Thyroid labs after 6 Weeks on 75mcg, would appreciate any advice 🙂

[FranklinSaint]

So I’ve been struggling with various symptoms such as ice cold hands and feet, major brain fog, joint and muscle aches, food sensitivities and low basal temperature.. these seems to point to a thyroid issue for many years now and decided to try medication to see if I get any relief.

Here are my findings on having taken 75mcg of T4 only for approx 6 weeks: my constantly cold hands and feet have completely disappeared, also I feel that my basal temperature has improved significantly… I finally feel like I’m “running” warm instead of cold all the time if that makes sense but I worry that I am trending towards hyper territory since sometimes I feel a little to warm, maybe it is a normal reaction to summer weather?

I also have a small reduction in joint and muscle aches but it is still bothersome and my brain fog is a little better so I managed to quit caffeine but that’s about it.

i have attached my labs underneath, these show my levels prior to starting and what they are now🙂

06/07/2023 - unmedicated

TSH 3.5 Range ( 0.4 - 4.0 )

Free T4: 14 Range ( 10 - 22 )

Free T3: 4.5 Range ( 3.3 - 6.0 )

TPO Anti <28 Range ( 0-59 x 10E3 IU/L )

22/08/2023 - 6 weeks on 75mcg Levothyroxine only

TSH 1.7 Range (0.40 - 4.0)

Free T4: 14 Range ( 10 - 22 )

Free T3: 4.6 Range ( 3.3 - 6.0 )

TPO Anti <28 Range ( 0-59 x 10E3 IU/L )

Many thanks for reading this and also any advice is greatly welcomed 😊

[GlowCoach Administrator]

Just checking how you took this test. What time of day was it and when was your last Levo before the test?

Your FT4 & FT3 have barely changed at all although your TSH has reduced a little. Theres plenty of room for an increase.

When hypo we get low stomach acid which means we cannot absorb vitamins well from our food, regardless of a great diet. For thyroid hormone to work well we need OPTIMAL levels of vitamins. Have you recently or could you ask your GP to test levels of ferritin, folate, B12 & D3? Private tests are available, see link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/help-and-supp...

There is also a new company offering walk in & mail order blood tests in London, Kent, Sussex & Surrey areas. Check to see if there is a blood test company near you. onedaytests.com/products/ul...

Only do private tests on a Monday or Tuesday to avoid postal delays.

Do you know if you had positive thyroid antibodies? Many with autoimmune thyroid disease aka Hashimoto's benefit from a gluten free diet. A smaller percentage of those also need to remove dairy from their diet to feel well. These are intolerances and will not show up on any blood test.

Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw, last T3 dose 8-12 hours before blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process)? Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo/T3 just prior to blood draw can show a falsly elevated result and your GP/Endo might change your dose incorrectly as a result.

[FranklinSaint in reply to GlowCoach]

Hi Jaydee, thanks for the reply!

Both these tests were at 8am and the last Levo dose was taken 24 hours before test as per advice from here🙂

My vitamins were fine other than low d, I have been taking 8000-10000 IU of D3 every day with vit k since those results and I am due for a follow up blood test privately soon..

I’ve also been gluten free for 4 weeks now and limit nightshades (tomatoes and potatoes) as these make my joint and muscle pains way worse and seem to give me a systemic inflammatory response.. I have not tried cutting out dairy as it is a big source of protein for me ( yogurt, kefir, cheeses etc..)

I have attached the antibodies results I got from the test and from my understanding they don’t show me being positive? No?

I have debated on increasing my dosage but I only have 150mcg and 25mcg tablets of Levi of which I am taking 75mcg ( a halve of the 150).

My only options is to take 100mcg for 4 days and 75mcg for 3 which equates to about 89mcg per day or increase by 25 to 100mcg a day and do that instead.. what do you think?

[GlowCoach Administrator in reply to FranklinSaint]

So what were the other vitamin levels? Remember that we need OPTIMAL levels and not just in range for our thyroid hormone to work well.

Keep going with the dietary changes. They are well worth while.

Your ntibody result only shows TPO which was negative. Privately you can get Tg antibodies tested which would be worthwhile.

100mcgs a day sounds about right as your FT4 was very low in range.

[FranklinSaint in reply to GlowCoach]

Hi again

So the last time I tested my vitamins was on the 11/04/2023 and these were the results

Iron: 14. Range (9-34)

Ferritin: 117. Range (22-375)

Vit D: 56 range (50-178)

I believe b12 was not tested.. i am planning on getting the sports pack blood test from medichecka once I get back to the UK so I can check these vitamins again aswell as my cortisol etc

Great! My plan is to try 100mcg and retest in 6 weeks, just currently worried about going hyper if I increase to fast..

[GlowCoach Administrator in reply to FranklinSaint]

Its highly unlikely that you will go hyper whith your FT4 so low in range at the moment.

Folate also needs testing and most peopleneed to be supplementing both B12 & folate.

[FranklinSaint in reply to GlowCoach]

Phew, that’s good to hear!

I will make sure to get my folate and other vitamins tested alongside my thyroid in 6 weeks time and hopefully we will see some improvements, fingers crossed!

