Hi, my mum (72) has had increasing hypothyroid symptoms over the last 20 years. In that time she has only seen one endocrinologist who determined her over medicated on TSH results only so she has struggled to get thyroxine. She is currently on 125g although her GP wants to reduce it. She's just found another doctor willing to do all the tests however despite asking the lab only did the following:-
Vit D63nmol/lrange 50-150
Vit B12419ng/lrange 180-914
ferratin135 ug/lrange 20-275
Folate9.1ug/lrange 2.7-34
Cortisol (done at 1pm) 356nmol/lrange 101-536
FT423.4 range 9-20
TSH0.01mu/l range 0.35-5
She is seeing a new endo this Monday, any advice on further tests she should ask for? Any help would be much appreciated.
As an aside I had a TT last Dec due to a substernal MNG and my sister had a HT last Nov due to a abnormal FNA of her MNG so thyroid problems seem to run in the family.
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mrsm49
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Your Mums TSH is supressed and this could be just because she's taking some thyroxine. It doesn't necessarily show that she's overtreated which is what GPs sometimes assume. My TSH became supressed when I started thyroxine and stayed that way. I have always had to adjust according to how I feel. I don't know if your Mum is just like me. I would ask for a trial of T3. You could ask for free T3 to be tested first, but if it's in range then that won't be much help. If T3 helps her, she will know within a few weeks, at least for me it was three weeks before I started to improve on T3, which isn't what you necessarily expect knowing its a short acting drug. T3 is more likely to be necessary as your mum has been on thyroxine for a while. I feel that T3 is much better for my brain. Wish your Mum good luck. If Endo doesn't help, ask for the list of helpful Endos from louise on this site. How lovely that you're posting on her behalf, she 's very lucky in that respect, hope she's soon feeling better.
She should have her fT3 tested. Her fT4 is above range at this dose. How does she feel? If she feels well, then refuse to have dose reduced unless her fT3 is also tested.
Thanks gabkad, I'll tell her to ask for ft3. To feel well should she be high/low in the range with ft4 & ft3? She's suffered since they reduced her from 150 to 125 and they're wanting to reduce further because of tsh although reduction hasn't had much effect on tsh at all.
People who take thyroxine should have all three tests done. I know, it's not being done. Possibly she's not converting. Why? Who knows. Her other results look good. Possibly talk to the doctor and convince him/her to prescribe 5 mcg of T3. That's not much. But it can make a huge difference. And at such a low dose, the doctor shouldn't be scared. Add it on, reduce the T4 to 100mcg. But then see how she feels because it takes time for the T4 in the body to go down from taking 125 to 100.
Did your Mother take levothyroxine on the morning of her blood test? If so her results could be skewed re thyroid hormones. Blood test should be taken with a gap of about 24 hours between the last dose and blood test. Take levo after test.
Don't permit the doctor to drop her dose. Many of us need a very low or suppressed TSH to feel well. I don't know if your Mother is well or is she having clinical symptoms?
Some of us need the addition of some T3 to our T4, in that case the Endocrinologist might reduce her levothyroxine by 25mcg and add 10mcg of T3. Read the first two questions/answers:
Your mother's B12 should be higher, although it's in range. She can supplement with B12 methylcobalamin sublingual. People over 60 should have at least B12 around 600 as there is a danger of alzeimers etc or other problems. We cannot overdose on supplements as the body takes what it requires and excess is excreted.
No shaws,thanks to reading this site I had told her not to take thyroxine before test . No mum's not well , it may b something else she needs (ie not more t4) she's also has loads of food allergies that cause weakness & voice problems (she thinks this is blood sugar related) I just wish they would investigate properly. She's going to try b12 & ask the new endo on Monday for a ft3 test or a t3 trial. Thank you for your help.
I didn't feel well at all on T4 but when 10mcg was added I felt an immediate improvement. I hope at least your Mother is given a trial and hope the Endocrinologist is kind and sympathetic. You wouldn't believe what experiences some members have from professionals who are not in the least helpful.
I can believe it, I was with my mum at her first endo appt about 4yrs ago . When my mum cried because she wasn't getting anywhere the endo said people treat thyroxine like cocaine and she wasn't having anymore as her tsh was low. The endo then subsequently wrote to mums gp saying she was aggressive. My mum bless her hasn't an aggressive bone in her body. She has just moved house and the new doc told her about the letter as its on her notes and from the way she treated mum had already prejudged her. Hopefully the new gp and endo will help. Watch this space...
You know mrsm, it always surprises me that intelligence doesn't equate at all sometimes with 'common sense'.
If your Mother's Endos description of the 'effect' of taking levothyroxine was true, why would all of us be complaining about it - would we want to be addicted to it? They talk a lot of nonsense really.
They are completely uneducated about the metabolism and the effect of thyroid hormones have on our bodies, particularly the lack of hormones which make us well - levothyroxine doesn't always accomplish this but we have to find this out the hard way by being ill for months or years on end and being told there is only 'one' product or bloods are 'normal'. The pity is the patient feels anything but normal and that's supposed to be the aim of getting a replacement hormone.
Oh dear, there are so many moronic endos in this world! Moronic and unkind!
With an FT4 that high, and still feeling unwell, she's more than likely not converting very well. But you can only tell for certain if the FT3 is tested. But in any case, a little T3 added to her T4 would do her the world of good. The frees should be high in their range.
I agree with Shaws that her B12 should be higher. So should her vit D, ferritin and folate.
I would suggest sublingual methylcobalamin daily - about 2000/3000, with a B complex containing methylfolate for the B12 and folate. And a couple of thousand vit D3 daily. Also, lots and lots of vitamin C to help absorb all that.
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Help with Mum's Results Please
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