Results advice

[Bagpuss123]

Hi. I've just had the results from my private thyroid test and hoping to get some advice please. I had a total thyroidectomy a year ago and have been taking levothyroxine since. The gp keeps changing my dose up and down and my levels have been up and down. I am currently taking 100mg.

T4-111. (58-154)

Tsh-1.55 (0.4-4.1)

Ft4-16.3 (10-22)

Ft3-4.33 (2.8-6.5)

Ft4:ft3 ratio-3.8 (2-4.5)

Rt3- 0.55 (0.14-0.54)

Tg-<20 (0-40)

Tpo-20.2 (0-35)

Doing the ft3/rt3 myself- 4.33/0.55= 7.8 (is this correct?)

My gp is pretty clueless so would like to go armed!

Many thanks in advance!

[rosetrees]

How do you feel and do you have symptoms?

[Bagpuss123 in reply to rosetrees]

Feel exhausted all the time even after a good nights sleep. Low mood and mood swings. Dry skin. Limp hair. Periods have stopped, again. Before dose change from 112.5 was feeling anxious, tearful, unable to cope, high heart rate at rest, palpataions.

[rosetrees in reply to Bagpuss123]

Have you considered that you might have adrenal problems? There's a good questionnaire here adrenalfatigue.org/take-the...

If that sounds like you, order the saliva cortisol test from thyroiduk.org.uk/tuk/testin...

[Clutter]

Bagpuss, If you're symptomatic there is room for small dose increase, IMO. This will reduce your TSH and improve your FT4 and FT3 levels. TSH of people on medication is usually comfortable just above or below 1.0. Scroll down to Guidelines and Treatment Options to read Dr. A. Toft's comments in Pulse Magazine thyroiduk.org.uk/tuk/about_...

If you want a copy of the article to show your GP email [e-mail]

TPO and Tg results mean you are negative for autoimmune thyroid disease antibodies (Hashimoto's).

Ask your GP to test ferritin, vitamin D, B12 and folate as hypothyroid patients are often deficient/low and these deficiencies can cause musculoskeletal pain, fatigue and low mood similar to hypothyroid symptoms. Good ferritin (70-90) aids absorption of Levothyroxine and good levels of vitD (75-200) aid conversion of T4 to T3. Post your results with the lab ref ranges (the figures in brackets after your results) in a new question and members will advise whether supplementation is required.

I don't understand T4:T3 ratios and rT3 and I doubt your GP will either. Happily there are members here who do and will be able to interpret.

[Bagpuss123 in reply to Clutter]

Just had a thyroxine reduction from 112.5 as was feeling very bad. Anxious, high heart rate. My dose has been up and down all year! I was wondering if I needed t3!

[Clutter in reply to Bagpuss123]

Bagpuss, Your FT3 could be higher but it doesn;t look unduly low. Frequent dose changes upset metabolism so see whether your symptoms improve on the reduced dose. If not, ask for a small amount of T3 in addition to a reduced dose of T4 and see if that helps. T3 seemed to calm the adverse side effects I experienced on T4 only as well as improving my very low FT3.

Good levels of vitD (75-200) aid T4 to T3 conversion and you should also have your ferritin, B12 and folate checked as they're often low/deficient in hypothyroid patients.