Hi All,After my post yesterday I went to the surgery and asked them to print my latest blood results.
I see they want me to reduce my Levo dose..I'm sceptical though.
My next visit I will ask if I can have the full range of bloods as I've seen lots of people recommend on here.
As your TSH result is outside the range they want to reduce your levo. Most doctors go on numbers rather than symptoms and extrapolate the one or few case studies were someone had adverse effects as all patients having adverse effects.
You have a couple of additional issues:
1. Most CCG/healthboards refuse to let labs do FT3 tests unless your results warrant it
2. The GP can decide there is no clinical need to do any other tests. So you need to justify why you need them when you ask even then they can say "No"
If either of these end up being true then you have to pay for your own private tests.
Mols_bols1,
FT4 is within range so you aren't over replaced but expect battle with your GP over the TSH which is suppressed and is the reason for the lab suggesting you are over replaced. Read the link below and Dr. Toft's comments in Treatment Options thyroiduk.org.uk/tuk/about_... Email louise.warvill@thyroiduk.org.uk if you would like a copy of the Pulse article to show your GP.
Few GP surgeries order FT3 and when they do labs decline to test it unless TSH is <0.03. I'm rather surprised the lab didn't automatically check your FT3 as TSH is suppressed.
Thanks, I've just emailed Louise to request a copy of the Pulse.
I'm really going to stand my ground about having the FT3 test and others.
I'll let you know how it goes.
Those results don't tell you that you are over-replaced.
Without knowing your ft3 level, no-one can justify making that judgement. Ask them about your free T3 level, as this is almost the only active thyroid hormone, and the one on which your body relies.
On T4 only, my FT4 was always at the top of the range or above it, and my FT3 was always at the bottom or below. We all need to help the doctors to understand!!!
Thanks dolphin5. I'be got an appointment with my dr tomorrow. How can I word what I need to say without getting her back up. Especially when I don't fully understand it myself.
I'm going to push for full bloods but feel like I need to justify it. Any advice will be greatly received
I'm no expert on keeping GPs on-side, but how about
"Well I understand your concern about my results, but since T4 is primarily a pro-hormone, and it does very little until converted to T3, I'm wondering how much Free T3 I have, and we don't seem to have a result for that."
If necessary, I would explain that T3 is virtually the only active hormone, and dropping T4, when the level is not above range, could lead to too little T3, and hypothyroid symptoms ie becoming ill (or more ill).
Good luck!!
Thanks very much.. I'll give it a go tomorrow and let you know how I get on.
PS I should have said that T3 as well as T2 and T1 are virtually the only active hormones! The main thing is that T4 has very few functions other than to be converted to T3.
The important thing is to talk to the GP as if you think they already know all this, then you're not showing them up (even though they probably don't know).
Thanks again.
I assume that the t4 is converted to t3 through the actual thyroid gland?
I had mine removed over 12yrs ago, so how would the T4 be converted to t3?
The thyroid gland produces mostly T4, but also some T3, T2 and T1. Then, all over the body, various organs convert the T4 into T3 ( and that can convert into T2, and so on). I can't remember precisely where, or where the most is produced, but all we need to know is that 80-90% of our active hormones come from conversion in the body.
For those of us without a thyroid gland, the situation gets tricky as we have no direct supply of T1, 2 or 3. I suspect that we need higher levels of T4 because our bodies just convert the usual percentage of the T4, leaving us with less T3 than normal.
But the body probably thinks it has enough because of the level of T4 (which might be enough if you also have your own supply of T3 etc.). Also, we take a 24hr does all in one go, and that may be enough to drop the tsh.
When the body thinks it has enough thyroid hormones (in the pituitary gland!), the tsh drops. Tsh exists to stimulate the thyroid gland to produce more hormones, and to stimulate conversion.
Then, when you have lower tsh, you get less conversion.
So, you can easily end up like me. In order to have only a low level of T3, I need T4 high above the reference range, and to have enough T3, I need to take T3 as well as T4 (as I do now).
Don't agree to drop your dose unless you have hyperthyroid symptoms and feel unwell. If you have hypothyroid symptoms or you feel well, it is best to refuse to drop. They can't make you drop your dose, but they can refuse to increase it.
Wow now it's all starting to make sense!
I have hypo symptoms for sure, aching limbs being one of the worst, followed by brain fog, terrible dry skin and so on. I have bought myself some T3 but I'm going to wait and see how I get on with the GP and bloods before I take it.
Thanks you for all of your advice, I may come back to you once I have results if you wouldn't mind. You've been a great help. Thanks 
Hi dolphin5, just wanted to let you know how it went with the GP..
The good news is, she has agreed to do the T3 blood test. The bad news is she wants me to reduce Thyroxine by 25mg for 6weeks and then will do both blood tests after that.
Did you agree to drop?
A couple of years ago I agreed to a "temporary drop" and I was then more ill for the 6 months I did it. Fortunately I managed to go back on my "normal dose" so I didn't have to stay on the lower dose, but many doctors would not allow a return to a higher dose.
Please be careful!
I kinda felt I had no choice but to agree.. it was a bit like 'I'll agree to the T3 bloods if you drop your levo' not her exact words but thats what she was leaning towards. Its only a 25mg drop so I'm hoping I won't notice too much...
Wish me luck
They make it very difficult for us, don't they? I only gave in to get them off my back. Do you think she understands how important T3 is?
In a sense, it doesn't matter how much T4 you have, (although yours isn't even over range), as long as you have enough Free T3 - and for most of us, that's not when it's at the bottom of the range.
We can get a low TSH just because our pituitary gland has higher levels of thyroid hormones, and that's where the tsh is produced.
Anyway, you can only take it a step at a time. My advice would be to keep records - starting asap, of your temperature and other symptoms. This way, you can show what effect the drop has.
Then post more information on here - there are lots of people to help and offer support.
Good luck! X
Help understanding blood results 
Understanding blood test results
Not understanding blood results 
Help understanding blood results please
Help to understand Blood test Results