Once again many thanks😊

[SlowDragon Administrator in reply to FranklinSaint]

My plan is to try 100mcg and retest in 6 weeks,

Good plan

At next test include both thyroid antibodies and vitamins

thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

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

List of private testing options and money off codes

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

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...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

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

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/wp-content/up...

Tips on how to do DIY finger prick test

healthunlocked.com/thyroidu...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

20% of Hashimoto's patients never have raised antibodies

If both antibodies negative an ultrasound scan of thyroid may give diagnosis

healthunlocked.com/thyroidu...

Paul Robson on atrophied thyroid - especially if no TPO antibodies

paulrobinsonthyroid.com/cou...

In an earlier post you said you were starting on a daily vitamin B complex. Are you taking this still

[FranklinSaint in reply to SlowDragon]

Hi SlowDragon🙂 no I am not currently taking a b complex as the one I got previously made me feel ill, I think this is due to being really overdosed! Any recommendations on good brands?

I forgot to add I had a ultrasound of my thyroid a few months back and the doc that did it said he couldn’t see any signs of damage on my thyroid and that it looked “healthy”. I believe my issue is of hypothalamic origin or something else entirely… I plan to go to a private endo sometime in the next few months once my funds allow me to do so as I am tired of not feeling my best.

[SlowDragon Administrator in reply to FranklinSaint]

So include vitamin testing with next Medichecks

See where B12 and folate levels are

If Active B12 under 70 add a separate B12

Eg Nature Provides B12 drops

If folate is low…initially try just a plain folate supplement eg Jarrow methyl folate 400mcg

[DippyDame]

After diagnosis you appear to have been immediately prescribed 75mcg levo

Yet, your thyroid hormone levels have stayed almost identical to before hormone replacement

But TSH ( pituitary hormone) has responded to the increase and reduced as would be expected.

YourVit D is far too low and vit B12 currently unknown

VitD, vit B12, folate and feritin must be optimal to support thyroid function

So long as FT3 -the active thyroid hormone - is in range you are unlikely to be overmedicated. Your FT3 labs are well below top of range.

If you are HYPOthyroid it is technically almost impossible that you will become HYPERthyroid.....you may become overmedicated if overdosed but the two are not the same.

HYPERthyroid is when the thyroid gland produces too much hormone.

Are you taking any other medication that may be preventing absorption of levo e.g. iron or calcium supplements, proton pump inhibitors, antacids

or soya, excess coffee, dairy foods

Do you take your levo regularly as prescribed?

Do you take levo at least an hour away from foods and drinks?

I'd suggest you increase to 100mcg levo ( you have plenty room to increase)wait at least 6 weeks on that steady dose then test again to include ...

TSH, FT4, FT3, vit D, vit B12, folate, ferritin and antibodies TPO and Tg

SlowDragon has already advised on testing

At the same time work to optimise essential nutrients

Post new labs and we can then better see what is happening

Good luck

[FranklinSaint in reply to DippyDame]

Hi DippyDame

No i am not currently taking any other medication other than the now increased Levo dosage to 100mcg… i have been having some wierd symptoms such as joint and muscle aches/pains since increasing the dosage aswell as periods of coldness in my hands and feet that I can feel creeping up again which I find strange since I am taking more hormones than previously, no?

Regarding diet, I don’t eat gluten, coffee, soy products and nightshades currently due to inflammatory response but do consume dairy inform of cheese and yogurt/kefir almost daily.. been thinking about cutting it out but it’s hard since it’s a big source of protein for me and I am trying to currently gain weight for sports.

The levo is taken whenever I get up at night to go to the toilet which is 3am or 4am then I usually fast with water until lunch time at work which is around 12am and I have been diligently taken the medication everyday.

[DippyDame in reply to FranklinSaint]

In just over 6 weeks your dose has reached 100mcg levo which is a fairly rapid increase.....your system is very likely taking time to adjust to this

However....your fasting protocol may play a part in your consistently low thyroid hormone levels

Long periods of fasting can lead to low blood sugar levels and cause your adrenal glands to release cortisol.

If you struggle with adrenal issues, like elevated cortisol levels, intermittent fasting may worsen cortisol balance and subsequently hinder your thyroid function.

How long before your mid day meal do you usually eat? Your evening meal? Time?

It may be wise to also have your adrenal function / cortisol levels tested

Your new labs will hopefully help point the way forward.

[FranklinSaint in reply to DippyDame]

So i usually eat my first meal at around 12 then second when i get home from work so around 4pm then i snack between second and third meal which is my last at around 9-10pm.. hope that makes sense 🙂

Do you think that the regular fasting is causing some kind of a thyroid issue or excabirating it somehow??

I actually had my morning blood cortisol tested before going on levothyroxine and it was at 825 with the range being between 240 and 730.

[DippyDame in reply to FranklinSaint]

Yes....understood!

And yes it is possible that intermittent fasting is affecting your thyroid levels. From what you say there is roughly a 14/15 hr fast, during that time, and depending what you have eaten, your blood sugar may have dropped causing cortisol to rise.

Raised cortisol can affect thyroid function and your test showed a raised result.

I'm not medically qualified but as I suggested above it looks as if you need to address both your eating pattern and it's possible effects on your adrenal, and consequently your thyroid function.

Good luck.