Blood test result - Hashimotos

[Saralouise67]

Hi all, I have recently had a scan of my thyroid and it’s confirmed my diagnosis of Hashimotos. When I spoke to my doctor about this I explained I was struggling massively with my weight, coldness and tiredness. Because of this he requested a blood test which all seems ok apart from my Thyroid peroxidase antibody which appears very high, see above. I was wondering if this is what could be causing my continuing symptoms. I am currently on 75mg of levo thyroxine. Thank you 🙏

[HealthStarDust]

75mcg is quite a low dose for many. I am sure the admins will be along in a moment to guide you through it.

[Jaydee1507 Administrator]

You had an axcellent reply about antibodies in this post: healthunlocked.com/thyroidu...

Antibodies don't cause symptoms. Its the lack of sufficient thyroid hormone that will be causing you symptoms, also quite possibly low vitamain levels.

Do you have a copy of your latest blood results that you can share with us? You are legally entitled to a printed copy of your results, ask at GP reception. In England you can get the NHS app and ask for permission to see your blood results on that by asking at GP’s reception.

Have you tried a strictly gluten free diet that many with hashimoto's find helps symptoms?

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/testing/priva...

There is also a new company offering walk in (includes free blood draw) & 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.

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 falsely elevated result and your GP/Endo might change your dose incorrectly as a result.

[Saralouise67 in reply to Jaydee1507]

Hi . I have added the other results below/above I think. I haven’t tried a gluten free diet but I will look in to that as anything that will help is worth a go. Thank you ☺️

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[Jaydee1507 Administrator in reply to Saralouise67]

Well theres your problem.

Your FT4 is only 53% though range. It should be in the upper quarter.

TSH is over 2 and many need it under 1 to feel well.

So currently you are under medicated and need to insist on an immediate dose increase. If doctor is reluctant then ask for it as a trial which is sometimes more successful.

If one doctor says no then try a different one. Do not give up trying!

What supplements are you taking and what are your latest results for ferritin, folate, B12 & D3?

[Saralouise67 in reply to Jaydee1507]

Thank you, it’s so nice to know I’m not losing the plot. I will try to get to speak to the doctor over the next few days. I am currently taking no supplements but am going to ask the doctor for some more blood tests to see where my levels are and I will definitely look into starting to take some.

[Jaydee1507 Administrator in reply to Saralouise67]

Post your vitamin blood results in a new post and members will comment.

Good luck.

[SlowDragon Administrator]

ALWAYS book early morning test, ideally before 9am, only drink water between waking and test and last dose Levothyroxine 24 hours before test

Which brand Levothyroxine are you currently taking

Insist politely that GP include test for Ft4 and FT3

Plus vitamin D, folate, ferritin and B12

What vitamin supplements are you taking

As you have Hashimoto’s are you on strictly gluten free diet

If not get GP to do coeliac blood test first - as per NICE guidelines

Approximately how much do you weigh in kilo

Guidelines on eventual dose is around 1.6mcg Levo per kilo per day

Unless extremely petite you are highly likely in need of next increase in Levothyroxine to 100mcg daily

[Saralouise67 in reply to SlowDragon]

Hi, I followed those guidelines before my blood test and my last dose was at least 24 hours before. My 25mg tablets are MercuryPharma and my 50mg are Accord and I have had these brands for a while now. I don’t take any supplements but maybe that’s something I should look into. I weigh about 108 kilos so using that I am under medicated. I will speak to the GP about further blood tests but they seem so reluctant to do anything. I will definitely investigate a gluten free diet.

Thanks for all the advice.

[SlowDragon Administrator in reply to Saralouise67]

You will find many GP’s are completely clueless on how to treat hypothyroid patients

You will most likely need to push hard for each dose increase

This is not a rare disease (approximately 2 million people in U.K. on levothyroxine…..90% are female) ……but it’s rarely well managed or adequately treated

TSH should be under 2 as an absolute maximum when on levothyroxine

gponline.com/endocrinology-...

Graph showing median TSH in healthy population is 1-1.5

web.archive.org/web/2004060...

Comprehensive list of references for needing LOW TSH on levothyroxine

healthunlocked.com/thyroidu....

onlinelibrary.wiley.com/doi...

If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).

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Hi Saralouise,

I have struggled since April last year to get a levothyroxine dose that is now making me feel like my old self. My dose is now the equivalent of 1.6mcg/ kg as per NICE guidelines. I’m a registered nurse and printed the guidelines and took them with me when I saw the GP. It seems the doctors are reluctant to increase doses because of potential complications but not having an adequate dose buts your health at risk also e.g, weight gain, high cholesterol, dry skin, mental slowness, chronic fatigue and joint pains plus hair loss amongst others. I get extremely breathless when I’m walking up hill or climbing stairs, pain in my hips, knees and shoulders making excercise difficult.

Hopefully one day in the future doctors will treat patients appropriately, until then we have to fight for our health and well-being.

Wishing you all the best. X