Interesting set of bloods!

[LindyMc]

First off, from private bloods got email from the Dr to say I must contact my doctor today as my blood were so off and I was hyperthyroid, a bit of a shock for a diagnosed hashi's! Then they failed to upload my results for 6 hours as the system went down which made making an appointment with Dr tad tricky. Anyway e mentally turned up had managed to bag the last call of the day with GP. Here are the results: Nov 24 April 25 Range

FT3 3.4 5 8 3.1 - 6.8

FT4 17 27.9 12 - 22

TSH 5.16 0.015 0.27 - 4.2

TPOAb 14 14.8 0 - 34

TgAB 16.2 21.9 0 - 115

I have had NHS bloods between these 2 - can't remember these results. But looking at the antibodies she and I are surmising that this would appear to be stable and there fore no longer autoimmune? Her first thought was stop the levothyroxine 62.5mg, but I thought that might be somewhat precipitous and so we settled on dropping 12.5mg and retesting in 6 weeks. Thinking back I had had a bit of a warning - increased resting heart rate, poor sleep, slightly raised BP, weight gain from early March and then weight loss over last 10 days. Anyone any comments on our mutual fubbling?

[SlowDragon Administrator]

was last dose levothyroxine 24 hours before test

Are you always getting same brand levothyroxine at each prescription

what about vitamin levels

When were B12, folate, vitamin D and full iron panel including ferritin levels last tested

What vitamin supplements are you taking

[LindyMc in reply to SlowDragon]

Yes the last dose was 24 hours previous. The only 12.5 mg ( teva) available was different from the 50mg (accord) - All the vitamins were fine, test yesterday. Thank you.

[SlowDragon Administrator in reply to LindyMc]

Teva upsets many people and 12.5mcg tablets are expensive

Just cut a 50mcg tablet into 1/4’s to get 12.5mcg

But looks like you need to reduce to 50mcg daily anyway

Retest in 8-10 weeks

[LindyMc in reply to SlowDragon]

As I said, GP initially thought just stop as the antibodies implied that I was not autoimmune ( confirmed by Dr from the private testing)!! But We decided to do as you sugguested. Thanks

[greygoose]

Well, first off, it takes more than a slightly below-range TSH and a little over-range FT4 to make you hyper. If you were truly hyper, your TSH would be undetectable and your FT3 very high, as well as your FT4.

Secondly, if you were diagnosed Hashi's due to over-range antibodies - TPOab and/or TgAB - you are Hashi's for life. The lowering of the antibodies due to destruction of the thyroid meaning there's less tissue to attack, or for whatever other reason, does not mean that you no-longer have Hashi's - Autoimmune Thyroid Disease - because that is for life. And even if the antibodies disappeared altogether, you would still have Hashi's.

So, I think what you're looking at here is a Hashi's 'hyper' swing, where the FT4 and/or FT3 levels rise suddenly, and temporarily, due to an immune system attack on the thyroid. This is not true hyperthyroidism. Levels will eventually come down again by themselves and you will be hypo again. So, it should be recognised that eventually you will need to put your dose back up again.

[LindyMc in reply to greygoose]

Your first comment was similar to my GP - I showed her the email from the test company - her comment was ' that was somewhat over reactive '. I will pass you thoughts next time we meet. She had never come across a similar situation before. Is remission really impossible? We did wonder as the original antibody test only threw up 43 or 44 if it could have been a misdiagnosis?

[greygoose in reply to LindyMc]

Highly unlikely given your latest labs. What was the top of the antibody range? It's usually about 36 I think. So 44 is quite enough to make it positive.

[LindyMc in reply to greygoose]

You in the ball park. Mine was 34. But when I have seen others at well over 100+ my little +9 does appear quite small beer. Thank for interest.

[LindyMc in reply to LindyMc]

Oops my upper limit on antibodies was 34- not that my first reading was that.

[greygoose in reply to LindyMc]

Positive is positive even if it is only +9. It's not a competition.

