Shall I raise levo?

[janiebell]

hello clever people, what would be your thoughts on raising my Levo a smidgen? I currently take around 135 mcg of levo per day ( I say around because I take a 100mcg tab and a 25 mcg tab and then I break a 25 mcg tab and take half of that or there abouts). This time last year my Tsh was suppressed at 0.1 and my t4 was 20.0 (12.0-22.0) and t3 was 4.8 (3.1-6.8) so all good. This year my TSH has gone up to around 1.3 and my free thyroxine was just above range at 25.0 (12.0 - 22.0) my t3 was 4.9 (3.1 -6.8). The bloods were drawn in the afternoon and I had not taken levo dose for previous 24 hours. IT was suggested I reduce my levo because my t4 was above range. I didn't do this. I have just had TSH taken again ( lab wouldn't test t4 or t3) and my tsh is still at 1.3. Shall i up my dose a bit to 140mcg? I prefer my tsh to be under 1 but maybe that isn't essential if my t4 and t3 are in top of the range. Is 4.9 good for t3? Is it ok to have a t4 above range at 25? I don't feel hyper at all infact I still feel pretty tired and am puffy. I follow a gf diet and my ferritin, vit d and b12 are all excellent. I am menopausal so my sex hormones dropping could have effected my tsh maybe? Also my very recent bloods showed a below range Eosinophil count - at 0.08 10*9/L [0.1 - 0.4] I looked this up and it mentioned cushings disease???! Sorry for such long post but would be very grateful for any advice.

[Musicmonkey]

How are you feeling janiebell? You say tired and puffy, and your TSH has gone up slightly. Lol, you sound a little like the GPs and Endo's as most of your post is about the TSH, but I understand why you would worry about that given the focus on it by the medical profession.

I am no expert, and hopefully someone more knowledgeable will reply, but I think your T3 could afford to be higher in the range, yet your T4 is outside of range. Perhaps you are not converting?

Do you know what kind of hypothyroidism you have? Primary? It may be that you have secondary and therefore not converting T4 to T3 very well.

I hope you get some other answers.

[janiebell in reply to Musicmonkey]

Thanks for your answer. I have Hashimotos so would that be secondary? Yes, I would like my t3 up a bit but I saw an endo in London last year who said I didn't need t3 and was converting well. My t4 wasn't above range then however. I'm off to the gps now to ask them to request (again) t4 and t3. They always do but the lab won't test. Grrrrrrrr.

[Musicmonkey in reply to janiebell]

I think I am right in saying that if you have Hashimoto's you fall within Primary Hypothyroidism.

[greygoose in reply to Musicmonkey]

Hashi's is autoimmune thyroiditis. And it could be that the TSH is high or it's low. People with Hashi's often have trouble converting.

Secondary hypothyroidism is when there's a problem with the pituitary, it doesn't produce enough TSH so the thyroid gland is not stimulated to make hormone. Levels fall, but the TSH does not rise. Nothing to do with converting.

[greygoose]

Well, an over-range FT4 isn't going to make you 'hyper' (over-dosed), it's an over-range FT3 that would suggest that. And your FT3 still has a long way to go!

Think is, though, you're not converting all that T4, are you. You've already got a load of it sloshing around in your blood unconverted. Adding more won't do much good. What you really need is a bit of T3 to bring up that FT3 level.

I would certainly want my FT3 a lot higher than that - it's only just over mid-range. But the big question is : how do you feel? If you still have hypo symptoms, then some T3 added would probably take care of them. But if you feel good, why not leave things as they are?

In any case, it doesn't matter how low your TSH goes. It is of absolutely no importance. The important number is the FT3.

Cushing's Disease is when your adrenals are making too much cortisol. You could ask your doctor to do a short syn... (forgotten the word) test where they stimulate the adrenals to see how much cortisol they make. Or, you could do a private 24 hr saliva test. I think, myself, I would prefer the saliva test, and if that shows high, then consult your doctor. But you won't get it on the NHS, it has to be private.

But that's all just my opinions, and I'm not a doctor!

Take care.

[janiebell in reply to greygoose]

Hi grey goose, thanks v much for all your info. Honestly, I really don't know how I feel! I'm struggling with menopause at the mo and trying bioidentical hormones which are working. I would love to try a nature thyroid as it would cover the t3 issue but can't afford it on top of the bioidenticals. I think I will let the bio identicals settle in and hopefully get that sorted and then look at t3. Is it poss to just take a tiny bit do you know? When people start t3 is it because their t3 level is bottom of the range or can you have it middle of the range and still feel the effects of not having enough?

[greygoose in reply to janiebell]

The majority of people need their FT3 up the top of the range to feel well. So, yes, you could feel bad with it mid-range.

As for taking a tiny bit... you might only need a tiny bit, impossible to say. But, you need as much as you need. A tiny bit might not be enough to make you feel well. That's all I can say. Sorry.

[janiebell in reply to greygoose]

Ok, will deff look at t3 issue. I've blindly gone along not realising that t3 needed to be top of range. I thought mine was ok and when I read about people with low t3 assumed it was below range or at 3.8 etc. Thanks very much for your help.

[greygoose in reply to janiebell]

You're welcome.