I have always felt tired, suffered from mouth ulcers, sore throats, coldsores.

So I can only assume my GP does think the high antibodies are because I've been on 25mg daily. I will ask for my FT3/FT4 to be taken although I know when I asked for iron, vitamin d to be taken they didn't see the relevance.