Assistance with latest blood results please.

[Watmum]

Hi, I have had Hashimoto's for several years and appeared to lose the ability to transfer T4 to T3 effectively. I've just had my first set of bloods taken since starting on a combined 20mcg of T3 with 100mcg of Levo and wondered if you could help me interpret them properly?

They are as follows;

Plasma free T4 level 11.5  (9-19)

Plasma free T3 level 3.8 (2.6 - 5.7)

No TSH this time but previously 2.2

Serum Iron level  19.3  (11-30)

Serum folate      3.7   (3 - 20)

Serum ferritin  82   (10-200)

Serum transferrin 1.98 (1.8 - 3.6)

Serum B12     281    (180-900)

Serum Vit D  13   (50+)

My GP has only flagged up the Vit D deficiency prescribing 3200 tablet daily for 3 months. I also appear to be at the lower range in ferritin, folate and b12 too.

Whilst my symptoms have improved, I'm still far from perfect.....

I'd be very grateful for any advice on whether I should stay at this level of T4/T3 meds.

[shaws Administrator]

Re your thyroid hormones, they are so low there's no way you can feel well. When we are on thyroid hormones T4 and T3 the aim is they should be towards the upper part of the range not verging on below the range! The reason you cannot convert T4 to sufficient T3 is that you are not on a reasonable dose of T4 to convert to T3 that's the problem. Not the T4 but the dose of levo. 

Vitamin D is woeful - why wasn't this picked up before? 

B12 should be at the top of the range 900- 1,000. Supplement with methylcobalamin sublingual B12. Other members will be along and put in their comments about your other terrible results. I am not medically qualified or very knowledgeable about the others.

Both Vitamin D and Vitamin b12 are actually pro-hormones that have essential work to do in our bodies , i.e. lack of B12 can cause alzeimers and damage to the mylein sheath which covers the nerves. Neurological damage.

[Watmum in reply to shaws]

Many thanks for your quick reply Shaws. Since joining this forum I've learnt so much and went to my GP insisting that Vit D, B12 ferritin and folate be measured with my latest tests. She was actually very apologetic that these hadn't been done in the past (I'd previously seen a different GP in the practice that actually cancelled an appointment with an NHS Endo, arguing that he was perfectly capable of treating me!) To be fair to this new GP she was the one that suggested that T3 might help. Should I go back to the Endo or the GP to tackle an increase in medication?

[shaws Administrator in reply to Watmum]

Definitely the GP if she's willing to add T3 as you cannot function without it but she might have to increase T4 as well so that it will also convert to T3.

What dose of levo are you on at present?

[Watmum in reply to shaws]

I've been on 100 mcg of  Levo for the last 18 months or so. I'm not sure the GP is comfortable adjusting the T3 without the guidance of the Endo

[shaws Administrator in reply to Watmum]

I cannot believe you are under the care of an Endocrinologist. It's unbelievable that he is unaware of the 'ideal' place in the range for the T3 and T4. He (my own assumption) because your TSH is low is compensating for that by denying you an increase in thyroid hormones. Is he not aware that heart can suffer as well as all organs as they need them to work efficiently not to mention that our brains need T3 and it has the most receptors.

[Watmum]

To be fair to the Endocrinologist, I have only had one appointment with him in January and he was happy to start me on T3. Previous bloods only covered TSH and he hasn't seen these latest results, so he hasn't had a great deal of info to work with. He seems quite open to treatment (and indeed is on Levo himself) so tempted to by pass the GP and see him again privately to move things along.

[greygoose]

With a B12 that low, you need 5000 mcg sublingual methylcobalamin daily. Also take a B complex, with methylfolate - not folic acid - and that will bring your folate up.

You obviously have an absorption problem. How is your digestion?  

[Watmum]

Many thanks for the advice on the B12 and B complex Greygoose.

Digestion issues have died down since going gluten free nearly 2 years again. 

I've booked an appointment with the GP for Friday in the hope that the meds can be increased - here's hoping I'm finally on the way to being optimally treated!