Help with test results - hypo to hyper ?

[Mst27]

I was diagnosed with hypothyroidism in 2022 and it is hashimoto. I have been on 100 thyroxin for over a year but can’t remember when I increased to this.

It’s been a year since I last had my bloods tested. I have had a had a really tough year and I completely took my eye off my own health. I hadn’t felt good -brain fog tiredness mood and an incredibly itchy head for a while before Christmas but didn’t join the dots. It was actually my daughter who came home from uni and noticed almost immediately and said your thyroid needs checking. I couldn’t get a blood test booked until this week. I was desperate for the results to come through so I could push for an increase however my results now have a comment that says I’m over medicated and need to reduce my levothyroxine.

Unfortunately they did not do a vitamin check which they normally do. I have not been good at taking my vitamin supplements so I could easily have dropped having previously had low b12 and iron. I have been strictly gluten free for a year and a half also.

I am nervous about reducing as I was so unwell at the start of my diagnosis and really don’t want to end up back there but I know that I need to do something as I am definitely feeling these symptoms.

Is it normal to go from hypo to hyper ?

I am querying if I am also menopausal but I don’t really know how to say which symptoms would be because of my thyroid and which could be because of the menopause or which to treat if that makes sense.

I have managed to get a call from my gp tomorrow. In the past I have know what I wanted to happen with my levo when I have spoken to my gp but I don’t know what to do with these results and don’t want to reduce to much too quickly in case it sends me the other way.

my results were

Tsh 0.10 normal range 0.27-4.20

T4 25.7 normal range 11-21.2

These were taken following the advice on here- morning no levo or vit and no food or drink before.

Any advice would be great. My brain fog means I can’t even remember what I would want my result to be if they were good !

[Mst27]

thank you for your reply. I appreciate it. I will discuss this option with my gp I didn’t know where to start !

[pennyannie]

Hello Mst -

With Hashimoto's you can experience erratic own thyroid hormone production as this Auto Immune disease systematically attacks and destroys your thyroid gland -

ultimately leaving you further compromised and needing additional thyroid hormone replacement.

Without a T3 reading - it's impossible to know if this T4 reading is simply over medication -

as it could well be that your ability to convert the T4 into T3 - has / is reduced :

To know for sure, we need to see a T3 and a T4 from the same blood draw -

and it would also help to know your ferritin, folate, B12 and vitamin D as no thyroid hormone replacement works well if these core strength vitamins and minerals are not maintained at optimal levels:

All things Hashimoto's - thyroidpharmacist.com

[Mst27 in reply to pennyannie]

Thank you I will try to push for a T3 and vitamin blood test from the gp.

[pennyannie in reply to Mst27]

OK then but you need the T3 + T4 from the same blood sample-

Did you leave a 24 hour window from your last dose of T4 - and your blood test always a fasting early morning - by 9.00am blood draw ?

[SlowDragon Administrator]

Do you always get same brand levothyroxine at each prescription

Request GP test full iron panel including ferritin, B12, folate and vitamin D

plus request retest of TSH, Ft4 and Ft3 together

If GP can’t/wont then test privately

[Enuffisenuf]

What was your B12 level when it came back low? Amongst all the other problems we have to contend with, B12d/PA often goes hand in hand with Hypothyroid.

Oral supplementation can make your results look OK, but may do nothing for you. Many need to inject, me included.

If it's not too late...Don't restart B12 supplementation before you get your B12 levels rechecked, or you won't get a true result.

[Mst27]

Thanks for all the replies. I do follow the rules before having a blood test so no levo for 24 hours fasted and have the blood test done by 7.45 am. I also only have the same brand of levothyroxin. My b12 result when it’s was low was 195 but this did improve and was last tested a year ago and was 270. The doctor I have tomorrow is the only one that has tested my t3 before so I’m hopeful she will test this along with vitamins etc thanks again for all your help

[Enuffisenuf in reply to Mst27]

Depending on why your B12 was so low having it increase via oral supplementation may not fix the deficiency and related symptoms. A level of 195 was only slightly higher than the 180 NHS level that should be treated by injection, though most PAS/B12d bods feel that this cut off level is woefully low.

There is an annoying cross over of symptoms with PAS and hypothyroid, brain fog being a biggy. You may have symptoms that you don't know are symptoms until you treat, I did.

I was trying to treat what felt like an under medicated thyroid, when I should have been treating PAS, and ended up in a world of NHS pain! I increased my T3 so T4 was reduced by GP to the point where I was very ill, because she didn't like it. Maybe if she had done something about my rock bottom B12.....

Under a new GP it has taken me a year to get my T4 where I was before, but still under threat of reduction because I had a couple of high BP readings. Of course I did I was on the lowest dose of T4 I have ever taken. My starting dose was higher!

PAS & hypothyroid often go hand in hand.

Please take a look at the PAS section on this site and consider pushing for B12 injections. If you do have PA, tablets won't cut it.

I started injections without my GP, but as symptoms started to clear up, I went to my NEW GP and asked to be treated by them. I now get a 3 monthly jab from them, and a daily or eod jab from me.

Sorry for the long reply, but I'm a bit of a B12 evangelist these days.

[KrazyKatMT70]

I’ve had Hashimoto’s since 1990. My thyroid hormone replacement has gone up and down over the years. I get tested once a year. TSH & T4. I started at 50mcg and have been as high as 150mcg. I am currently on 100mcg. Your numbers are not too far off. Only minimal. Hormones and weight loss both can effect thyroid replacement. I have type 2 diabetes and been on diet only since 2001. My numbers have always been within normal range with diet, but one summer I could not get enough water,and I thought it was the heat until I checked my sugar. It was almost 300, like 280. I immediately went on my diabetic diet. I lost weight ,like 45 lbs and found out my TSH was below zero. So I went from .137,to .125 ,to .100mcg which I am currently on. So YES, thyroid numbers can go up and down over the years for different reasons. The weight loss also affected my Blood Pressure meds,had to lower those also. So weight loss to me was #1 in affecting all my medications. One strange blood result was that I no longer had anti-thyroglobulin antibodies or anti-microsomal antibodies which are autoimmune Thyroiditis “Hashimoto’s ! So welcome to the seesaw of thyroid numbers. Everything can effect the function of your thyroid. Just make sure it’s checked once a year at least, unless you are having problems involving it.