Another adjustment

[Recon]

Ok, so my table needed to first not sure how to move it down, but please read below...

First, thanks for this great community. I have benefited from lots of wisdom and experience over the past three years. Last year my endo freaked when my TSH was low. I attempted to stand up for myself, but was brushed away and told "she was responsible" for me (like she knew ANYTHING about me).

The end result was she lowered my levothyroxine to 88mcg/day (from 100) immediately and she would not reinstate it when I had my appointment. I now take 88mcg levo and 20mcg lio daily. I spent the entire year fuming about this, and have found a private doctor that I am hoping to see in June or July (unfortunately he is on "the other side of the mountain" so driving in the winter/spring can be a journey). I cancelled my appointment with the old endo at the first of this month (which is another gripe I have, how is it that she thinks she is "responsible" for me when she sees me for a total of about 10 minutes a year, but I digress).

My point of this post is to get some feedback. I have been feeling increasingly tired over the past months, my weight loss has stalled, in fact I have gained weight, while continuing a good non-gluten diet (I have autoimmune), exercise, water, timing, etc. I went ahead and got some of my vitamins tested, along with my thyroid basics. I followed the recommendations here on timing (7am), stopping my folate 1 week, delaying my morning dose until after collection, and splitting my T3 the day before. Here are the results (and previous results from last year): (oops they are at the top).

So, I do know I have actively worked on the B12 situation, I also continue to struggle with Vitamin D (I take 5,000 daily, along with the K vitamin) and would like to see that higher, and my ferritin is off the top (and the scale changed, so I don't really know how to compare).

Any suggestions - I really, really am not willing to go back and be a slug (that's what it felt like for years!)

Thanks in advance!

[SlowDragon Administrator]

was test done as recommended

all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

T3 ….day before test split T3 as 2 or 3 smaller doses spread through the day, with last dose approximately 8-12 hours before test

assuming yes

you are now on inadequate dose levothyroxine

Ft4 is below range

Free T3 (fT3) 3.2 pmol/L (2.3 - 4.2) 

Ft3 only 47.4% through range

Get dose increase in Levo to 100mcg daily and retest in 8 weeks

Many, many members on Levo plus small doses of T3 find they need BOTH Ft4 and Ft3 at least 60-70% through range. TSH almost always suppressed on T3 when adequately treated

[Recon in reply to SlowDragon]

Thanks, SlowDragon - that is what I was thinking, too. I did follow protocol for testing, 7am draw, only water, 24-hour for levothyroxine and last T3 at 10pm, so 9 hours prior. I don't think I have ever tested for more than 37% of FT4 through range in the past 3 years. Should I be concerned about the high ferritin? Or is this just another indication of inflammation? Or ?

[SlowDragon Administrator in reply to Recon]

Higher ferritin common after menopause

Updated reference ranges for top of ferritin range depending upon age

healthunlocked.com/thyroidu...

Thank you for your incredible patience while you have been awaiting the outcome of our ferritin reference range review. We conducted this with Inuvi lab, which has now changed the reference ranges to the following:

Females 18 ≤ age < 40. 30 to 180

Females 40 ≤ age < 50. 30 to 207

Females 50 ≤ age < 60. 30 to 264l

Females Age ≥ 60. 30 to 332

Males 18 ≤ age < 40 30 to 442

Males Age ≥ 40 30 to 518

The lower limits of 30 are by the NICE threshold of <30 for iron deficiency. Our review of Medichecks data has determined the upper limits. This retrospective study used a large dataset of blood test results from 25,425 healthy participants aged 18 to 97 over seven years. This is the most extensive study on ferritin reference ranges, and we hope to achieve journal publication so that these ranges can be applied more widely.

[janeroar]

Your doctor is gaslighting you and at same time telling you she is responsible for you. That’s an outrageous power play at the expense of your health. I would get another doctor. It’s clear you need more T4. It’s your body, she clearly is not going to be a part of your future good health.