Help with next steps please.

[JennyC2]

Thyroid, B12 and Ferritin results. Not feeling great but I am not sure what to do. My results are

Ferritin 220.6 (20 - 150)

Vit B12 855 (142 - 725)

Free T4 13.42 (13.9 - 26.1)

Free T3 5.59 (4.5-10.5)

TSH 0.01 (1.36 - 8.8)

I take 25 T3 and 75 T4. I also take a multivitamin with iron and 1 Jarrows B12 each day. I take thyroid meds in the morning an hour before breakfast and the other two last thing at night.

I am much improved following the T3 prescription about 18 months ago but currently am lacking energy and some of the brain fog/ poor memory/feeling low has returned. I am not sure about increasing the T3 since it does seem to raise my heart rate.

My GP is quite helpful but doesn't seem to know too much about differing thyroid meds.

Can anyone help or advise me please?

Many thanks

J

[Clutter]

Hi Jenny,

I've not seen TSH and FT3 ranges like those, what area are you in?

Suppressed TSH and low FT4 are to be expected when you take T3. Your FT3 is low in range though and may be why you're experiencing brain fog and lack of energy.

It's usual for heart rate to raise an hour or two after a dose of T3 but it should return to normal within another hour or so. Have you tried splitting the 25mcg into two doses 6/12 hours apart to see whether the raise in heart rate is reduced? You might try this for a week. Some people feel an energy slump a few hours after taking T3 and splitting dose can even out the peaks and slumps.

If splitting dose makes the heart rate increase more tolerable you could try increasing T3 by a quarter tablet (6.25mcg) and reducing T4 by 12.5mcg and see whether brain fog and energy improve.

Ferritin is over range which can be due to having a cold or virus at the time of testing or inflammation somewhere in the body. It isn't anything to be concerned about but ask to be retested in 6 months. In the meantime, you don't need the iron in the multivitamin so stop supplementing unless you can find a multivit without iron.

B12 is good at the top of range. It will usually be high when supplementing and as it is water soluble any excess will be excreted in urine.

Ask your GP to do a vitamin D 25 OH test. Most hypothyroid patients are low/deficient in vitD unless they supplement and symptoms can be fatigue, musculoskeletal pain and low mood similar to hypothyroid symptoms. Good levels of vitD aid conversion of T4 to T3.

[JennyC2 in reply to Clutter]

Thanks Clutter. I live in the North West - is that important?

I notice the increased heart rate mostly at night - probably because I am not doing anything else. It gets to about 85 which is high for me. I haven't had Vit D tested since last year and it was ok then. I will take your advice and get it tested again.

Thanks again.

J

[Clutter in reply to JennyC2]

Jenny, no it's no important, I was just intrigued

[JennyC2 in reply to Clutter]

Sorry - did you mean where was I tested? It was Blue Horizon☺️

[Barrister]

It isn't clear from your post whether you have had a raised ferritin result in the past? If you have it may be worth talking to your GP as high levels of ferritin can indicate Haemachromatosis, in which case you really do need to know about it. Clemmie

[JennyC2 in reply to Barrister]

I am not aware of previously high levels but I will look it up.

Thanks for responding. J