My dose increased from 125 to 150/125 on alternate days in August 23 then 150 in Jan 24
After my latest test
TSH 0.24 0.3 - 4.2
T4 20.01 12 - 22
T3 4.2 3 - 5.4
My Dr has reduced it to 125 again. I am concerned about how well I am converting levo.
The test was early morning, 24 hrs after my last dose and fasting.
I take vitamin D and vitamin B supplement, the test was booked at short notice so I only stopped the vitamin B 3 days before.
Any advice please?
I struggle to get enough blood out of me for private tests and do not have access to anyone for a blood draw so do not have more data…although I was v pleased to have the Dr test T3 this time!
Many thanks
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Apples
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Your GP is advising your reduce Levo based only on TSH, which is common practice but shows a lack of understanding of the other thyroid blood readings. Even though they have tested FT3, they have not taken into account that you have conversion issues. As a first step, I’d ask for the dose of Levo to remain as it was.
Have you ever seen an endocrinologist? Seeing a practitioner willing to consider combination treatment in the future may be beneficial to you.
Results still show poor conversion. I personally wouldn’t want FT4 over range (as can affect heart health), so a slight decrease of Levo by 12.5mcg may be enough to get it within range.
Have you seen/ are you planning to see an endocrinologist who might be willing to consider a trial of Liothyronine in addition to Levo (ie combination treatment)?
I have never seen and endocrinologist, somehow I doubt my GP would refer me. If I manage to see him again I will ask though. I have another test in 8 weeks, but am unlikely to get him to do T3 .
If GP says " I have to reduce your dose because the guidelines say i can't let you have a below range TSH" .....
The first paragraph in the NICE (NHS) Thyroid Disease, Assessment and Management guidelines says :
nice.org.uk/guidance/ng145
"Your responsibility
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. "
I’m auto immune, post menopause, 9stone 10lb and 5ft 7 inches.
The brand has been consistent for at least 6 months,
I do not follow a special diet, take 1000u/25ug D3 every day, and a B complex which has 100% of the daily recommended dose of B 12, 3, 5, 6, 2 and 1 Folic acid and D-biotin but no other supplements.
I’ve no idea when iron and ferritin were last tested, unfortunately I struggle hugely with getting sufficient blood for a postal test and I very much doubt I can get my GP to do one.
How do I improve conversion? Is there a way to do that? Also I have been having a very stressful time for the last few months, I have no control of the causes and wonder if this is having an affect?
Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee
ALWAYS worth trialing strictly gluten free diet with Hashimoto’s
Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential
A strictly gluten free diet helps or is essential due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and may slowly lower TPO antibodies
Ideally if not had coeliac test …….While still eating high gluten diet ask GP for coeliac blood test first as per NICE Guidelines
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
Similarly few months later consider trying dairy free too. Approx 50-60% find dairy free beneficial
With loads of vegan dairy alternatives these days it’s not as difficult as in the past
Eliminate Gluten. Even if you don’t have Hashimoto’s. Even if you have “no adverse reactions”. Eliminate gluten. There are no universal rules except this one.
This is a box, rather than a brand. 50mcg and 100mcg are Accord brand….but beware 25mcg is Teva brand
Teva brand upsets many people
Teva is lactose free, but contains mannitol as a filler instead of lactose, which seems to be possible cause of problems. Mannitol seems to upset many people, it changes gut biome
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please could I have feedback on my private blood test results 
