Thyroid results - hypo?

[Violetrose123]

Hi, hoping someone can help me understand my latest results.

Age 27, no major health issues. Had a TFT in August as part of a range of blood tests due to suffering from depression. Had no expectation of finding anything out of the ordinary as thought I was “just” depressed. TSH was 4.67 (range 0.27-4.2) and free T4 13.4 (range 12-22). GP explained this was slightly out of range and ordered a retest in 3 months (now)

Have just had my latest results back:
TSH 7.32
free T4 13.5 (range 12-22)
TPO Ab 13.9 (range 0-34)

Haven’t spoken to the GP yet since getting these results today. I’m definitely symptomatic: depression, always bone tired, very dry skin and hair.

Should I expect to start levothyroxine based on these latest results? From what I’ve read online, the normal antibody result suggests this might not be Hashimoto’s (?). Or does the presence of ANY antibodies itself suggest that something isn’t right?

Will hopefully be speaking to my GP on Monday but would like to know what to expect

Thanks

I think it's optional to treat if you're under 10 but not within range (over 4.2) it's subclinical as it is called. Since you have symptoms you might want to discuss it with your GP. You might want to find out why THS has increased from 4.7 to 7.3 in three months time? I think you could become hypothyroid during pregnancy for instance.

Thank you for your response - definitely not pregnant. Is that a big increase for this time frame? Have never had any tests before these so not sure what is normal for me unfortunately.

I’ve read some articles that suggest anti depressants can cause a rise in TSH, but nothing conclusive to say that mine (sertraline) can have that effect.

You are definitely hypothyroid, you are symptomatic and you should therefore press for treatment.

Your TPO antibodies have come back negative, but your thyroglobulin antibodies (TgAB) may be off the scale. It’s just that for some reason the NHS doesn’t test those.

Maybe you don't need the anti-depressant if you treat your /subclinica?/ hypothyroidism? Depression being one of the symptoms of hypothyroidism (not the other way around, though). Suggest you discuss it with your doctor.

Thanks everyone. I’ll be speaking to my GP on Wednesday. I can see that he has marked the results as normal when they were filed, and was told by the receptionist today said the same, so I’m assuming he isn’t too concerned at this stage.

I’ll report back

Yes I had a bit of a do with sertaline confusing my thyroid levels but I was on thyroxine already. It helped initially but after a while didn’t and I only got better when off it.

Ironically when I was first diagnosed (or before) I was treated as if depressed. I became steadily worse and into a cfs like state (I loose weight terribly even if hypo and become very weak) and really struggled with early days seroxat before all the media coverage about its issues. After changing gp my thyroid was tested and I was put in thyroxine - I imagine it was over 10 but it was 20 years ago. Took me a long time to recover fully as I couldn’t get off the seroxat - when ever I’ve had a mh wobble, my thyroid has always needed an adjustment.

Nice guidelines do say if symptomatic and between the 4.2 or 4.5 and 10, trial thyroxine. If your gp agrees, (wave the nice guidelines at them) I’d leave it for a good 3 months to see how you feel and re test to see if tsh is better. I’d work with gp to get the tsh in the lower range (eg around 1) and wait a while to see if symptoms improve. There’s sometimes quite a delay in thyroid symptoms.

The other things that interfere are oral contraceptive hormones; I become hypo due to starting the pill, briefly improved when off it, then never improved after going on it. It doesn’t ‘cause’ it, but it increases the requirement for thyroid hormones, mainly oestrogen I think. So if you’re starting to slip a bit that would make it more so.

I must say, my results were flagged at borderline at 3.5 the other day, but might be different if actually on thyroxine already. Tsh 7 is subclinical though so do look up the nice guidelines in that.

Update - have spoken to my GP this morning, he is going to start me on the lowest dose of thyroxine and we’ll retest again in 2 months to see if it’s having an effect

I just recently read a book by Anthony william - thyroid healing. Definitely worth worth looking into. He suggest a 30day thyroid healing detox and many people swear by it. I just started it and been a week and I feel such a difference that I'm basically getting off meds soon. Check out reviews on google and YouTube.

