I've had under active thyroid for 5/6 years and have been on a dose of 50mcg of Levothyroxine for all of this time. This year I developed chronic urticaria and then a different kind of dermatitis/eczema and I want to rip my skin off it's so itchy.
This week I did an Advanced Thyroid Function Blood Test (before 9.00am on an empty stomach) and the results are attached.
Could anyone interpret my results and arm me with some information on the state of my thyroid to go back to my doctor with please?
I'm interested to know if there is any correlation between under active thyroid and skin conditions, especially as my autoimmunity scores are off the scale.
Many thanks.
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Chestercheese
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50mcg Levo is usually given as a starter dose, so I would 100% push for an increase. TSH should always be under 2, with most members reporting they feel best with TSH under 1. Your FT3 and FT4 are also low in the range.
Can you share key thyroid vitamins (ferritin, folate, B12 and vit D)from your advanced test? Having these optimal will support thyroid health.
Please remember that when medics say your results are ‘normal’ or ‘within range’ this may not be the same as ‘optimal’
Have you ever tried a gluten free diet? Many of us with an autoimmune condition (as you also have with positive thyroid antibodies ) benefit from fully eliminating gluten.
Do you find your skin issues flare when eating certain foods/ alcohol? Do antihistamines have any affect?
Do keep posting and seeking advice Chestercheese. We are very friendly group & are here to help & support 🦋
Thank you so much! I'm been monitoring my food intake and reaction but as the itching is constant it's very difficult to see a direct link. I've had other advice to try a gluten free diet. Alcohol definitely makes the hives worse and antihistamines help a little but don't stop the itching completely.
Very interesting link article. I have attached the key thyroid vitamins from my advanced test.
I have the same issue as you sudden breakouts of hives …. Im not sure what yours looks like but mine are large patches of dark red that eventually turn purple like a bruise with medium sized lumps only on the outer edge of part of the patch and horrible itching with rib pain involvement that comes and goes and only on the side of my chest …. Originally the doctors said shingles “not” and finally went to derm who did biopsy and it came back as Tumid Lupus … Now I haven’t reacted to this yet because well it just seems nutz to me but Lupus does run in my family so not necessarily impossible…. I’m kind of on the fence and think it could be more of a drug reaction from my meds thyroid … but still not sure.
Do you take folate supplements? It's unusual to see such a high level for folate.
If you do take supplements for folate what are they?
Folic acid is often prescribed by doctors in very high doses for people with low folate and it isn't recommended. We usually suggest taking a product which contains methylfolate.
There is a possibility that your folate is so high because you get a lot of folic acid in your diet. Some foods are fortified with folic acid, and if you eat a lot of them you could end up with high levels in the blood.
Some people can't convert folic acid to folate and so the folic acid builds up unused in the bloodstream.
The people who have problems with the conversion of folic acid to methylfolate often have issues with their MTHFR genes. This is extremely common. About 50% of the global population has difficulties associated with their MTHFR genes. Folic acid was only invented/developed in 1943 - so the evolution of humans hasn't caught up with learning how to deal with it. Until folic acid existed people got their folate naturally from their food and wouldn't have a build up of folic acid in their bloodstreams.
One thing to point out is that the body needs good levels of folate in order to metabolise Vitamin B12 correctly.
It can be difficult to get reliable information on folic acid and folate because many people writing about it use the terms interchangeably, even though they aren't the same thing.
After reading all the replies yesterday it seems that I shouldn't be taking multivitamins. I've just read the label and one of the ingredients is folic acid so I'll stop.
A quick edit to my post also to say... WELCOME TO THE BOARD! I see you joined today, and I'm happy to say you are in the right place to ask all your thyroid and related questions. And you will soon see that those on this board have shared experiences and advice that will be a very valuable addition to your self care and health strategies!
Now, a few observations.
Yes - skin issues can be related to sub-optimal thyroid. (My rosacea was, and went away as my Free Ts started improving). I know others on this board have tons of similar stories for all kinds of skin problems!
It's not surprising that your skin issues are acting up - you are on a "starter dose" of Levo - and if you have been since 5-6 years ago, I bet you have a few other symptoms as well. Typically people start at 50 mcgs, and titrate up in small increments and over time towards a ballpark of 1 mcg per 1.6 Kgs body weight. So unless you are super petite, likely you should increase levo.
