Could you give me some feedback on my recent blood results. My doctor tells me all is fine but I don't feel fine.
She thinks my problems are psychological...hard to tell as I experienced overt hypothyroidism this year for the first time due to another doctor's lack of knowledge and insistence....which was very destabilising, as I had never before experienced such bodily discomfort over an extended period of time and needed to self medicate to subdue the symptoms (which terrified me as I was scared of what may happen...!!)
I have also attached a file of the most detailed blood work (results are from a German lab but the values are recognisably similar).
TSH basal: 0.23 (Normal value: 0.4-4.0)
FT3: 3.42 pg/ml (Normal value: 2.2-5.0)
FT4: 1.32 ng/dl (Normal value: 0.9-1.8)
Calcitonin: <2 pg/ml (Normal value: <20)
25-OH-Vit.D3: 41.40 ng/ml
Ferritin: 32.50 ug/l (25-150)
B12: 607pg/ml (211-911)
Folic Acid: 16.6ng/ml (>5.38)
I had a complete thyroidectomy in 2011 and was on a dose of 100 until last year and some of this year. I am 153cm tall so, although I have been told it was a light dose for my condition, it appeared.....
However, after this result I visited family in the UK with my 3 small children and experienced hypothyroid symptoms again (extreme tiredness and muscle aches with cramps) so raised my thyroxin by 25 per day. On the next test (after having taken the extra 25 dose for 10 days) the TSH had dropped from 0.22 (slightly high) to 1.0 (high end of normal) which she thought was fine, although I felt it proved a drop had occurred....I have posted questions about thyroxin depletion when activity is greatly increased, with replies that appear to indicate that a depletion old occur...my doctor seems to listen but says it shouldn't make a difference...??
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NadeNud
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I am not an expert and can only write from my own personal experience, but I am of the belief that thyroxine on it's own is not the answer for everyone. Whilst my blood work shows 'normal' I still experience strange things happening with my muscles (aches & cramps), afternoon slumps, restless legs, insomnia... which seem to disappear with the addition of a tiny amount of T3. My body seems to prefer a T4/T3 combination.
I'm a little confused over your last paragraph. Taking more thyroxine should have lowered your TSH... a TSH of 0.22 is low, and to go to 1.0 is a rise in levels. (0.2 - 0.5 - 1.0 - 1.5 - 2 and so on).
Yes, I felt I experienced hypo symptoms due to great physical exertion so I took more. For me, this proves I was depleted and needed more. However, my doctor seemed to ignore the fact that I'd needed more and just said it was still a good result.
If the blood results fit the ranges, most doctors will ignore any lingering symptoms - this is my experience and that of many others... I see from the responses below - yes - keep reading/learning about it! Good luck.
Your ferritin and D3 are both too low and B12 isn't great. Low ferritin means that you can't convert T4 to T3 properly and low D3 can cause aches and pains. So improving iron and D3 status might help.
Most people reckon ferritin 70-90, D3 around 100 in UK units, B12 top of the range or over (as the test isn't very accurate - doesn't apply to MMA or active B12 test. just the regular serum one).
just a little note as the different units of VitD measure can be confusing....
41.4 ng/ml is roughly 103 nmol/l (UK measure) which is quite a good level (for a change!) but it's possible the optium for you could be higher - my tell-tale pains are elbows, wrists and shins. As Angel said ferritin is also low in range - low iron can also cause aches/pains and fatigue. J
It's very annoying that your Doc saw the improvement but didn't acknowledge why
Sorry, Nadenud, but that last paragraph is a bit strange. A TSH of 0.22 is not slightly high, it's pretty good, actually. And it didn't drop from 0.22 to 1.0, it went up - but 1.0 is hardly the high end of normal. 4.0 is the high end of normal.
And your doctor is right. A TSH of 1.0 is fine. Trouble is, the TSH is meaningless. It doesn't tell you how the patient feels. For that, the Free tests are a better indication - but still only an indication. What they should take into account are the symptoms, how the patient feels. But they don't, because they know nothing about thyroid. And they blame lingering symptoms on a low dose as being psycological problems. That's the way it is.
The fact is that your Frees are much too low. Neither of them even reach mid-range, whereas to feel well, most people need their FT3 up the top of the range and the FT4 between mid-range and the top. It's really not surprising you don't feel well with Frees that low.
100 levo is a small dose for someone without a thyroid gland, doesn't matter how tall you are! You need an increase. Or, even better, some T3 added to your dose. How you will persuade your doctor to give it to you, I don't know. But, don't be afraid of self-treating. Lots of us do it. I do it. First you have to learn as much as you can about your disease. Then, you have to take the plunge. Increasing by 25 is not going to make you drop dead on the spot! Your body will tell you over the next few weeks, if it is too much. And if it is, you just lower it again. Hormones have a very bad reputation, so many doctors are terrified of them. That reputation is unjustified. No hormone is going to make you drop dead on the spot, they aren't arsnic or any other poison. They act gradually, so if you know your body, you can adjust them to your needs. Of course, if you take them when you don't need them, over time that's not so good. But you're not going to drop down dead the instant you put them in your mouth. So don't worry.
Thanks for the reply. I'm aware I'm probably using the wrong terminology to describe the highs and lows...I've been on a real learning curve since April with a doctor's incompetence and the subsequent hypothyroidism. Now I can't believe why I never got a book about my condition as soon as I had the operation! Anyway, I now have 'Stop the Thyroid Madness' thanks to this forum...
I'm still learning about these things myself, but I think your vitamin D is OK - to convert ng/ml to nmol/L you multiply by 2.5. Yours would be around 100 so I think that is OK.
Nadenud, low numbers mean you are lacking. Your FT4 is almost in the 'ideal' top 75% of range. Your FT3 could be a little higher. Your recent dose increase should improve your FT4 and FT3 (they don't respond as quickly as TSH to dose changes) and improving ferritin and vitD3 levels will improve absorption and T4 to T3 conversion.
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Further to my last post about Levo and joint pain I now need help to understand my blood results.
Feeling lost! T4-T3 ratio > blood tests results > please advise! 
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