Totally confused

[Battlecat]

I had a partial thyroidectomy about 2010. My thyroid levels were fine for several years but then started dropping into hypothyroidism range. I was put on Levothyroxine at 50mg and was ok for few years. Tested Jan 2023 was ok. Tested early Feb 2024 and was hyper not hypo so my gp reduced the levothyroxine. Hyper again in April so taken off Levithyroxine. My GP has only scheduled retest every 3 months, I also have had tests done at various times of day. Should I push for a 9am test now to get a more accurate picture? Also the tests only cover free serum TSH and FT4.

Levels TSH have been

19 April 2024 < 0.005 mU/L

1 February 2024 0.020 mU/L

28 January 2023 1.614 mU/L

31 March 2022 3.088 mU/L

12 February 2021 4.765 mU/L

23 October 2020 6.575 mU/L

25 August 2020 3.675 mU/L

9 July 2020 5.486

FT4

19 April 2024 18.9 pmol/L

1 February 2024 20.6 pmol/L

28 January 2023 15.5 pmol/L

31 March 2022 15.4 pmol/L

12 February 2021 12.6 pmol/L

23 October 2020 14.4 pmol/L

25 August 2020 15.8 pmol/L

9 July 2020 12.6 pmol/L

26 November 2018 11.3 pm

thanks

Sue

[Battlecat]

Just as an update, having read more of the posts on here again. I've decided to pay for a test so have ordered the Blue Horizon Gold to try and cover all bases and asked for their Doctor to comment on the results too.

I know from previous requests that my GP is unwilling to do the full range of tests.

[SlowDragon Administrator in reply to Battlecat]

Make sure you test early morning, ideally just before 9am, only drink water between waking and test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

What was reason for partial thyroidectomy

What vitamin supplements are you taking, if any?

Are you taking any other medications

Request ultrasound from GP

Are you male or female

Approx age

[Marz in reply to Battlecat]

Even though you are paying for your tests, I'm afraid the Doctors comments may well differ from the members comments here ! They are NHS doctors...! Best to post your results here in a new post...

You are only over-nedicated when the FT3 is over range - which was not tested. Sadly your GP is TSH obsessed and stopping your nedication is NOT a good idea. What ever next. The TSH is not a reliable marker once on thyroid neds..

[Battlecat]

Also ranges are

Normal range: TSH

0.570 to 3.600

FT4 7.9-14.0

Cheers

[FallingInReverse]

Any chance you could add the Levo dosage you were on, and for how long, when each of those tests was taken?

[Battlecat in reply to FallingInReverse]

Hi,

Thanks for the replies.

I was on 50mcg Levothyroxine which was reduced to 25mcg then to nil.

I had half my thyroid removed as I had a benign growth.

Not sure about antibodies. May have had them done when it was thought I had Graves disease in 2020 as I had double vision. I had a scan and the nerves to my eye were OK.

The test I've ordered covers antibodies too.

[greygoose]

Highly unlikely you 'went hyper' with just half a thyroid. And highly unlikely you would have such high FT4 results on just 50 mcg levo. So, one wonders if you have Hashi's? Have your antibodies ever been tested?

[Battlecat]

I'm also female, 59 years young. On Lamictal/Lamotrigine for controlled epilepsy 100mcg twice daily.

I take Vit D in the winter. Was taking multivits for a while but stopped them in Jan before surgery that I had in March.

[FallingInReverse in reply to Battlecat]

It would be important for you to test all 4 thyroid antibody types. These include:

1) TRab

2) TSI

3) TPOab

4) TGab

Also curious - What year did you begin the lamictal/lamotrigine? Has that dosage changed over time?

(This is interesting reference: ncbi.nlm.nih.gov/pmc/articl... noting the class of AED you are on makes it less likely to impact your thyroid, still could be a factor depending on your AED history.)

[Battlecat in reply to FallingInReverse]

Began Lamictal over 15 years ago, been stable and only minor tweak lowering doseage about 5 years ago.

[FallingInReverse in reply to Battlecat]

Just make sure you get all antibody tests (TRab, TSI, TPOab, TGab) and share all your results here when you get them.

As noted above, we recommend you test early morning, ideally just before 9am, only drink water between waking and test. If on Levo - last dose 24 hours earlier. But whatever you do, be consistent so results are consistent and comparable over time.

Also, incidentally, you don’t say how you feel in all this. That is as important as blood tests.

We look forward to an update when you have one!

[Battlecat in reply to FallingInReverse]

I feel lacking in energy, bloated, retaining water,not sure if that's a symptom. Gained weight in last few weeks. Not really got any other symptoms as yet.

I've recently had cholesterol, diabetes and renal check under government scheme and all were in normal range.

Mainly frustrated that my GP thinks it's ok just to message me to stop meds without any discussion and to leave it 3 months without review or any suggestion of full blood tests.

[FallingInReverse in reply to Battlecat]

Those are/can be symptoms yes.

Once you test, share your new results here.