Pls help with my Thyroid results

Pls help with my Thyroid results

I need some advise pls.I am still hypo but my dr.says that my thyroid is OK.

Free T3 3.61 Pmol/L (4-8.3)

Free T4 10.75 Pmol/L (9-25)

TSH 3.65 ulLU/ml (Euthyroid 0.25-5/ Hyperthyroid :<0.15 /Hypothyroid :> 7.0)

IRON 53 ug/dl (37-145)

Folate ↑ >20.0 ng/ml (4.8-20.0)

Vitamin B12 ↓ 117 pmol/L (156.1- 698)

CREAT 0.7 mg% (0.5-0.9)

UREA 19 mg% (upto 40)

The doctor didn't do my Vitamin D test because he said that I don't need it.But last time when I had my Vit.D tested,it was 49.5. I am still maintaining it.So I am assuming it to be around 40-50. (I know it's still low)

I have attached my CBC report and as you can see,I have Leukopenia.I don't see any improvement in my blood count even though the doctor's say that my thyroid is OK.

I have no choice then to self medicate because the doctors won't help me.I don't think Levothyroxine is enough.It's just keeping me sick.

I am tired all the time and I am tired of mucus in my throat,chest and cough.Doctor's blame everything on my low immunity but don't adjust my thyroid medication to treat the low immunity.

I have lost all interest in life.My symptoms are endless but thank god,I haven't gained any weight.But I am too weak and look anorexic.

My urinalysis doesn't look normal and the dr has asked for Urine culture.I will get the results after 3 days.

Looks like I got urine infection again :(

Color Yellow

Appearance Turbid

Protein Nil

Glucose Nil

Blood Nil

WBCs 5-10

RBCs 0-1

PH 5

Spec Gravity 1.020

Bilirubin Nil

Urobilinogen Norm

Acetone Nil

Nitrate Pos

Comments : Epithelial +1

(All tests were done on the same day i.e in the morning and on fasting)

Some more info.

My basal body temperature is 36.2-36.3 and resting pulse rate is around 80-90

4 Replies

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  • Your GP's understanding of fine thyroid levels leaves something to be desired. Your TSH is too high, your FT4 too low, and your FT3 is below range because you are undermedicated. The goal of Levothyroxine is to restore euthyroid status and for most this will be when TSH is just above/below 1.0, FT4 in the upper quadrant of range and FT3 near, or in, the top third of range. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email louise.warvill@thyroiduk.org.uk for a copy of the full Pulse article if you would like to show it to your GP.

    I don't know that more thyroxine will do anything to improve a low immune system but UTIs are common when undiagnosed and undertreated, and chest infections may improve when weak chest muscles strengthen and lung function improve on optimal medication.

    I think you will be feeling very sick due to thyroid undermedication and B12 deficiency. B12 117 is deficient. Your GP should investigate whether deficiency is due to pernicious anaemia by checking intrinsic factor, gastric parietal cell antibodies, red blood cell count and MMA. You need B12 loading injections on alternate days until neurological symptoms resolve and to restore B12 to replete. If you have pernicious anaemia you will require lifelong B12 injections if you have pernicious anaemia.

    b12d.org/b12-signs-symptoms...

    VitD 49.5 is inadequate. 75-200 is replete. How much D3 have you been supplementing and for how long?

  • Thanks for replying.

    I am taking 5000 IU once a week now.Before that I was taking 5000 IU daily.I took that for 2 months and my Vit.D went from 20-49.5 easily.

    I take extra vitamin D when I feel like I am going to get flu or respiratory infections and this helps me from getting more sick.So I know that I need to increase my Vit.D dose.

    Do I need to take Iron and folate? My doctor gave me Iron+Folic acid lozenges.But I stopped taking them about 10 days ago.If my iron and folate are optimal then I won't take them.Regarding Vit.B12,the doctor gave me Methycobalmine 500mcg to be taken 3 times a day.

    I can't afford further tests this time so I'll have them later.

    I read somewhere online that respiratory and urinary tract infections are due to hypothyroidsm (i think it was low t3).And also low blood cells is due to hypothyroidsm because bone marrow needs a certain temperature to make new blood cells and since body temperature is low in hypothyroidsm,it makes sense why my blood count is low.

    Anyway,can you pls tell me if I will benefit from adding T3 to my T4?

    I am currently talking 50ugx5 days and 25ugx2 days.

    How much T3 should I add to my T4 and how should I take it?

  • SA, If you are in the UK your GP can and should test for pernicious anaemia on NHS. I see RBC is on your pic above and everything is in range, just. 1,500mcg methylcobalamin is wholly inadequate to treat B12 deficiency, you should be given injections.

    b12deficiency.info/what-to-...

    Iron seems low in range and haemoglobin (HGB) is bottom of the range so I would continue supplementing iron. Folate doesn't need improving.

    It would have been better to continue 5,000iu daily until vitD was >75. I would up the D3 to 5,000iu alternate days until April.

    You will benefit from increased Levothyroxine which your GP should prescribe, and T3. I would start with a quarter tablet (6.25mcg) T3 added to your Levothyroxine dose to see how well you tolerate it. If you feel okay, after a week increase to 12.5mcg split into 2 doses 6-8 hours apart. A further increase a week or two later to 18.75mcg is unlikely to push your FT3 over range. I would recommend holding at 18.75mcg for 6 weeks and test FT3 before increasing further. 18.75mcg T3 is equivalent to 56.25mcg T4 which is more than double your current inadequate dose. Your TSH will be lower, perhaps even suppressed, and FT4 will be lower, maybe below range, but FT3 should be mid-top of range.

  • @Clutter

    Thanks Clutter,you are so helpful.I will follow your advise regarding Vit.D supplementation, Iron and B12 injections.

    Can you pls tell me what do you think optimal levels should be for B12 and iron?

    GP won't prescribe T3.I will have to buy it online.But I can ask for increase in T4.

    Can you pls tell me what do you mean by "suppressed TSH"?

    Will it be lower than 1?

    My TSH was 0.04 when I was taking 50ug daily and that's why the dr.reduced it to 5 days only and 2 days,25ug .I think he will increase 50mcg to 6 days and 1 day 25mcg.

    But even if I continue the same dose of T4,shouldn't adding T3 will lower TSH anyway?

    I also noticed something strange when I was comparing my previous results with the latest.Last year before starting T4,my TSH was 13.3 and FT3 was 4.19,FT4 was 10.61.

    I have been telling all the drs that I have been to that I was better before taking Levothyroxine and they don't believe me.It's very surprising to see that even after 14 months of taking Levothyroxine,my FT4 is almost the same, infact it further lowered my FT3.

    I am on my own now to find a solution to balancing my thyroid hormones.

    Can you also pls tell me if FT4 should be in the upper quadrant of the range ( 9-25),does it mean FT4 should be around 14-16?

    and FT3 (4-8.3) should be around 6?

    Lastly,when I start with T3 (i.e 6.25mcg),should I take it at the same time I take T4?

    And if I am taking 25mcg any day,should I take 6.25mcg T3 or half it?

    I am sorry for so many questions and also apologize if any question was dumb.

    Thanks again for your help. :)

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