But you are probably not super petite, as evidenced by the fact that your TSH is too high, and Free T4 and Free T3 is too low. Being in range is NOT what we aim for (esp for us thyroid folks, and for those of us on any T hormone replacement). We aim for optimal. And although it's personal, general numbers are that TSH should be under 1, and the Free Ts in the mid to upper of the range. You are scraping the bottom for both. Unfortunately doctors think that is you are in range, you are normal and fine. That is almost never accurate.
Lastly - once your antibodies test positive - that confirms an autoimmune cause for the thyroid issue. But you generally don't need to test ABs again, and if you do, you can expect those tests to fluctuate randomly. So whether they are sky high or not for any particular test is not useful for making conclusions or treatment decisions.
Others on this board may weigh in with additional replies!
Thank you so much. I feel like I should have joined years ago! It's very interesting to hear you (and others) say that just because the test comes back normal it doesn't mean it's optimal. And no, I'm not super petite so I think I definitely need a higher does of Levo.
Chestercheese There's a great analogy mentioned on this board comparing blood ranges to shoe sizes.
If you imagine the range of shoe sizes out there - let's say it's "normal" to have anywhere from 36-41. But if you are a size 40 and are wearing a 37, then your feet will hurt. So just because you are "in range" does not mean it's the right number for you to feel good. And just like shoe sizes, even with the range, we can also say that ~most/many~ people do not feel good at the bottom of the range. And then the rules also slightly change for hypothyroid people & esp when you start taking levo (for example, knowing that once you are on replacement Levo, then you pituitary will stop sending out its TSH because it knows you have T4 coming in. That's one of the biggest things you'll read on here - that doctors still think they should prescribe based on a TSH reading - but TSH is one of the things we look at, but pretty much the last thing we look at to make med decisions.)
I look back at my older blood results, before I was fully symptomatic with my thyroid, and wish I knew then what I know now. They were just barely in range, and so I didn't give it a second thought. Now in retrospect I can see where I was headed!
Thanks. I never considered that my rosacea went away once my T4 was increased. But it fits exactly into the timeline. I had thought it was from an improved gut microbiome, but I guess those two things also go hand in hand.
Thanks so much for your reply. I'm taking TEVA Levothyroxine. I take multivitamins and iron plus I've just started taking Vitamin D3 based on some of my own research. I thought I had attached the rest of the test results but clearly hadn't so here they are. Thanks again.
I'm only reasonably new on here myself - there are others who are better qualified than me to advise on your vitamins, but I know that your Vitamin D is low. I think it needs to be around 100 so taking Vitamin D3 will definitely help. When taking vitamin D, I am told you need to take K2. Can't remember the science behind it but I'm sure others will come on here and tell you that. Just a thought on the itch - something similar happened me several years back and it turned out that I was allergic to an antibiotic that I was put on for a chest infection. Do hope you get sorted soon. Take care.
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg)
Post discussing how biotin can affect test results
Meanwhile Look at increasing iron rich foods in diet
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Posts discussing why important to do full iron panel test
Welcome to the forum, chestercheese. As others have said, there is an established link between thyroid and skin conditions. That's how I presented, with an intense case of eczema. A GP wanted to rule out a link with thyroid or diabetes, all credit to her. It took me quite some time to sort my thyroid. In the short term I got relief from traditional Chinese medicine. Very important to break the itch-scratch cycle, as I'm sure you'll appreciate. Good luck.
Thank you. It's really very interesting reading about this link and I'm going to do all I can to find out what's going on with the thyroid. I'll definitely try to break the itch-scratch cycle but it's so hard, I am just so itchy and no cream works. I'm sure the creams don't work because the problem is internal not external so 🤞
It's so frustrating, isn't it. The prescprition and otc creams and tablets can sometimes help, but come with their own issues and don't work for everyone. You've received some excellent suggestions and it's good you're going to pursue a broad approach to the issue. I hope you get relief soon!
I just wanted to give you an update on my Chronic urticaria condition. I have removed (as far as possible) hystamine and gluten from my diet and the rash has gone. I'm still going to look into finding someone who can optimise my thyroid function as the doctors have refused to increase my Levo dose.
I don't think you were given this before . it's useful for persuading reluctant GP's to increase Levo dose when needed ...list of reference all recommending GP 's keep TSH lower :
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As others have said, there is an established link between thyroid and skin conditions. That's how I presented, with an intense case of eczema. A GP wanted to rule out a link with thyroid or diabetes, all credit to her. It took me quite some time to sort my thyroid. In the short term I got relief from traditional Chinese medicine. Very important to break the itch-scratch cycle, as I'm sure you'll appreciate. Good luck. 
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