Bloods in normal range but underactive symptoms

[octobergirlie67]

In February my blood results were TSH 0.09 / FT4 19.40 / FT3 5.50. I was told to reduce my Levothyroxine from alternate days of 100mcg and 125mcg to 125mcg 2 days a week and 100mcg for the remainder. My latest blood results are TSH 0.44 / FT4 15.50 / FT3 4.80. My endocrinologist has told me to remain on the dose I am, however for the last few weeks I have been experiencing underactive symptoms again. Any suggestions as to what I should be discussing at my next appointment.

[greygoose]

Discuss putting your Dose back up to where it was. He had no real reason to reduce it, your FT3 wasn't over-range - well, as far as I can tell. It would help if you put the ranges. He was just lookiing at the TSH. Doctors are terrified of Under-range TSHs . They think you're going to have a heart attack, but that's totally unfounded.

Tell him you felt better on the higher dose, and are willing to accept responsibility for any possible risk of a heart attack - there are none!

[octobergirlie67 in reply to greygoose]

Thanks. I'll see what he says at my next appointment - I thought that might be the case as I felt so much better on my previous dose. With regards the ranges, is that something that comes through with the blood results? The copy letters I have only detail my levels and whether I'm classed as being under or over.

[greygoose in reply to octobergirlie67]

I'm afraid I Don't know. On my copies of results, the range is always noted after the result, but I Don't live in the UK. You could try ringing the lab where they were done, and asking for the ranges. It's a very strange world where lab technicians give clinical diagnosis!

[octobergirlie67 in reply to greygoose]

I've now managed to get the ranges from my GP so my current results are TSH 0.44 (0.2 - 4.0) / FT4 15.50 (11.0 - 22.6) / FT3 4.80 (3.5 - 6.5) and my previous ones were TSH 0.09 / FT4 19.40 / FT3 5.50 when I felt much better.

[greygoose in reply to octobergirlie67]

OK, so your TSH has come up - which is what he wanted - but your Frees have both dropped. So, no Wonder you Don't feel as good! Your FT3 is much too low, now.

As I said, he just didn't like your lowish TSH - I bet he didn't even look at the Frees, which weren't high at all. In fact, there was room for an increase. Honestly, they are so dumb!

Your FT3 now isn't even mid-range, which is too low for anyone to feel good on. But, at least you're converting ok, so that's one good thing. I think you just have to stress how ill you feel since he lowered the dose, and how well you felt before it was lowered. After all, the purpose of thyroid hormone replacement is to make the patient well, is it not!

[octobergirlie67 in reply to greygoose]

Success! I've now had my dose put back up so hopefully I'll see some improvement again soon. Many thanks for your advice

[greygoose in reply to octobergirlie67]

You're welcome.

[greygoose]

I'm sorry, I disagree with you. A lot of people would have symptoms with an FT3 of 4.8. It isn't even mid-range. Most people need it up the top of the range to feel well.