[LindyMc]

No I know. But I guess I was question how secure are limits? For instance, in UK Hb1Ac has to be 42 for prediabetes where in other places eg Germany and US it the equivalent to 39, a number I think is more sensible as you set to change it before it is so entrenched. So what's so special abotc34? A guess? Some putting a finger in the air or real research. If the latter, then I would love to read it - I am curious about stuff like that!😀

[greygoose in reply to LindyMc]

I would say 'experience' rather than a guess. Experience of reading other people's blood test results compared to how they feel and react and behave counts for a lot. And the people that set the upper limits have been at it for a long, long time.

And, also, to a great extent, all ranges are dependent on the machines that do the analysing. It's all machines these days, not a little lab technician with a pipette and test tube. The machines have to be calibrated. Have a look at this article talking about how ranges are set:

helvella.blogspot.com/p/the...

No blood test is 100% reliable but they're the best we've got for diagnosis and treatment. And I'm pretty sure that what you've just experienced is a Hashi's 'hyper' swing, so you can't get more secure proof than that.

[LindyMc in reply to greygoose]

Found the link interesting.. Also enjoyed video by David Halsall. Thank you.

[LindyMc in reply to LindyMc]

David Halsall said that the TPO test is somewhat unreliable and raised TPO is not necessarily lead to hypothyroidism. In the same way as TSH of more than 10 is not that reliable either!

youtu.be/Z0Z-zYF3OP4?si=cfy...(Not working as expected?)

[greygoose in reply to LindyMc]

Just his opînion. Not gospel.

[greygoose in reply to LindyMc]

OK, so if you haven't got Hashi's - and you're obviously not convinced you have, how do you explain the sudden massive leap in your FT4 without an increase in dose?

[LindyMc in reply to greygoose]

But possibly not hashi's but still hypothyroidism? But I don't know, just being curious. Also I am a hypo-responder to several medications so the surgery are loathed to let me increases quickly . So started off with 25 and then 2 months later up to 50. After another 6 weeks was still suffering from muscular pain and cold etc they only agreed to 12.5mg. By weight I should have landed closer to 75mg but slowly does it. It was barely a month after starting the extra 12.5mg that looking back, having checked symptoms of hyperT, I was showing signs, getting sweaty in exercise classes, raised resting heart rate, slightly raised HP. +++. That has got worse in the last couple of weeks, lost 2 kg, definity high energy. So it appears to be as a result of 12.5mg on a new brand,?? Anyway I have been told to drop the 12.5mg so perhaps it'll start to sort itself out. Whether it's hashi's or straight forward hypothyroidism will work out and since the treatment is similar I don't suppose it matters. Thanks for you patient help and advice.

[greygoose in reply to LindyMc]

No, sorry. No way is an increase of 12.5 mcg levo going to take your FT4 from 17 to 27.9. It's such a tiny increase that it will barely register.

And that's exactly why it does matter that you know whether or not you have Hashi's, to explain a jump like that. It sounds as if your GP is cool but a lot of them would have had 50 fits, accused you of 'abusing your hormone' and taken you off levo completely! It is important to know even if the treatment is exactly the same.

And, of course, with an FT4 that high, you would get hyper-like symptoms, because it's much too high.

What do you mean by 'hypo-responder'? I've never heard that term before.

[LindyMc in reply to greygoose]

It a name that one of the GP doctors gave it. Over a period of time what ever I was prescribed, it overshot the desired result and at the very least had to halved. Back when I was younger, I found more than 2 paracetamol would knock me out. Regular local anaesthetics don't agree and I have to have different ones.

[greygoose in reply to LindyMc]

Sounds more like hyper responding to me, rather than hypo, given that hypo means 'under' and hyper means 'over'. But levo isn't a drug, so why would it have the same effect?

[LindyMc in reply to greygoose]

Apologies Part typo part dyslexic. Thanks.

[LindyMc]

OOPs not sure if I have seen a live youtube here before? Is it against the rules? If so I am sure soemone can remove it. If so apologies

[greygoose in reply to LindyMc]

It's fine.