2 x test Results on Thyroid S, need advice please.

[princess20]

First test done Sept 2015 on 3 grains. Free T3 11.5 pmol/L Range 3.10 - 6.80 pmol/L

Free T4 18.8 pmol/L Range 12.00- 22.00 pmol/L. TSH <0.20 mU/L Range 0.27-4.20mU/L.

Second Test Dec 2015. on 1.5 grains. Free T3 11.2 pmol/L - Range 3.10 - 6.80 pmol/L.

Free T4 12.3pmol/L Range 12.00-22.00pmol/L. TSH <0.20 mU/L Range 0.27-4.20mU/L.

I really need advice on what to do or where to go next. When on 3 grains I felt really unwell, my heart was racing and jumping all over the place I thought I was going to have a heart attack. Now having dropped back to 1.5 since Sept my heart no longer races and I have felt very calm and fine until a couple of days ago when I felt thoroughly depressed, with anxiety & panic attacks as well as exhausted, cold, achy and the beginnings of very dry skin.

What I don't get is why is my heart ok now, with no palpitations and racing when the T3 result is near enough the same as last Sept. What's going on, I don't get it?

Will I have to change my meds for something else, or can I supplement with T4? Really appreciate any help on offer.

Thank you

[Clutter]

Princess20, did you take NDT before your thyroid blood test?

[princess20 in reply to Clutter]

No I don't think I did. But even if I had how can one explain my low T4 result??

[Clutter in reply to princess20]

Princess20, Levothyroxine only delivers high FT4 which is necessary for T4 to T3 conversion. FT4 is usually a lot lower on NDT, sometimes below range. FT3 should remain within range. If you left 24hours between NDT and blood draw you are overmedicated.

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I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

[shaws Administrator]

The blood tests were introduced along with levothyroxine so cannot match what our bloods are when on T3 only, or even T3 added to T4.

It's best to go on how you feel, as you have done, when you lowered your dose. Sometimes we need to adjust up/down to hit the right dose for us. Of course, it mustn't be too often otherwise you'll be forever doing so.

Once you feel well stay on the dose and sometimes we can have an off day, or maybe two so I wouldn't alter dose straight away and let my body settle down before I introduce a small change either up/down.

[princess20 in reply to shaws]

Thanks for getting back to me. Yes!!! I do agree that feeling well is more important than the dose, but i have been on 1.5 grains since blood result back in Sept/Oct and and only started to feel really unwell again in the past 3 weeks just after Xmas. If i had taken a dose before my blood test why would my T4 be so low? Thanks again

[shaws Administrator in reply to princess20]

Bearing in mind I'm not medically qualified - these are a couple of my thoughts.

You were doing well on Thyroid S but reduced from 3 to 1.5 grains due to feeling overdosed. Normally, when increasing/decreasing it's best to go 'gradually' particularly if you think you're reaching your optimum dose. If feeling very overdosed you can miss a day's medication and take a reduced dose, usually by 1/2 gr for 2 weeks and then drop again if you were still feeling it was too much.

When we alter doses it does take some time for body to adjust and I think you maybe feeling unwell because your body needs more hormones.

You dropped from 3 gr to 1.5 which is a big drop, whereas you should have dropped by around 1/2 grain till you felt stable. Sometimes a 1/4 makes the difference between o.k. and good.

Your FT4 is low because you dropped your dose by too much, I believe.

Also when T3 is in the mix it lowers T4.

[Flatfred]

Did you just start on 3 grains straight off? And did you just drop from 3 to 1 1/2 because that's just to much of a change too quickly. It would have taken 10-14 days to come down form 3 grains and another couple of weeks to settle on 1 1/2.

You need to pick it up slowly from 1 1/2, 1/4 grain at a time. I know that's a hassle with T-s as they're 1 grain tabs but try if you can...if not then 1/2 grain increase at a time.... And wait for 10 days and see how you feel.

It's also important to NOT take your thyroid meds before the blood test as it gives a false reading on the T3.

Best of luck!

[princess20]

Hi. I started on 1/2 grain last Feb gradually coming off T4. But stayed on this dose for too long and felt unwell so increased to 3 grains incrementally until I had blood test last Sept. Then dropped to 1.5. So bit confused about results and don't think I took a dose before bloods in Dec. Don't understand why I have very low T4 and high T3??

[shaws Administrator in reply to princess20]

The blood tests were introduced along with levothyroxine so if we are on NDT or T3 or T4/T3 they cannot correspond as accurately as our meds are different from levo - T4 only..

If on T3 only our T4 result will be negligible.

[princess20 in reply to shaws]

Thank you. You have made things a lot clearer. Lower T4 is to be expected on NDT which I didn't know. Having bloods taken again tomorrow, so I'll have a better idea, hopefully, of what is going on.

[shaws Administrator in reply to princess20]

When your hormones at an optimum you should feel much better and blood tests don't feel so important and are guides really. We usually only have a blood test yearly when stabilised.