Blood test result interpretation please

[JanKindon]

Sorry peeps this is a long one, but I'm at a roadblock and not sure where to go from here

I converted to NDT from Levothyroxine approx 5 months ago and after a few problems on Thyroid S where I reacted to fillers and a break of 10 days where I was taking a dose of Levothyroxine half my normal dose, I finally started over on a low dose of Westhroid P on 22nd May. I had 2 NHS blood tests after and paid for a private one too as just couldn't get FT3 from my GP. Anyway they have come back as follows:

22nd June TSH 0.25 (0.35 - 4.5) FT4 10.4 (10.5 - 26)

24th July TSH 0.008 FT4 22.4

11th August TSH 0.005 FT4 14.8 FT3 6.99 (3.1 - 6.8)

24th July Iron 18 (11 - 32)

11th August Ferritin 56.1 (20 - 150)

Now my GP was obviously concerned my first test showed me badly hypo on the first test, but I did start on 1/2 grain WP a day and was on 2 grains by the time the test came about in June. So I increased quite quickly and was on 3 1/2 grains by the time the second test came along, and 3 3/4 by the time he told me the results. Again he was fretting that I would be hyper, tho I really had on symptoms when I had the test or even when he told me the results but I reduced the amount I was taking over the following few days and by the time I had the third test was on 2 1/4 grains. I also discovered when the third (private) test came back that I have raised antibodies so was duly welcomed into the Hashi world yaaaaaaay.

Anyway I immediately reduced to 1 3/4 and could feel the hypo symptoms kick back in within days, so gradually increased over the following days and have now been on 2 1/2 for the last 3 days. Where I find I am pretty much ok most of the time, but will have an occasional crash, the brain fog and forgetfulness is creeping back and also my IBS symptoms constipation and bloating) too because I am craving junk food again aarghhh. I have restarted some of the vitamins and minerals I had been taking but stopped taking 2 weeks prior to the test, as I was reacting to something again, thinking it was the D3 vits (as my level sits at 25), or the K2, iron or B Complex ... all of which I started within a weeks or so of each other. I had been taking selenium, magnesium and B12 for 5 months, but stopped them too.

Last week I restarted selenium; and D3, magnesium and iron in liquid form. I only really need to take the D3 and selenium, but the magnesium and iron are low doses and I'll continue taking them till the liquids are gone

What I am concerned about more than anything is the varying levels in my FT4 results. A Hashi's friend of mine is convinced I'm pooling, but I've had my iron/ferritin checked recently as you can see above and they don't indicate that I am. And although I've not had a cortisol adrenal test done, I did do the extensive questionnaire about 5 mths ago and started supplementing Nutri Adrenal for a few months, but have been off them for about 2 months now and can honestly say don't feel any different to how I felt before or while I was taking them lol. I carried out the adrenal questionnaire again today and it points to me having no adrenal fatigue ... but I knew that anyway. You do know your own bodies after all.

My widely varying FT4 results over the last few months is confusing me. The first hypo one is understandable and the second hyper one too. but the 3rd one is the killer. If I hadn't had the FT3 test which obviously pointed towards me being hyper, that FT4 result probably wouldn't have bar the fact I had a few mild hyper symptoms ... shakes, but not all the times, palps but again not all the time, lost a bit of weight and had loads more energy (liked those 2)

I feel I should get another blood test in the next 4 - 6 weeks, either NHS or pay for my own again, as that will give me FT3 again (I'm more inclined to go for that tbh) but don't want to be wasting any of my time, or my money, unless I can get to the bottom of this.

My friend has tried to convince me I am definately pooling, and she IS more experienced in this thyroid lark than me ... as far as I was concerned I was hypo for 15 years, and now I have discovered I have Hashi's (no idea when all that started tho) but there's a nagging doubt I can't quite put my finger on and feel there may be something I'm missing :/

Anyway back to the crux of this post Before giving into the pooling idea what else could be going on? to make my T4 go from 22.4 to 14.8 in the space of a few weeks. And where do I sit as regards taking NDT now? Would I be better off going the T4/T3 route? I am hoping that the more experienced users of NDT and alternatives of you out there may be able to give me a kick start in the right direction.

Thanking you all in advance

[Clutter]

Jankindo, Raising from 2 grains to 3.5 grains would elevate your FT4. FT3 can lag behind dose reductions longer than TSH and FT4 which may be why your FT3 was elevated at 6.99 after decreasing from 3.75 grains 2-3 weeks earlier. FT4 is generally low to mid range on NDT so FT4 14.8 is good. Ideally FT3 will remain within range.

I think your rapid dose changes are causing level fluctuations rather than pooling. When you are close to your optimal dose it's best to adjust in quarter grain increments to avoid overshooting your 'sweet spot'. Hold at 2.5 grains you are currently taking for six weeks and then have another private test with FT3.

This link explains why dose adjustments need to be steady and gradual.

thyrophoenix.com/adjusting_...

If you suspect you are having an adverse reaction to one of your supplements stop taking them for 2 weeks and then introduce one at a time every two weeks to find the culprit. D3 is available in tablets, softgel capsules and spray if your current D3 doesn't suit. Some people can't tolerate D3 supplements and have to get as much sun as they can to stimulate natural vitD but vitD 25 is very low and it's worth trying alternative supplements to try and raise it.

[JanKindon in reply to Clutter]

Clutter, thank you so much for your reply. It's given me something sensible to hold onto lol. I will check that link out and take your advice and hold on 2 1/2. I actually feel pretty good all in all, apart from the odd symptoms, but I guess some of them could be down to being low in D

I did stop taking the supplements in tablet and softgel form and after an almost 3 weeks break have restarted them on liquid versions and so far, a week in I'm good, no nasty side effects

Onwards and upwards and once again ... thank you

[Hidden]

Hello Jankindon,

I don't take NDT but thought this link may help you.

stopthethyroidmadness.com/m...

I think you are just having a few teething troubles as those who don't do well on NDT usually have trouble raising in the first place.

Hang in there and follow Clutters excellent advice.

Flower007

[JanKindon in reply to Hidden]

Thanks Flower, I've read the original STTM book and perused many STTM links many times. Even that pointed towards me pooling so it hasn't been much help. Tbh I found it pointed far too much towards success stories and made the change from Levo to NDT seem a lot more straightforward than it is. As a result I'm not a massive fan of STTM oops lol