is this a flare?

[B1lly]

I’ve recently had a Medichecks thyroid test with some surprising results.

My results in Nov from GP were:

FT3 6.3 - range 2.6-6pmol/L

FT4 19.3 - range 9-19pmol/L

TSH 0.01 - range 0.4-4.9 mu/L

Recent medichecks results attached. My GP wanted to reduce my Levo on Nov but agreed to monitor it because I’d felt so awful when she reduced it from 100mcg to 75mcg earlier last year

I had covid before Christmas and a tummy bug that laid me low in the new year, alongside quite a lot of ongoing stress with ageing parents and all that brings.

I have noticed a bit of weight loss, but have also recently had a tummy bug so had put it down to that. I’ve definitely had increased anxiety but have a few stressful things going on so that was also not alarming. In the last week I have felt a bit breathless and my heart rate has been elevated (to around 100bpm without having done any exercise to cause it.

I’ve had an alarming email from Medichecks that says this is urgent and I may need to head to A&E if I have chest pains - which I don’t thankfully.

I’ve been in touch with my Dr who has suggested I reduce from 100mcg to 75mcg levothyroxine. I’m seeing him for an appointment in a couple of days. This is a new private Dr who has put me on LDN for the past couple of months to reduce inflammation.

Any advice welcome. Feeling a bit thrown by these results.

[greygoose]

It probably is a small one, yes. Best thing to do is to stop levo until your next test to bring the levels down and see where that takes you. Or, if you start to feel really hypo before then, restart them. But do it on your own, don't involve your doctor if you can possibly avoid it. Because they just don't understand how Hashi's works. And once they have officially reduced your dose, it can be very hard work to get it raised again. And if this is just a Hashi's 'flare' - or Hashi's 'hyper' swing, as I prefer to call it - you're going to need that 100 mcg when you go hypo again.

[B1lly in reply to greygoose]

Many thanks for responding so quickly. My private Dr is a functional medic who specialises in Hashimoto's, so my GP isn’t involved atm, she’s the one who would want to reduce my Levo and I get my prescription from her still. My private Dr has suggested reducing to 75mcg for now in response to the emailed results, but I’ll learn more when I speak to him.

My T4 has been tracking upwards for a while which is another reason my GP wants to reduce my dose. That and my almost non existent TSH.

Any other top tips for a flare or anything you could suggest I read? Thanks again.

[SlowDragon Administrator]

personally I would just reduce dose Levo a little

Down to 87.5mcg daily

Retest in 6-8 weeks

Even that may be too large a reduction

Some people are incredibly sensitive to dose changes

[B1lly in reply to SlowDragon]

Thank you tricky to cut those little tablets up!

[SlowDragon Administrator in reply to B1lly]

Get a weekly pill dispenser

Use a sharp craft scalpel to cut some in half

And other info 1/4’s

Save the spare 1/4’s and every 4th day you don’t need to cut 1/4’s

They don’t have to be 100% accurate.

Levothyroxine is a storage hormone, it evens out over the week

If 87.5mcg per day too fiddly

Just try 75mcg and 100mcg alternate days but use ACCORD for both doses

[B1lly in reply to SlowDragon]

Ok. Thank you! X

[Bertwills]

LDN, which I take, is known to somehow increase the effectiveness of thyroid hormones. It’s common to reduce your dose once established on a high enough dose of LDN, How much are you taking? How long have you been taking LDN & did you start with a very low dose & slowly increase? You should have been warned that it’s expected that you reduce your T4 & been testing frequently so that you don’t end up over medicated.

You also have Hashimoto’s so that could also cause a sudden increase in your own thyroid’s production of T4. Reduce your dose & test again. Maybe Google the effect of LDN on thyroid hormones. This outcome should have been expected. Maybe your prescriber is not very experienced.

[B1lly in reply to Bertwills]

My Dr suggested I test about a month after starting LDN but that was delayed and it was more like 6 weeks after - mainly because I was ill with a nasty virus. I increased gradually starting on 0.5ml and increased 0.5ml each week. I seem to have tolerated it well.

[Bertwills]

Ok that’s good to know. I’ve found LDN very beneficial in many ways. Hopefully you feel the benefit too. I took 3 months to reach maximum dose of 4.5 ml. I’m using sublingual drops. It looks as if you’re increasing more quickly so if you find you have symptoms I would suggest slowing down your increasing dose & taking your time. By the way, I had to swop to sublingual drops as the LDN I swallowed gave me dreadful diarrhoea, I wonder if your stomach upset was caused by LDN?

Reducing your T4 needs to be done & then retesting in a month to six weeks. You’ve had a great deal to deal with. COVID infection has been noted to cause strange hormone blood results too. Hopefully if you persevere all will fall into place. Good luck.

[B1lly in reply to Bertwills]

Many thanks for your thoughtful responses. I seem to have been ok with the LDN and haven’t noticed any side affects apart from a few vivid dreams. My sleep is much better, I’m getting much more deep sleep (according to my Fitbit). I didn’t get diarrhoea with my tummy upset, just awful nausea and cramps. I put it down to a bug because it came on so quickly, but you may be right. Covid was much worse for me this time around, it floored me for weeks and then after that came a stressful family Christmas! Hopefully things will level out soon. My Dr has reduced my Levo from 100mcg to 75mcg for now and I have an appointment with him on Tuesday.

Thanks again for your messages. Really helpful. X

[Bertwills]

Just a quick thought, if dreams are tricky many people switch to taking LDN in the morning. I do myself.

[B1lly in reply to Bertwills]

Thanks, they're not tricky, or disturbing, they were just quite vivid at the start. Overall I love the impact it is having on my sleep!