First results in a while : Finally managed to get... - Thyroid UK

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First results in a while

Petgirl2 profile image
22 Replies

Finally managed to get a doctor. My results are below,

Yesterday I've had blood taken for zinc copper and selenium levels.

I have to wait until May 2nd to get results explained to me.

If anyone could tell me what this result means please, I could have an idea of what's going on with me.

I've been on levo since 2002,

I can only load one image, so here's the one I need explanation to.

Many thanks

Petgirl2

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Petgirl2
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greygoose profile image
greygoose

It's just saying that you have Hashi's. But you already knew that. Can't imagine why they tested antibodies again.

You can post further images in replies. Just click on the oblong with a mountain under a comment and upload your photot. :)

Petgirl2 profile image
Petgirl2 in reply togreygoose

Thanks for your reply. This is a new doctor in a different country, I think she just wanted a complete work done so she has it in her records.

greygoose profile image
greygoose in reply toPetgirl2

OK, but it doesn't advance you any further.

However, you want to know what is going on with you, and it's that: you have Hashi's, which is slowly destroying your thyroid. The problem is making sure you are optimally medicated with thyroid hormone replacement, and that your nutrients are optimal. It's good that you're having zinc, copper and selenium tested, but what about vit D, vit B12, folate and ferritin? Have they been tested?

Petgirl2 profile image
Petgirl2 in reply togreygoose

Trying to load rest of results, but they don't want to load. Will keep trying

SlowDragon profile image
SlowDragonAdministrator

High thyroid antibodies confirms autoimmune thyroid disease also called Hashimoto’s

Hashimoto’s destroys your thyroid and you need to rely on replacement thyroid hormones

Looking at previous post

You have reduced or stopped levothyroxine?

How much levothyroxine are you currently taking

How long on this dose

Please add TSH, Ft4 and Ft3 results and ranges

Plus vitamin D, folate, ferritin and B12 results

Vitamin levels likely low if reduced/stopped levothyroxine

Always test thyroid levels early morning, ideally before 9am and last dose levothyroxine 24 hours before test

Petgirl2 profile image
Petgirl2 in reply toSlowDragon

Yes, had stopped for 4 months. But this result is after 6 or 7 weeks on 50mcg. Yes, was a fasting test, with no meds that morning.

Results
SlowDragon profile image
SlowDragonAdministrator in reply toPetgirl2

TSH should always be under 2 on levothyroxine

Most people, when adequately treated will have TSH below 1

Looking for Ft4 at least 60-70% through range

FT4: 0.97 pmol/l (Range 0.8 - 1.76)

Currently Ft4 is just 17.71% through range

Helpful calculator for working out percentage through range

thyroid.dopiaza.org

So your under medicated and need next increase in levothyroxine up to 75mcg

Retest 6-8 weeks later

Likely to need further increase in levothyroxine after that

tattybogle profile image
tattybogle in reply toPetgirl2

These results show 50mcg your dose of Levo is not enough. The TSH is still too high and the fT4 is quite low . You GP should be aiming to keep TSH under about 2 on Levo.

gponline.com/endocrinology-... "Replacement therapy with levothyroxine should be initiated in all patients to achieve a TSH level of 0.5-2.0pmol/L." Written for GP's by "Dr Iqbal is a specialist registrar in endocrinology and Dr Krishnan is a specialist registrar in cardiology, Liverpool".

gp-update.co.uk/files/docs/... "The goal of treatment is to make the patient feel better and this tends to correspond with a TSH in the lower half of the reference range (0.4–2.5 mU/l).

If a patient feels perfectly well with TSH between 2.5 and 5 mU/l there is no need to adjust the dosage" .

So (unless you feel perfectly fine at the moment) , your dose should now be increased to 75mcg , and TSH /fT4 retested after 6/8 weeks on 75mcg.

Also your Vit D is obviously very low . ( 10 -30 'insufficient' )

* your TPOab is very high ... but , it just means you have hashimoto's . (anything over about 500 is considered high.. lots of people with Hashimoto's will only have about 100/300 ... but some people do have much higher TPOab than yours, mine were >3000 , and somebody else on here had 6000... so don't panic.

