Not sure what to do Hypothyroidism

[esssssssssss]

Hello,

I'm a 24y male and right now I'm on levothyroxine (Euthyrox) 88mcg daily. These are my current lab tests

TSH - 2.82 (Range - 0.27-4.20)

FT4 - 1.86 (Range - 0.93-1.70) High

FT3 - 3.07 (Range - 2.02-4.43)

4 months ago my results were while on 100mcg levothyroxine

TSH - 0.40

FT4 - 1.88

FT3 - 3.67

I have no idea what to do now as my doctor is very likely to reduce my dose even more. Right now while on 88mcg I feel constipated, frequent diarrhea and pretty much tired all the time. I recent had a cold, not sure whether that changes anything with my results. Within the 4 months period I lost about 2kg. Would appreciate any suggestions.

[RedApple Administrator]

Welcome to the forum esssssssssss.

What makes you think your doctor will reduce your dose further? TSH and other numbers are well within range, which is all most doctors care about, so no reason at all to reduce your dose.

How did you feel on the 100mcg dose? Assuming the ranges were the same for your previous test 4 months ago, there was no reason to reduce your dose then either. Unless you had symptoms of over-medication?

[esssssssssss in reply to RedApple]

Hello,

Doctor felt that FT4 was too high and I had similar issues with constipation and diarrhea back then, since I have FT4 at a similar level which is higher than the range he is likely to lower my dose again. Do you reckon I should get back to 100mcg?

[RedApple Administrator in reply to esssssssssss]

When did you take your last dose of levo prior to these blood tests? And what time of day were the tests done?

The high FT4 is inconsistent with the TSH and FT3 numbers, so it looks as if you may have taken your levo too close to the blood draw.

[esssssssssss in reply to RedApple]

My blood tests are always at 8:30am, I take levo in the mornings and always after the blood test not before.

[RedApple Administrator in reply to esssssssssss]

TSH of 2.82 is too high and FT3 of 3.07 is too low for someone on replacement thyroid hormone. I'd consider having a discussion with the doctor about maybe lowering the levo a little (say down to 75mcg) and adding in a low dose of T3 to see how that helps your symptoms and balance your free levels.

[esssssssssss in reply to RedApple]

Will ask my endo thanks for the help

[SlowDragon Administrator]

When were vitamin D, folate, ferritin and B12 levels tested

What vitamin supplements do you take

What’s the cause of your hypothyroidism

Have you got high thyroid antibodies

[esssssssssss in reply to SlowDragon]

All my vitamins are in check.

I take a multivitamin, iron, omega3 and vit d on the side. I have high b12 currently but that's mostly as I have been drinking less water. I take the same vitamins for over 2 years now and my b12 levels were always in the normal range. I don't have high thyroid antibodies, it's very low. The cause of my hypothyroidism is most likely because the first doctor that I went to misdiagnosed me. Which was about 8 years ago. I was still very young so I didn't think much of it, doctor put on 25mcg levothyroxine and called it a day. Since then I have been increasing my dose which stabilised around 75-100mcg depends on the weight. We tried lowering the dose even more but that didn't work out for me.

[SlowDragon Administrator in reply to esssssssssss]

Multivitamins never recommended on here

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Suggest you stop multivitamins. Retest vitamin D, folate, ferritin and B12 6-8 weeks later

Continue current dose vitamin D

Never supplement iron without doing regular full iron panel test 3-4 times a year. It’s possible to have low ferritin and high iron or vice versa

You need BOTH TPO and TG thyroid antibodies tested for autoimmune thyroid disease

Link about thyroid blood tests

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

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

If both antibodies negative get ultrasound scan of thyroid

20% of Hashimoto's patients never have raised antibodies 

healthunlocked.com/thyroidu...

 

Paul Robson on atrophied thyroid - especially if no TPO antibodies 

 paulrobinsonthyroid.com/cou...

Gluten intolerance is often a hidden issue too.

Request coeliac blood test BEFORE considering trial on strictly gluten free diet

Medichecks Thyroid plus both antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes both antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins then cheapest option for just TSH, FT4 and FT3 and includes BOTH TPO and TG antibodies -£29 

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