Re: And now my latest results - confused!

[Guest guest]

T4 70.5 (58-154, optimal 77-150) LowTSH 1 (0.4-4, opt 1.0-2.0) Previous - 1.2FT4 13.3 (10-22, opt 12-20) Pr - 12.2 August, 12.4 AprilFT3 6.24 (2.8-6.5, opt 3.4-6.0) HighFT4:FT3 ratio 2.1 (2.0-4.5, opt 2.5-4.0) LowAntibodies:TG 20 (0-40, opt <35)TPO 41.1 (0-35, opt <30) High

I am pleased with the antibody result - I know these can skew things a bit so I was expecting to see something there. Could that be the cause? Would medication help with that (I have generic Armour sat waiting in my cupboard)?Hi Niki,

Yep – this is the most likely explanation.... your TPO could have pushed up your FT3 – either that, or your body is making too much rT3, which would also show up as FT3, unless you have asked (and paid) for a separate rT3 check....

I am not certain about it, because I am not too familiar with rT3, but I have it in the back of my mind that in order to have high rT3 the FT4 would also have to be high (and yours isn't).... don't hold me to it though – I am hoping that Nick or or somebody else clued up on rT3 can clear up this question.

If it is as I suspect (TPO skewing FT3 results) then the STTM website explains much better what is happening than I could – please read the whole page, not just the excerpt below......

http://www.stopthethyroidmadness.com/hashimotos/

WHY IS IT IMPORTANT TO KNOW IF I HAVE FULL BLOWN HASHI'S?? As the attack increases, you will tend to swing between hypo and hyper, making dosing by labs, and especially the TSH, impossible. Your labs will be high one time, and low the next…back and forth. The hyper is caused by the release of thyroid hormones into your blood due to the destruction. The hypo is caused by the lessening function of your thyroid due to the attack. If you do have Hashi's, you may have to insist to your lab-obsessed doctor to let you raise by the elimination of symptoms, not labs, due to this reality.

Also, knowing if you have Hashimoto's tells you that you may need to be on the watch for other immune problems, now or later.

You did not say, but I assume that you currently take Levothyroxine. Please always mention your medication and dosage – with nearly 3000 members it is impossible to keep track of everybody's medication. If your high FT3 were caused by an AA attack and subsequent release of thyroid hormone into your bloodstream, then the high FT3 is an artificially elevated figure and you are still very much hypothyroid underneath it all – so in need of more, not less, thyroid hormone despite the high FT3 figure.

PROBABLE auto-immune thyroid disease. From the notes I gather they're putting me down as thyroiditis (not bad enough to be Hashimoto's I *think*). It says "with sub-acute thyroiditis, the [antibody] levels are usually normal or slightly increased." So this is me - sub-acute thyroiditis? is that right?

OK, let's untangle this J - Hashimoto's = autoimmune thyroiditis – it is the same thing, just a more sophisticated diagnosis for the baby to which good old Mr. Hashimoto lent his name. A lab is not a doctor, they don't see you, they don't have your medical history... so unless something is absolutely clear-cut, they cannot diagnose you – they can only say what is probable in light of the lab results in front of them.

As for the term `sub-acute'.... thyroid autoantibodies fluctuate constantly. When they launch an attack on your thyroid gland (or on gluten in your diet) their numbers will rocket (causing acute thyroiditis). When they go into remission, their numbers will reduce (sub-acute thyroiditis).

At the time of your blood draw, your TPO numbers were reduced, but still exceeding the normal ref range – so sub-acute thyroiditis. Whether acute or sub-acute.... you still have Hashimoto's (autoimmune thyroiditis). Nothing will change that until your thyroid gland is as dead as a dodo – THEN you will be well and truly hypothyroid.

We use the term "Hypothyroidism" loosely; strictly speaking Hypothyroidism is the end stage of Thyroiditis (autoimmune or non-autoimmune). So until our thyroid gland and its function has been totally destroyed, we are not "hypothyroid" but suffer from thyroiditis (inflammation of the thyroid gland). But the whole subject is confusing enough as it is, so we all know what is meant when we speak of Hypothyroidism and being hypothyroid.