Im on 12.5 levothyroxine- broke the 25mg into 2. My TSH was 2.5 and t3 t4 within range a month ago. So due for a blood test soon.

Keep us posted

Please please don’t spend a single penny or second of your time on the absolute guff from Anthony Williams

Or at least read this first:
https://sciencebasedmedicine.org/the-medical-mediums-thyroid-pseudoscience

AIBU to say it doesn't do any harm to try some of the things he suggests? It's just diet change and introduction of some minerals/vitamins into your diet. He hasn't mentioned some new wonder drug or doesn't ask you to stop taking medication.

Idk tbh, maybe I'm just over excited about it because of how I feel but I wouldn't knock it till you try it.

Brilliant news violet!

I think it’s worth knowing that if you wanted to ttc you’d have to have your tsh under 3, below 2.5 during pregnancy according to the nice guidelines. A friend was ok meds that affected her thyroid, it was subclinical and she had a mc. She insisted the gp contact obstetrics / fertility (possibly and endo?) and they confirmed this (though nice are clear on it) and so she started thyroxine.

I only say this as if someone is struggling along at 3.5 or 4, it’s not acceptable for pregnancy and they’d have to start thyroxine. Similarly, you really should be aiming to get your tsh in the lower end of the ref range, around 1.

Regarding vits etc - it’s well accepted (by consultants) that deficiencies are more common if your thyroid is struggling- anaemia can occur as the red blood cells are not made as quickly and as well as when euthyroid. Low vit d has similar symptoms, and b12 autoimmune disease may coexist with thyroid and has similar symptoms. You do need selenium and the rda of iodine to support thyroid function.

Eating a healthy diet is going to help anyone in many ways; at the same time a decent multivitamin with iron, selenium, vit d and iodine in is going to have you covered. (Actually, preconception tablets tend to have everything you need). But imo this is common sense with an added multivitamin.

A renowned consultant did write a paper on t3/t4 medication and did note that it was worth making sure there were no deficiencies or other issues that could be confused for thyroid symptoms, along side optimising thyroxine, before exploring t3 medicating. I feel it’s therefore sensible to make sure things like b12, vit d, ferritin (iron stores) and some say folate (folic acid) are good and well covered in your diet.

*on meds

Op I’d seriously be on the floor if my TSH was at 7

Don’t you feel like you’re trying to walk through treacle?

Your thyroid stores thyroxine so this will be why your go wants to test again after 8 weeks - but please make sure you go back for blood test on time and take medication regularly

ivy yes wading through treacle is a good description. I’m always tired no matter how much sleep I get and massively struggling with “brain fog” over the last few months - I can’t concentrate, forgetting words all the time, my head feels very empty at times and I can’t formulate thoughts. Hair and skin are just shit - dry, sallow.

I feel quite relieved that there is a cause. I put a lot of symptoms down to depression but actually now there is a likely cause behind that itself. I’m so glad my GP opted to do blood tests when I first presented with depression, as otherwise I would have never even thought my thyroid could be an issue.

Thanks for all your comments, they’ve been really really helpful

Violet - what dose if thyroxine has gp put you on?

50mcg

Result! Well done!

That’s brilliant! Yes treacle brain is the term.

I’ve just gone to tsh 3.5 and started to notice a distinct mushiness. Certainly when not pregnant, I always knew when I was even only 1.5 or 2. 50 is a good starting point!

I have my next blood test soon - should I still take the thyroxine tablet on the morning of the test?

I usually take it around 6am and the blood test is at 9:30am. I don’t want the results to be skewed by taking it (or not taking it?!)

No, don't take your tablet until after the test

But also avoid eating and drinking before taking your tablet if possible

Don't take your thyroxine until after your blood test. If you do, it will skew the result.

Thank you

TSH is now 3.75 [ref 0.27-4.2] and free T4 is 13.4 [ref 12.0-22.0] so looks like 50mcg is working ok?

That's ok but not great. What's the advice?

How are you feeling? Could you feel better?

You do still have auto immune activity so you are likely to need more in the future.

Another 25 might be good at the moment. That level is still borderline really - eg you'd have to be below 3 to conceive, and below 2.5 in pregnancy. Are you still on sertraline? That can affect levels etc but you clearly have antibodies too.