Advice on latest test results please

[Jamima]

My results below are from 19/1/24 and 26/3/24. I’m not using any thyroid meds and it would seem that my tsh is increasing while frees are decreasing. Any advice on what I should do would be welcome.

19/1/24

TSH: 2.77 (0.27-4.2)

FT3:4.8 (3.1-6.8)

FT4:14.3 (12-22)

26/3/24 - same ranges

TSH:2.81

FT3:3.9

FT4:12.7

[SlowDragon Administrator]

previous posts

healthunlocked.com/user/Jam...

So in past you have been on Metavive or Levo ….or NDT?

How long have you been taking nothing at all

What are your most recent folate, B12, vitamin D and ferritin results

Exactly what vitamin supplements are you taking

Are you on gluten free diet and/or dairy free diet

[Jamima in reply to SlowDragon]

Thank you for replying SlowDragon. I’ve previously tried both metavive I and Levo, the highest dose was 3x metavive per day and separately 62.5 Levo. I also added 6 t3 to the Levo and that was the highest amount of hormone I’ve used. I stopped because of debilitating side effects (having to grab on to walls from light headedness) and a variety of others. I suspect my problems with thyroid hormone might have something to do with low cortisol so I’ve sent a regenerus test off this week too. I haven’t taken any thyroid hormones since 19/1/24.

Most recent vits was 7 months ago:

Active B12 71.2 (37.5-188)

Vit D 205 (50-250)

Ferritin 149 (44-150)

My b12 had dropped as I’d stopped my preferred b supp but have since re-started. I also supplement vit d daily with sublingual drops and take 2000mg vitC daily. My folate test was damaged and I was offered another by thriva but they didn’t come through with that.

I’m dairy free.

[SlowDragon Administrator in reply to Jamima]

So you likely need lactose free Levo

Are you prescribed or self sourcing

Lactose free probably only available on prescription

Levo doesn’t top up thyroid it replaces it. Essential to be on high enough dose as fast as possible. Starting on 50mcg and retest 6-8 weeks later

Approximately how much do you weigh in kilo

And how old

[Jamima in reply to SlowDragon]

Thank you. I'm currently self sourcing and have both euthyrox and eltroxin available. I weigh approx 57kg, I'm 61. I haven't been told I'm lactose inltolerant, although I do suffer some bloating if I eat too much cheese. I just prefer the alternatives. Not on any other meds other than low dose hrt.

[SlowDragon Administrator in reply to Jamima]

So likely to eventually need to be on approximately 90mcg Levo per day

A few people need less per day than guidelines, and others need higher dose

All four vitamins must be optimal too

[Jamima in reply to SlowDragon]

Ok, thank you. Would you say from those results that I'm definitely hypothyroid? I ask because historically my tsh has always been low, even with low frees.

[SlowDragon Administrator in reply to Jamima]

Free T4 (fT4) 12.7 pmol/L (12 - 22) 7.0%

Free T3 (fT3) 3.9 pmol/L (3.1 - 6.8) 21.6%

Ft4 is dire

Ft3 poor

Retest again including vitamin levels in another 6 weeks

Are you vegetarian or vegan

Ever tried gluten free diet

[Jamima in reply to SlowDragon]

Thank you, should I start levo and then re-test in 6 weeks? I'm very much a meat eater which helped raise my ferritin as I was pescatarian previously. I've tried very low gluten but never entirely free. My thyroid antibodies are normal.

[SlowDragon Administrator in reply to Jamima]

Have you tested both TPO and TG antibodies

Ever had ultrasound scan of thyroid

Low gluten won’t be effective

Trial does need to be absolutely strictly gluten free

[Jamima in reply to SlowDragon]

Thank you, yes, these were my antibody results in Jan ‘24:

THYROGLOBULIN ANTIBODIES

0 - 115 R

13.3kIU/L

THYROID PEROXIDASE ANTIBODIES

0 - 34 R

<9kIU/L

I’ve never had a thyroid ultrasound, how would I get one? Should I start Levo now and go gluten free then test in 6 weeks?

[SlowDragon Administrator in reply to Jamima]

Only ever make one change at a time

I would wait and retest thyroid and vitamin levels again before starting levothyroxine

Or if you feel you can’t wait any longer, start on 50mcg …..retest in 8 weeks

important to get vitamin levels tested

Meanwhile get ultrasound scan - £100 approximately

Roughly where in U.K. are you

thyroiduk.org/get-support/t...

[Jamima in reply to SlowDragon]

I’ve found somewhere near me that does scans. What should I look for in a scan or will they direct me?

[SlowDragon Administrator in reply to Jamima]

They should explain it to you

Could have nodules or look like it’s full of holes

Ord’s thyroiditis = small shrivelled up thyroid

20% of Hashimoto's patients never have raised antibodies

healthunlocked.com/thyroidu...

[Jamima]

Thank you, I’d rather start now and see what happens, my life has pretty much ground to a halt so there’s not much to lose. I’ll schedule a full test in 8 weeks. I live in Scotland.

[SlowDragon Administrator in reply to Jamima]

With these last results you might consider seeing thyroid specialist to get formal diagnosis and prescription

Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists who will prescribe T3

Ideally choose an endocrinologist to see privately initially and who also does NHS consultations

thyroiduk.org/contact-us/ge...

[Jamima in reply to SlowDragon]

Many thanks.

[Jamima in reply to SlowDragon]

Thank you.