SlowDragon profile image
SlowDragonAdministrator in reply toPetgirl2

Vitamin D is insufficient

EU units are ng/ml

Looking for vitamin D at around 40ng/ml

That’s equivalent to 100nmol U.K. units

26.8 ng/ml = 66nmol

endmemo.com/medical/unitcon...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via NHS private testing service when supplementing

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7. One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need, with hashimoto’s we frequently need higher dose than average

Vitamin D and thyroid disease

grassrootshealth.net/blog/t...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Great article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

Suggest you get folate, ferritin and B12 tested

What’s your diet like

Do you eat plenty of red meat

Petgirl2 profile image
Petgirl2 in reply toSlowDragon

Dairy and gluten free, season fruits and veg. Very little coffee and tea. Mostly vegetarian meals. But all homemade, with a rare treat of a pizza. Carry water with me. (And yes I drink from itl🤣

SlowDragon profile image
SlowDragonAdministrator in reply toPetgirl2

So quite likely low iron/ferritin if not eating much red meat or organ meats

Can you get iron and ferritin tested

Are you pre or post menopause?

Petgirl2 profile image
Petgirl2 in reply toSlowDragon

I'd say I'm at the back end of menopause now, been going through it for around 3 yrs after coming off of depo provera, which was an amazing change for me, I lost 22 kilos over 8 months.

Results
SlowDragon profile image
SlowDragonAdministrator

About 90% of all primary hypothyroidism is autoimmune thyroid disease

The aim of levothyroxine is to increase the dose slowly upwards in 25mcg steps until TSH is around or under 1

Most people when adequately treated will have Ft3 at least 50-60% through range and Ft4 usually a bit higher

Essential to test vitamin D, folate, ferritin and B12

These need to be at good levels

Even in Portugal you might be vitamin D deficient

Petgirl2 profile image
Petgirl2 in reply toSlowDragon

So bear in mind I've been very poorly since mid Jan and wrapped up completely trying to keep warm, shorts weather is here and I have more energy to get outside, so I'm not concerned with the vit d at this moment, seecwhat the next test shows. B12 is already being supplemented now. So there's not really anything I can do until May and see the doc?

The antibodies number, not an issue? Just that it shows I have hashimoto.

Thanks for your feedback . Much appreciated

Results
SlowDragon profile image
SlowDragonAdministrator in reply toPetgirl2

Antibodies should/might drop

A) as dose levothyroxine is increased

B) many people find TPO antibodies reduce slowly on strictly gluten free diet

Request coeliac blood test before trialing strictly gluten free

Petgirl2 profile image
Petgirl2 in reply toSlowDragon

Already on dairy free (hence asking for the b12 test)and almost gluten free. Purely because I have bad reactions to too much of either. So I guess I'm just going to have to cope until May , hopefully she will qbe happy to test regularly until a happy place is found.

What are your views on alternatives to levo?

SlowDragon profile image
SlowDragonAdministrator in reply toPetgirl2

Request 25mcg dose increase in levothyroxine now

You don’t want to wait

Meanwhile getting iron and ferritin tested

Many people find once on high enough dose levothyroxine, all four vitamins optimal that conversion of Ft4 to Ft3 improves

Typically dose levothyroxine is increased slowly upwards in 25mcg steps until on approx 1.6mcg levothyroxine per kilo of your weight per day

Some people need more, some less

Always test early morning, last dose levothyroxine 24 hours before test

When you get Ft4 near to top of range and all four vitamins optimal…….if Ft3 remains low

Will need T3 prescribed alongside levothyroxine

Not sure if T3 is prescribed in Portugal, definitely not prescribed in Spain

Petgirl2 profile image
Petgirl2 in reply toSlowDragon

As it happens, I'm taking half of my old 125mcg ATM, so am getting a little increase anyway, but can't do anything until May when I have an appointment, I actually don't feel too bad except the strange numbness I get. I think that may be zinc or selenium poisoning, get results for that 27th . If its not, don't know where to go next with that.

SlowDragon profile image
SlowDragonAdministrator in reply toPetgirl2

So you have increased dose levothyroxine to 75mcg now anyway

Retest 6-8 weeks time

Petgirl2 profile image
Petgirl2 in reply toSlowDragon

She wouldn't even test ft3, so I'm guessing no. But, if I come across my old results, I don't think t3 was a problem. Just the tsh ,

SlowDragon profile image
SlowDragonAdministrator in reply toPetgirl2

TSH to high …or too low

TSH is not a thyroid hormone….it’s largely irrelevant on replacement thyroid hormones

Many people when adequately treated have very low/suppressed TSH

Most important results are always Ft3, followed by Ft4

Petgirl2 profile image
Petgirl2 in reply toSlowDragon

Last test before everything closed 2 yrs ago T3 and T4 were OK, she was concerned that tsh was 6 or 7. But I felt really good, so I wasn't worried

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