confusing results - any advice (other than I should be better with my supplements)

[MrsQ20]

I would really appreciate some thoughts on my latest results from Medichecks.

I am on 125mcg levo (was upped from 100 in November).

My TSH is 2.8 (range 0.270-4.2) - the highest it has been since 2.93 in Novembe 2020. My last reading in December was 0.36 the lowest I have recorded since I started testing in March 2019.

My TPO antibodies are 119 (range 0-34) the lowest they have been since a six month spell August 21- Feb 22 when they were 77 and 106. My Tg antibodies are 227 the lowest they have ever been.

My free T4 is 14.7 (range 12-22) the lowest it has ever been, down from 21 in December.

My free T3 is also at its lowest at 3.47 (range 3.1-6.8) down from 4.34 in December.

My B12 is also at its lowest at 69.4 (range 37.5-188). It was 92.1 in December but on a different range (37.5-150).

My vit D has gone from 66 (range 50-200) in December to 87.1 now (50-250 range - not the range change).

Unfortunately my folate could not be read.

I don't know what to make of these results. I took them in the usual way - early morning on empty stomach and before levo.

My dog died in March; I had a period of being really sad, have also been busy and have got really out of the habit of taking my supplements (I know it is stupid) but I regularly spray 4 sprays of vit D every day (betteryou red spray).

I am also on HRT (since last May). I am generally feeling well but definitely run out of energy easily. I have limited flair ups but get bad headaches when tired. My exercise is not as good as it used to be through busy lifestyle and it making me fatigued when I do it. I am 80% gluten free and am pescatarian. My stomach is generally good.

If anyone is able to comment I would really appreciate it as always.

Many thanks.

[Jaydee1507 Administrator]

HRT can increase the need for thyroid hormone. To feel well people need their TSH to be at or just under 1 so yours has a way to go.

Your FT4 is only 27% of its range so far too low and a dose increase would help raise this. You may need to insist on this with your GP. Raising your Levo dose would also help your FT3 which is far too low currently.

As a pescetarian its really doubly important to be diligent with supplementing so you know what you need to do there.

There is little point in being 80% gluten free, it just doesn't work like that. If you wish to try a gluten free diet it needs to be 100%.

Was there a result for ferritin?

[MrsQ20 in reply to Jaydee1507]

Thank you for replying.

My ferritin was 83.4 (range 13-150).

I am really confused as to why my TSH has jumped up at this point- especially when it was low in December - although that was only a month after increasing. Isn't 150mcg levo getting to the higher range of dose? My FT3 has always been in the low range (this is the lowest it has been) but usually my FT4 is higher (this is the lowest reading I have had) - it was 21 in December. These results just feel like a strange odd set and I really don't know how to respond to them.

My gut is the best it has been for years in terms of how it feels and functions.

[Jaydee1507 Administrator in reply to MrsQ20]

Your FT3 was only 33% of its range and now down to 10%. Certainly my numbers jumped about a bit with a low FT3.

Can I ask how much you weigh in kilos? Theres a very rough guide as to how much a person needs by weight. 1.6 x weight in kilos.

Also you are on HRT and some people require more thyroid hormone due to HRT.

Your ferritin isnt too bad at all. Around 100 is the best number. Keep eating chicken liver, pate etc

[Marymary7]

I wonder if you would absorb or utilise your diet/ supplements better if you improved your gut. Maybe investigate that?

[MrsQ20 in reply to Marymary7]

Thank you for taking time to reply. My gut feels like it is in the best place it has been for years in terms of feel and function but maybe not? I haven't taken gut supplementation for some time because of this - using a healthy diet as the main way to help it function. Very limited gluten, limited sugar, no caffeine, no alcohol, no meat other than fish, lots of grains, eggs and varied fruit and veg.

[Marymary7 in reply to MrsQ20]

Well its just an idea. We don’t always know if we have a healthy gut balance of microbes. Wouldn’t hurt to investigate that.

[tattybogle]

So for some reason the fT4 is now much lower ( hence the much higher TSH ).

The question is ~ why is the fT4 so much lower despite you still taking the same dose as Dec .

eg~ something stopping you absorbing the full dose (food / coffee / other drug / iron , calcium etc) .

~ something wrong with the tablets . eg bad batch , subpotent / significantly out of date .

~ accidentally been taking wrong dose/ forgetting to take on some days during the last 6 weeks .

~ a different brand of levo that for some reason you don't absorb so well

The Dec test was perhaps a bit too soon to be totally reliable for TSH , but that TSH result did logically fit in with your previous tests and a dose increase

Aug 22 TSH 1.23 (what was fT4 ? .... was dose 100mcg ?)

Oct 2022 TSH 0.81 (what was fT4 ? ....100mcg ? )

Dose then increased to 125mcg

Dec TSH 0.36

fT4 21.1 [12-22]

[MrsQ20 in reply to tattybogle]

Thank you for your time in replying. I had three days the week before where I took 75mcg instead of 125 because i had mistakenly taken a 50mcg tablet instead of a 100 but once realised I changed it straight away so that is the only thing I can think. I never forget a dose. I have attached last few sets of results.

blood results over time

[tattybogle in reply to MrsQ20]

ok so that will have made a difference (higher TSH / lower T4) .. whether the half dose for 3 days is enough to explain all the difference is very hard to say .. but it means you can't rely on the TSH / fT4 / fT3 results to be accurate this time . so don't make any dose decisions based on this test.

Get retested when you know you've definitely taken 125mcg/ day for at least a month preferably 6 weeks .. if TSH is still relatively high / T4 relatively low then you would consider a dose increase. but don't increase based on these potentially dodgy test results.