Next is 'Lower than optimal Thyroxine T4 level' presumably in referral to the total T4 as the FT4 is in the optimal range - but I think still low at 13.3 even though it's crept up a point. I'm assuming that's due to me addressing the vit/min deficiences?

Could be and supplements will help… - but do bear in mind that thyroid levels do not stand still. They fluctuate all the time depending on your daily activities and hundreds of other personal circumstances. Whether the figure is 12.something or 13.something – fact is, your FT4 is still too low. The FT4 should be in the upper third to near the top of the ref range in a medicated patient.

Last bit says SUSPECT a possible iodine deficiency or T3-based supplementation.

So - am I right in thinking the iodine deficiency isn't linked to the antibodies so I still have sub-acute thyroiditis regardless? I've just started taking kelp tablets - if I do manage to get an iodine test should I stop taking thosebeforehand?Iodine deficiency is very likely. I am not very good with the instructions for taking iodine, but I am sure somebody else will be along to help with that and advise about the use of Kelp tablets…. I think you might need something like Lugol's solution rather than Kelp tablets….

And yes – a possible iodine deficiency has – as far as I know - nothing to do with AA's (autoantibodies). AA's are diagnostic for autoimmunity. Iodine is a building block for producing thyroxine and it is helpful in other respects, like the prevention of breast cancer.

I'm confused with the FT4/FT3 ratio - that is low, does that indicate a conversion issue or the opposite (whatever the heck that is)? But the FT3 is high - hence the confusion!

Sorry – I don't understand this ratio-business myself, but in my view you are still a long way off optimal thyroid medication, you are undermedicated and the high FT3 is a red herring. In my personal view there is nothing better than natural desiccated thyroid and since you have already got Armour in your cupboard I assume you are itching to switch over.... I would do too...

I hope somebody in the know will be along and help you with the iodine issue. According to Dr. Peatfield most of us are iodine deficient and even people with Hashi's should take it, although there is another school of thought, which says that in case of Hashi's iodine is contraindicated. I don't know who is right; I have tried Iodine supplementation (Lugol's solution as well as Kelp) and I cannot tolerate it. I have tried salt loading – it did not work. Iodine makes me dizzy beyond the level of tolerance. So I have given up with Iodine and just stick with my NDT.

I hope this makes things a little clearer, Niki J

With best wishes,

[Guest guest]

Thanks .

I didn't mention meds because I'm not on anything - I've been waiting to get

this test done before I decide what to do next. As I said I have generic Armour

sat waiting in the cupboard - I ghighly doubt that the endo will prescribe me

levo even with the a-b results because everything else is in range.

I'll go read that page now, ta.

Niki

[Guest guest]

A bump and a question.

The file on how to use NDT - the actual dosing instructions read as for someone

who's already on levo and is switching over - should I be starting it the same

way or have I missed another file on starting from scratch with NDT?

Or, anything specific I should know as someone who's never taken any form of

thyroid hormone?

Thanks,

Niki

[Guest guest]

The file on how to use NDT - the actual dosing instructions read as for someonewho's already on levo and is switching over - should I be starting it the sameway or have I missed another file on starting from scratch with NDT?

Hi Niki,

Not sure what it says in the file, but since you are starting out with NDT and don't switch over from Levo, I would say start with ½ grain (half a tablet.... you are taking Thiroyd, right?) in the mornings, at least one hour before breakfast and stay on that dose for at least a good week or two, but longer (up to 4 weeks) until you feel "ready" for an increase.

Since you have never used any thyroid hormone before, your body needs to get used to the active hormone (T3) in the tablet slowly; it can come as quite a shock (in a good way) to the system. The main thing is to take things slowly – don't rush it, that would be the biggest mistake.

As a rule of thumb – when you start out, start with ½ grain, stay on that for up to 4 weeks. When you feel ready double the dose to ½ grain am and ½ grain pm. Make sure to take the afternoon dose at least 1 hour before any food or 2-3 hours after you had some food. You can take Thiroyd sublingually or swallow it – personally I feel no difference, but some people do find it more efficient when taken sublingually. Thiroyd does not have an unpleasant taste – bit like Papaya.

Good luck, Niki - and please let us know how it's going. With a bit of luck you should start feeling better in about 10 days – but don't hold me to that. We are all different and it is a long road to full recovery.

Love,