thyroid function test results antibodies not tested

[KDJ1]

Hi everyone, I could do with some advice. Prior to medication I had severe symptoms of hypothyroidism: fatigue, dry skin/skin problems, weight gain, low mood. Test last November  2022 came back with T4 13.2 TSH 7.87 Thyroid Peroxidase antibodies were at 240 Prescribed Levothyroxine 75mg started medication early January 2023 Since taking Levothyroxine I’m feeling a lot better most days. The most recent thyroid function test taken today 13 March 2023 showed Free T4 at 20.9 and TSH at 0.19. Antibodies were not tested Does anyone know what this change in Thyroid levels means and will I still be given the Levothyroxine? I don’t want to go back to feeling ill all the time. Also can you tell by the results if your thyroid problems are auto immune related (Hashimoto’s)

[Regenallotment Ambassador]

hi,

Great that your symptoms have improved 🤗

if it was me I’d test again in 8 weeks and see if your levels maintain. FT4 is close to top of range, TSH is fine for medicated.

Ideally you would test FT3 to understand how well you are converting the Levo T4 to the active hormone. But GPs never test this, you would need to do it privately, I use either monitor my health (an NHS lab that does private testing). Or Medichecks.

GP will be glad your symptoms have improved. Once antibodies confirm autoimmune you don’t really need to keep testing. You’ll read some sites and books that talk about bringing these down but I think that’s wishful thinking personally 😊

You should be able to continue on the current dose, FT4 is in range and TSH very close, if they suggest a reduction say please can I do 8 weeks more at this, no signs or symptoms of overmedication.

Let us know how you get on 🌱🦋🌱

[KDJ1 in reply to Regenallotment]

Thank you for the advice, this is all so new to me

[PurpleNails Administrator]

Welcome to forum 

Your diagnosis results - November  2022…. Do you have ranges?  Lab ranges vary so needed for each test.  

FT4 13.2 

TSH 7.87 

Thyroid Peroxidase antibodies 240 

By *most* ranges this shows low FT4, High TSH and high TPO antibodies.

High TPO confirms Hashimoto’s (autoimmune thyroiditis) drs just can it “under-active  thyroid or hypothyroid” 

drs don’t treat the autoimmune aspect, they treat the low thyroid levels.  It’s useful to test antibodies for diagnosis but it doesn’t correlate to condition & therefore not necessary to repeat regularly.  

Usually a standard starting dose it 50mcg and it’s important to retest 6-8 weeks after starting to see how levels have changed.  Not everyone copes with a higher dose, some tolerate it’s well, others don’t.

Depending what the range is the FT4 is now at top of range. Doctors often go by TSH the Thyroid stimulating hormone - which is a pituitary hormone signalling the thyroid.  When the TSH is low doctors assume FT4 is too high. ie it signalling thyroid to lower production of hormone.

When it’s low (if the TSH is a true reflection) you may be over replaced and doctors tend to use terminology such as you are “hyperthyroid & it’s very dangerous”

Do you currently feel well? If your FT4 is over range & you have symptoms - then the replace dose does need to be reduced.  This should be by 25mcg per day.  Retest in 6 weeks……BUT The TSH can be unreliable for many reasons.  So you need to look at the FT4.

Also the FT4 is not the only not thyroid hormone,  it has to be converted to FT3 the active and powerful hormone.   Many test privately to find out if FT3 are adequate.  Most feel well when this is in top half of range.

Also Important to test folate, ferritin, vitamin D and B12.  levo wont work well If not optimal. 

Thyroid test should be arranged early in morning, fast overnight (drink water) delay dose until after draw cease supplements containing biotin 3 days prior (biotin can in interfere with test) —— was your retest done like this?

Do you always have same Levo brand? 

[KDJ1 in reply to PurpleNails]

Hi thank for the advice, I do feel a lot better since taking the medication, I’m 62 and the starting dose was 75mg (I read it should be 50 to start) for the first few weeks of taking I felt so much better, I still do, although I have had a few not so good days in the last couple of weeks, in the main I feel better thank I have in years.

The test was done in the morning, I drank plenty of water and I did fast but I took the Levo 5 hours before.

[KDJ1 in reply to PurpleNails]

here are my lab results

My lab results

[PurpleNails Administrator in reply to KDJ1]

Recent Serum free T4 level 20.9 pmol/L [11.1 - 22.0]

Is NOT above range. If Doctor suggest lowering dose & you feel well. Point out FT4 is in range (& no FT3 to go on)

[KDJ1 in reply to PurpleNails]

Thanks so much and sorry for the slow replies, I’m not great on message boards , will find my way round eventually

[Charlie-Farley]

Hi KdJ1

Gosh you were out of whack at the start of this journey! Glad you are feeling better. Do you have the ranges for these results - the numbers in the brackets? Antibodies just have a greater than symbol next to the number.

One thing I can tell you though, Thyroid Peroxidase Antibodies at that level whatever the lab range confirm Hashimoto's - autoimmune hypothyroidism. Here's a link to useful summary of hypothyroidism off of the Thyroid UK website

thyroiduk.org/if-you-are-hy...

You should not be taken off your medication. I'm a Hashi too and if you want to read a case study click on my face and go to my bio. there is some useful information in it. Also read the NICE guidelines on dosing by weight with levothyroxine with this caveat - its a guide. Symptoms are the most important guide to getting well and doctors should be discouraged from 'treating the lab work' to the detriment of the patient - if they use TSH this can frequently happen.

TSH is unreliable and on 1st scientific principles should not be relied upon and is not even a thyroid hormone it is a pituitary hormone.

FT4 and FT3 are far better, but your doctor will not test for FT3. Even if they were to ask, the request is frequently refused by the labs.

Vitamin levels can be badly affected by being hypo. Look up   SlowDragon she provides oodles of info on blood tests vitamins pretty much everything. I worked my way through the info (and there's a lot) and I'm well now thanks to SlowDragon and the other forum members. My first few posts covering this period still sit in my profile. AS do the ones when I'm better!

Here is a link to another post with loads of links to information within

healthunlocked.com/thyroidu...

Most of us here use certified labs a list can be found on the Thyroid UK site (and often money off codes!).

[KDJ1 in reply to Charlie-Farley]

Oh thank you so much for the lovely reply, such a relief to find this site, I’m so grateful for the advice, I’ve had problems for years but only just had it all confirmed as thyroid related. Here’s my most recent test results.

My test results

[SlowDragon Administrator]

At next test get vitamin D, folate, ferritin and B12 tested if not been tested yet

Also coeliac blood test too (as per NICE guidelines) ….on diagnosis of autoimmune thyroid disease we should always be tested for coeliac ………unless you are already on gluten free diet

[KDJ1 in reply to SlowDragon]

Hi thank you, I will most definitely look into getting the tests. Actually I have just switched to gluten free.