Brief history is that I've been hypo and on levo since I was 21 (I'm now 40). Only saw an endo for the first time a couple of years ago and was diagnosed with hashi's and since then other autoimmune issues - lichen planus and possible antibody negative sjogren's syndrome.
I switched last year to an endo in London who was on a list of good endos and I thought he wasn't too bad but I saw him before Xmas and he ran loads of bloods (my local hospital will only test tsh and not T4 or T3 which is astonishing!!!) and he's written to my GP with the results but I'm not overly happy. Here's the main body of the letter (hope it's okay to post it here):
'Results of blood test undertaken at that time are now back
which show acceptable renal and liver function, apart from a slightly elevated ALT of 50 IU/L, normal <40, with a normal glucose of 5.1 mmol/L. Free T4 is normal at 11.1 pmol/L, normal range 9 to 23, with free T3 of 5.1 pmol/L, normal range 2.5 to 5.7, with a low TSH of 0.03 mu/L, normal range of 0.3 to 4.2. Vitamin D was good at 99.8 nmol/L, normal range being 70 to 150, and full blood count was unremarkable along with acceptable iron studies, although transferrin saturation was within normal, it was towards the lower end of this at 22%, target being 16 to 55%.
Vitamin B12, C-reactive protein and ESR levels were normal, with thyroid peroxidase antibodies being negative.
Overall, these results suggested good vitamin B12 and vitamin D levels and that no change to her supplementation with these is needed at this stage, but her iron levels are towards the lower end of our target range, even though they are within normal, and with her current symptoms suggest she would benefit from increasing her iron intake, using a suitable over-the-counter supplement, which should be taken at a different time to both her T4 and T3 therapy, to avoid any interaction.
Her current thyroid hormone levels suggest slight over treatment at this time, and I would therefore reduce her Levo-thyroxine from 100 mcg to 75 mcg daily at this stage, keeping the Liothyronine at its current dose. I would suggest a further blood test is undertaken in six to seven weeks’ time, to see the effect of this change'
Basically I'm really not happy to reduce my T4 - it's not high in range anyway and I've always had suppressed TSH since adding T3 in a couple of years ago and I thought it was pretty standard that T3 reduces TSH to an abnormal level? I've written back and asked if he'll reconsider asking to reduce my T4 dose as I'm not happy to do that really.
I'm just wondering what others think and if there's anything else you notice about the results?