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Help with thyroid bloods

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bot8675309

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I'm on levothyroxine for hypothyroidism. It's a new medication for me so i am still in the adjustment period. A recent round of bloodwork shows that my number are improving but TSH has not improved at all.

I'm not sure what to make of this. Does anyone have knowledge on this subject? I do have a follow up consult with my doctor but wanted to get the thoughts of others as well.

thank you for reading
 

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TSH
FT4
FT3

as a start. Your labs (except TSH) are outdated tests. Knowledgeable provider won't order the ones you shared.

Autoimmune issues? Autoantibodies?
 
bot8675309 said:
I'm on levothyroxine for hypothyroidism. It's a new medication for me so i am still in the adjustment period. A recent round of bloodwork shows that my number are improving but TSH has not improved at all.

I'm not sure what to make of this. Does anyone have knowledge on this subject? I do have a follow up consult with my doctor but wanted to get the thoughts of others as well.

thank you for reading
Click to expand...
Been diagnosed hypothyroid for over 12 years now. Had the same basic experience at the start. GP started me at 80mg Levothyroxine but they had to keep upping it. 100, 120, the again at some point to 140 to keep the numbers in the correct range. A few years ago I switched to NP on advice from a TRT doc. Maybe felt some benefit, (more energy). Had to up it again about a year ago. Now on NP 150mg/day... Just had blood done and BAM, numbers off again. See below.
I'm going to find an endocrinologist! Way overdue. I suggest you do the same.
 

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readalot said:
TSH
FT4
FT3

as a start. Your labs (except TSH) are outdated tests. Knowledgeable provider won't order the ones you shared.

Autoimmune issues? Autoantibodies?
Click to expand...
Interesting. How long has this been the standard? I wonder if I've ever had a GP order an FT3? Healthcare has gone to hell in the US. Respectfully, are you the resident "expert" on thyroid issues?
 
readalot said:
Yes.

You'll need to provide more info to get any help. Baseline labs. Med dosages. Time on. Etc. Etc.
Click to expand...
1000002254.webp1000002256.webp

1000002258.webp
Thanks for the reply


Yeah, I suppose baseline stuff would help. Makes sense.


These are baseline. I've had one adjustment to medicatIon. I started at 25mcg for a couple months (late June through the end of August) and then it was adjusted for a few more months to 75mcg. There are bloods that prompted the increase in dosage but I don't see them in my patient portal. I remember them being slightly higher than baseline but nothing moved out of the red. Exact numbers escape me.





readalot said:
TSH
FT4
FT3

as a start. Your labs (except TSH) are outdated tests. Knowledgeable provider won't order the ones you shared.

Autoimmune issues? Autoantibodies?
Click to expand...

Noticing the baseline bloods do not match what I had done for my second bloods. Obviously something off there. The bloods posted here are more in line with what you'd say is correct?

No autoimmune issues or anything that I know of. Would there be blood work to help indicate if there might be? I had a decent workup done when I started this back in July or June so maybe I have them?
 
YatesIsBased said:
Been diagnosed hypothyroid for over 12 years now. Had the same basic experience at the start. GP started me at 80mg Levothyroxine but they had to keep upping it. 100, 120, the again at some point to 140 to keep the numbers in the correct range. A few years ago I switched to NP on advice from a TRT doc. Maybe felt some benefit, (more energy). Had to up it again about a year ago. Now on NP 150mg/day... Just had blood done and BAM, numbers off again. See below.
I'm going to find an endocrinologist! Way overdue. I suggest you do the same.
Click to expand...

Thanks for sharing. What is NP?

GLR pfp? Awesome
 
bot8675309 said:
View attachment 303959View attachment 303960

View attachment 303961
Thanks for the reply


Yeah, I suppose baseline stuff would help. Makes sense.


These are baseline. I've had one adjustment to medicatIon. I started at 25mcg for a couple months (late June through the end of August) and then it was adjusted for a few more months to 75mcg. There are bloods that prompted the increase in dosage but I don't see them in my patient portal. I remember them being slightly higher than baseline but nothing moved out of the red. Exact numbers escape me.







Noticing the baseline bloods do not match what I had done for my second bloods. Obviously something off there. The bloods posted here are more in line with what you'd say is correct?

No autoimmune issues or anything that I know of. Would there be blood work to help indicate if there might be? I had a decent workup done when I started this back in July or June so maybe I have them?
Click to expand...
Who is managing your care? PCP? Your TPO antibodies (autoimmune disease) are through the roof and your TSH is very high. You are severely undermedicated on levothyroxine. TSH target should be < 3.
 
readalot said:
Who is managing your care? PCP? Your TPO antibodies (autoimmune disease) are through the roof and your TSH is very high. You are severely undermedicated on levothyroxine. TSH target should be < 3.
Click to expand...
Yes. It is my pcp.

I have a follow up in a handful of days and it's obvious that another jump in dosage is needed.

I'm seeing literature online saying 1.6mcg per kilo of bodyweight per day for an adult, generally speaking. At a weight of 260 that put my dose around 190mcg daily. I know dosage can differ depending in factors but does that sound like a more reasonable dose?
 
bot8675309 said:
Yes. It is my pcp.

I have a follow up in a handful of days and it's obvious that another jump in dosage is needed.

I'm seeing literature online saying 1.6mcg per kilo of bodyweight per day for an adult, generally speaking. At a weight of 260 that put my dose around 190mcg daily. I know dosage can differ depending in factors but does that sound like a more reasonable dose?
Click to expand...
Yes. But you may need quite a bit more with autoimmune disease. Trial and error. I'm on ~360 mcg/day (just as anecdote). Your TSH level really hard on the heart.
 
readalot said:
Yes. But you may need quite a bit more with autoimmune disease. Trial and error. I'm on ~360 mcg/day (just as anecdote). Your TSH level really hard on the heart.
Click to expand...

I didn't realize that TPO number was so high. Seems unreal high. I have some questions for my pcp now that I didn't have before.

Thank you for your time and input guys. I'll try to follow up after my next dr appointment
 
readalot said:
Your TSH level really hard on the heart.
Click to expand...
Do you perhaps have a reference for this claim? My understanding is that low TSH increases atrial fibrillation risk, but that high TSH is generally not an issue for cardiovascular health.
Genetically determined lower TSH levels (odds ratio 0.928; 95% confidence interval 0.884–0.974; P = .003) and genetic risk of hyperthyroidism (odds ratio 1.049; 95% confidence interval 1.016–1.083; P = .003) were associated with increased AF risk. These associations remained significant even after adjusting for cardiovascular risk factors. Colocalization and multivariable Mendelian randomization revealed height as a key mediator between TSH/hyperthyroidism and AF. These findings were further corroborated in the independent FinnGen cohort. However, no clear evidence was found for relationships between thyroid function and other cardiovascular outcomes and cardiac structure and function.
Click to expand...
 
narta said:
You have hashimoto's? It takes time to normalize things, a year or even more till your doctor nails the dose
Click to expand...
Suppose it's possible. Some of the symptoms fit. I'll bring it up to my pcp

fatigue; extra sensitivity to cold; dry skin; muscle stiffness are the symptoms that stand out the most with the first two being the most prominent
 
bot8675309 said:
Thanks for sharing. What is NP?

GLR pfp? Awesome
Click to expand...
NP is comparable to Armour. It's a naturally derived desiccated thyroid extract (DTE). (porcine-derived aka pig thyroid) Difference being that it is non-synthetic and contains both T4 & T3. Some people report "feeling better" on one vs the other. Good luck getting it dialed in. Your inquiry reminded me that I need to get mine dialed in too. -Gott mit uns!

​

 
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