Advice needed: latest blood tests

[NortherlyRose]

I started on 50mcg Levothyroxine just over 7 weeks ago after TSH of 9.34 peroxidase antibodies of 1300+ and hypothyroid symptoms. Full results including vitamins in profile.

Last week I developed a strange heart rhythm and got diagnosed with bradycardia and ventricular ectopics at hospital. The blood test they did showed TSH as 0.34 (range started at 0.35). T4 and T3 were just given as “normal”.

This morning’s blood test was done at 9.15am at the GP. Nothing to eat or drink beforehand apart from water. I hadn’t taken Levothyroxine since yesterday morning. The results have really confused me.

Should I reduce to 25mcg Levothyroxine immediately? Should I be taking Levothyroxine at all?

I was told that the ultrasound scan of my thyroid that was done this afternoon “looks normal”.

I have an appointment with my GP next Tuesday morning.

Any advice or insights you can give me would be much appreciated.

Thank you.

Rose

[SlowDragon Administrator]

Your high thyroid antibodies confirms cause of your hypothyroidism is autoimmune thyroid disease also called Hashimoto’s

You need vitamin D, folate, ferritin and B12 levels tested

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) we must maintain GOOD vitamin levels

What vitamin supplements are you taking

Also VERY important to test TSH, Ft4 and Ft3 together

Also coeliac disease blood test

ask GP for coeliac blood test first as per NICE Guidelines

nice.org.uk/guidance/ng20/c...

[NortherlyRose in reply to SlowDragon]

Thank you.

I had quite a few blood tests done before Levothyroxine was first prescribed a few weeks ago. Hope to get them repeated soon to see if levels have improved.

I’m on a loading dose of vitamin D (week 6 of 7). Also taking B12, magnesium, selenium. I’ve upped the folate content of my diet. Haven’t started taking a Vitamin B complex yet in case it interfered with the blood test results. Plan to do so now though.

Foolishly I went gluten free a few weeks ago then realised I should have got a coeliac test done first. I’m dairy free at the moment too.

I think I panicked when I first saw these blood test results. The TSH isn’t that low and the T4 isn’t that high. Maybe I can stay on 50mcg Levothyroxine until I speak to the GP next week.

Thanks again for your reply.

Best wishes,

Rose

[SlowDragon Administrator in reply to NortherlyRose]

As long as you don’t feel hyper you should be fine

If you did need to reduce dose Levo (temporarily) you would only reduce a SMALL amount

Eg

37.5mcg twice a week and 50mcg 5 days a week

Or

25mcg once a week and 50mcg 6 days a week

But as vitamin levels improve and conversion rate increases you should see Ft4 drop a little as Ft3 increases

Which brand of levothyroxine are you taking

[NortherlyRose in reply to SlowDragon]

Thanks so much for this. I’m taking Accord 50mcg at the moment The hospital doctor gave me a prescription for 25mcg so I have a pack of Wockhardt that I haven’t used yet. I definitely feel hypo rather than hyper at the moment.

Thanks again for all your help and advice.

[SlowDragon Administrator]

Free T3 (fT3) 4.8 pmol/L (3.5 - 6.5) 

Ft3 is only 43.3% through range

So currently poor conversion rate of Ft4 (levothyroxine) to Ft3 (active hormone)

[NortherlyRose in reply to SlowDragon]

Thank you. I hope the conversion will improve as my vitamin levels get better. I think I read somewhere that Hashimoto’s also makes poor conversion more likely. I can see now why I should have had a coeliac test done before changing my diet. I was anxious to feel better so went gluten free without considering all of the consequences.

[humanbean in reply to NortherlyRose]

I can understand why you want a coeliac test done. But it really isn't essential for everyone.

I did get a coeliac test done by the NHS, probably 10 or more years ago, and it came back negative. As a result I felt justified in not trying a gluten-free diet for several years. When I finally tried a gluten-free diet for the first time I got obvious benefits in less than a week. I stayed gluten-free for five years, but then relapsed. (The lure of jam doughnuts was too strong one Christmas.) I am now struggling with repeated attacks of the indigestion from hell, and I can only blame myself - and jam doughnuts.

[NortherlyRose in reply to humanbean]

Thanks so much for this.

I can see why you succumbed to jam doughnuts, they are one of my weaknesses too! Hope you get some relief from the indigestion soon.

My gastritis has cleared up completely since I changed my diet a few weeks ago. It was almost constant before.

There’s far more to thyroid issues than I ever imagined. Optimising health is such a challenge. The irony is most people think taking a pill fixes everything.

.

[humanbean in reply to NortherlyRose]

The irony is most people think taking a pill fixes everything.

Yes, I agree. And sadly those people are often doctors.

[jgelliss in reply to humanbean]

Yes! Yes! Yes! I would laugh if it wouldn't be so sad. And we are the recipient of the medical negligence.

[SlowDragon Administrator]

I was tested for coeliac twice 20 years apart

Both were negative

Cutting gluten was a revelation ….and now dairy free too

More on my profile

[humanbean in reply to SlowDragon]

Your experience and mine makes it obvious that the coeliac test is fairly useless and pointless.

[SlowDragon Administrator in reply to humanbean]

Yep.. Gastroenterologist said, having looked at my gut with (private ) endoscopy, that he was struggling to understand why my coeliac test was negative

Subsequent NHS DNA test was inconclusive…..but on balance….probably not coeliac.

[HealthyBefore in reply to humanbean]

no its not useless or pointless at all, it tests for coeliac disease very well, which is a serious autoimmune disease, with a genetic marker (inherited). what we have on this site are people with a negative result but that are intolerant to gluten. theres no medical test for that... you go by your gut feeling😜

[jgelliss in reply to SlowDragon]

SD what a Game changer it is for me to omit Gluten and Dairy. I can shout it out from the roof top. In all honesty with my Thyroid Journey I can say that dairy and Gluten omitting and adding T3 to my T4 mix was nothing less than a Miracle.