Advice before Monday please

My doctor has phoned for me to come in and discuss thyroid blood results . I asked for a printout so I will be prepared.

What do you think.

TSH 5·76 mu/L. ( 0·35. -5·5 )

T4 15pmol/L. ( 9 - 23 )

T3. 4· 1 pmol/L ( 3·5 - 6·5 )

A TSH only test on April 2nd showed

TSH 3·46 mu/L. Range as above .

A blood panel in October showed

TSH 0·51

T4 17

T3 4·4

I was told by a disinterested doctor in October , to take an extra 25 of Levo ( I was taking 100 )when I asked about some T3.

I tried this and felt awful , so I have been taking alternate 100/125 ,but I don't feel well still.

My vitamins and minerals were all at the bottom last year, and I had hoped when they were sorted ( which they are b12 jabs etc ) I would start to improve but not so.

The young Doctor I am seeing on Monday is very helpful and willing to listen. I gave him Dr Tofts article last time and he took it to read.

Any opinion would be welcome.

Thanks Pp

14 Replies

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  • Pinkpeony, you are undermedicated. People on Levothyroxine are usually comfortable with TSH just above or below 1.0 and FT4 towards or in the top 75% of range >19. When optimally dosed FT3 should be towards/in the top third of range >5.0.

    Dr. Toft discusses dosing and levels in the article you gave your GP and in Treatment Options in the link below.

    thyroiduk.org.uk/tuk/about_...

  • Thanks Clutter

    Would I be justified in asking for a T3 trial?

    Pp

  • Pinkpeony, not unless you are unable to tolerate higher doses of Levothyroxine. T3 is usually prescribed when FT3 remains low on optimal T4 dosing, ie low TSH and high FT4.

    If you can't tolerate higher doses of Levothyroxine it is worth asking for T3 to be added. I found the addition of T3 calmed adverse effects I had on Levothyroxine.

    Some GPs are discouraged from prescribing T3 without specialist recommendation.

  • Hi Clutter

    I was puzzled as to why my TSH has gone from 0·5 to 5·76 in less than six months despite taking a small increase of 75 weekly.

    Thanks for your reply

    Pp

  • Pinkpeony, perhaps your thyroid was previously producing hormone and has now failed or perhaps you are not absorbing the Levothyroxine as well as you were previously. Have you had gut issues or started new medication which may affect uptake of Levothyroxine?

  • Clutter

    My thyroid was destroyed with RAI over two years ago, so not that.

    An Endoscopy in October showed gastritis and I had no symptoms of this.

    I was given Lansoprazole and boy did I get symptoms with that.

    I couldn't take it. I am drinking ACV at the moment.

    Thanks Pp

  • PP, Lansoprazole and other PPIs and antacids are prescribed to reduce stomach acid when there is inflammation and these can reduce absorption of Levothyroxine. I'm not sure it is a good idea to raise stomach acid with ACV when you have inflammation.

    nhs.uk/conditions/gastritis...

  • Clutter , saw doctor this morning and we have agreed to monitor this.

    I do not have reflux just occasional discomfort.

    As to the thyroid blood levels it has been arranged to see Endo on Saturday.

    Incidentally I am taking Dilitziam and Apixaban anti-coagulent also so a bit of juggling with meds and vits.

    Thank you for your replies!

    Pp

  • Your TSH should be below 1

    your free T4 should be in UPPER QUADRANT of its range

    your free T3 should also be in upper quadrant of its range

    sounds to me that your ferritin will be way below required halfway in its range

    and thus your body simply cannot convert T4 into the T3 your cells are screaming for

    hence you need to correct iron and vitamin deficiencies

    take T3 only in the meantime

    take at least 2000mcg of Vit C with iron at least 4 hours away from your thyroid meds

    be sure to take a good multivitamin before bed

    theres research on this forum titled "more on ferritin and folate"

    Plus if you do a google scholar search for hypothyroid +ferritin you should find any research papers to give this new GP

  • RFU and Debby.

    Sorry for delayed reply , feeling lousy today.

    B12 1248 ng/L (190- 910)

    Serum folate 13·8 ng/mL. (3·3-99999 )

    Ferretin 64·3 ug/L. ( 30- 400 )

    These were taken in February

    Cheers to you both

    Pp

  • b12 and folate way over the top

    yet ferritin still pretty low

    Very strange

  • Thanks rfu

    Puzzle for me too.

    Pp

  • Are you still having B12 jabs? If so, how much are they giving you and do you know your B12 levels now?

    I agree with above, Levo won't work sufficiently (if at all ;-) )if vitamin and minerals are not at a good level x

  • Debsy see reply above.

    Thanks

    Pp

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