Anomalous results - please help!

[Italiangirl123]

Hi there,

My levo was increased to 100mcg on 1 June and tests done following the usual protocol as follows:

NHS on 31/7 at 8.30

Medichecks on 1/8 at 9.15

NHS results

TSH 0.06 (0.35 - 5)

FT4 17.5 (9 - 22) 65.38% through range

Medichecks results

TSH 0.06 (0.27 - 4.2)

FT4 24.4 (12 - 22) above range 124%

FT3 4.6 (3.1 - 6.8) 40.54% through range

D3 96.6 (50 - 250)

ferritin 233 (30 - 650)

folate 41.8. (8.83 - 60.8)

B12 104 (37.5 - 188)

Towards the end of June I started to feel improvements viz more energy, better sleep, brain fog better and excess weight reducing despite no change in diet which all seem to suggest that I'm on the right track. However whilst the TSH is consistent between the two tests there is a big difference in FT4.

My GP had been reluctant to increase dose to 100mcg and based on the TSH will certainly not entertain a further increase and given the NHS results doesn't seem appropriate. However I wonder if the Medichecks results suggest poor conversion. In these circumstances should I repeat the tests and/or do the gene test for DIO2?

Any advice gratefully received - thank you.

[Regenallotment]

hi there,

So one day apart you got wildly different FT4 results?

I’d go back to Medichecks and ask them to explain this.

My last Medichecks results were way over range despite a drop in dose…. I’m wondering if they have another error in their testing.

I’d stick with 100mcg another 6 weeks and test again maybe try Monitor My Health as it’s an NHS lab.

🌱

[Italiangirl123 in reply to Regenallotment]

Yes really strange. Will see what Medichecks have to say and in the meantime had already considered testing again with MMH. Hope I manage to get a repeat prescription without them noticing my TSH!

[arTistapple in reply to Regenallotment]

I recently asked Medichecks to comment on my non thyroid results as they had changed all the ranges. I was assured a doctor would look at them and get back to me. Very irksome that being scrupulous with my supplements, I now can’t tell if my levels have improved. I could probably sit down and work it out myself (I will) but it’s a very annoying part of the service when you make a complaint/observation and no-one has the courtesy to get back. I don’t think I will particularly trust them to the level I had again.

[SlowDragon Administrator]

I would either stay on current dose and retest in another 6 weeks

Or possibly reduce dose very slightly

You presumably have autoimmune thyroid disease….levels do change

Perhaps consider 100mcg 6 days and 75mcg one day a week

Which brand levothyroxine are you taking.

Do you always get same brand levothyroxine

[Italiangirl123 in reply to SlowDragon]

I don’t currently have any autoimmune disease. There is an assumption that I did have when I was diagnosed with TED in 2009. It was never followed up and it appears that my thyroid function was gradually declining.

I was given Teva on my first prescription and have kept to that with no apparent ill effects. My Endo predicted that I would end up on 100 mcg and that is just below what the body weight calculation suggests.

Will await with interest test results in six weeks!

[SlowDragon Administrator in reply to Italiangirl123]

If you did have autoimmune disease in past, even if BOTH TPO and TG antibodies are now negative…..you do still have autoimmune disease

NHS only tests TG antibodies if TPO antibodies are high. Significant minority of autoimmune thyroid disease patients only have high TG antibodies

If not had both tested you will need to test privately via Medichecks or Blue Horizon

If both antibodies are negative it’s worth getting an 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...

[Italiangirl123 in reply to SlowDragon]

Thanks. When my GP could no longer deny the numbers she said she would need to take advice from an Endo. I took matters into my own hands and saw one privately having already done the Medichecks test including both antibodies which were negative. He advised a scan which revealed suspicious nodules. These were biopsied and at follow up had become normal. His clinic report to my GP made interesting reading! I had never previously been tested for antibodies but the Endo's theory was that when I had TED in 2009 I probably had both which cancelled each other out and that my thyroid has been in slow decline since then...

[seveneleven]

You're really not converting well - you may need T3. Have you had cortisol tested? Low cortisol can be a big reason for not converting. Worth considering doing a 4-point saliva cortisol test (Regenerus is best), and if you're working with an NHS GP, the DIO2 test may be worthwhile, as you say, because it can give you the evidence you need to get T3 through an endo if warranted. Good luck!

[Italiangirl123 in reply to seveneleven]

Thanks for your response. I will re do the thyroid tests as already suggested with MMH as I suspect you may be right about conversion. Haven't considered cortisol so will explore that too. I certainly feel somewhat better since being on 100mcg levo but I've forgotten what it feels like to function normally!

[SlowDragon Administrator in reply to Italiangirl123]

wait until after retesting thyroid levels in another 6-8 weeks before considering cortisol and DHEA test

regeneruslabs.com/products/...

[19aglow49]

Hi Italiangirl123

I have hypothyroidism since 2002. I wasn’t happy with my symptoms/unstable levels so I requested a referred to an endocrinologist. Which was the best thing for me as the tests showed I had Hashimotos ( raised antibodies) and secondary hypoadrenalism.

I had a private test which showed I have DIO 2 Polymorphism which prevents the conversion of T4 to T3. I now take Liothyronine with Levothyroxine which has given me a new lease of life.

I now have eye brows which have been missing for years. This sounds trivial but it hits your self esteem. My energy has increased, the cholesterols at a healthy level and my weight decreased (also joined SlimmingWorld)

I hope this has helped. Best wishes with your health.

[Italiangirl123 in reply to 19aglow49]

Thank you so much for your response - very encouraging. I really don't know for how long I've been hypothyroid but it should certainly have been picked up in 2009 when I had TED. All my GP said at the time was that I couldn't be because TED is caused by a hyperactive thyroid. I now know better and am not of course surprised by her lack of knowledge about all things thyroid.

Like you my eyebrows went AWOL and its good to hear they will return so I can stop spending a fortune on regrowth serums!

I am already feeling better but may well have to explore conversion issues - will see what the next blood test results bring...