My latest blood test results - how to get doctor to consider symptoms

[queenmabroo]

Hello,

Me again, this time with my own recent results!

I am currently on 75mcg Levo. I was put on 25mcg 2 years ago after a fight with the doctors (symptoms plus family history!) which I stayed on for a year. I then went back with further symptoms 1 year ago and finally got a dose increase to 50, then to 75. 75mcg was good for a while but now my symptoms are back again. I've put my table of results over the years at the end of this post.

My latest results were as follows:

TSH 2.1 (0.2 - 4)

FT4 14.5 (10.00 - 20.00)

Serum T3 1.4 (0.9 - 2.5)

I was so excited to see T3 until I realised that Serum T3 is total T3 and not Free T3. Can this result still tell me anything?

My doctor said when we went for these tests that he didn't want me to be upset if my TSH came back below 2 and therefore he couldn't treat me. Well, fortunately it's 2.1, but as the tests say "All fine!" I suspect I am going to need to fight in order to get it done.

I suspect I have malabsorption issues. I haven't had a recent vit/minerals test, but have had low Vit D (61, and 65) in the past for which I've been taking daily 1600 iu replacement for the past 8 months. My B12 has also come back on the low side (390, 423, 419) but I'm not currently supplementing that - I plan to but want to see my latest levels first to work out where the issue is. I have also had low calcium and at one point had a high parathyroid result: (vit D 65 (75-500), calcium 2.17(2.2 - 2.6), Parathyroid 8.5 (1.5 - 7.6)) So I am supplementing iron, vit c, calcium, magnesium, zinc. I suspect I need to do more supplementation, and this might be causing my symptoms.

I also suspect an adrenal imbalance, and am looking to go back to the doctor to get this checked - and then to do a private 24 hour test for cortisol. I'm also going to look into dietary ways to support my thyroid and adrenals so that I can throw everything at it! Will also see what vit/mineral tests he'll do and then consider BlueHorizon.

I'm just sick and tired of these symptoms, and sick and tired of fighting numbers that show me as "well". If they refuse to treat/investigate I'm doing to do a letter to the practice manager and threaten self-medication!

As a summary, as I know I've written a lot here.

- Can we tell anything from my Serum/Total T3 result?

- Any particular arguments I can use with my doctor to strengthen my case?

-Am I also going along the right lines with looking for optimal vits and minerals, then optimal adrenal function, and then if all that doesn't work considering addition of T3?

- Should I also be asking for a hormone profile?

Thank you all so much in advance.

[bluebug]

One thing most NHS doctors won't tell you is that in some cases people need to supplement certain vitamins and minerals either until their lifestyle changes e.g. hit the menopause or for life.

In your case it seems like you are one of these people so I would start supplementing vitamin Bs again.

Btw what kind of doctor is looking after you?

[queenmabroo in reply to bluebug]

He's a GP. A locum did me an endo referal which i stupidly cancelled because GP agreed a dose increase and I thought he'd be helpful! Now I regret that.

[queenmabroo]

Yep, I agree - Is that noted in Dr Toft's Pulse article?

[greygoose]

I don't think you should lose any sleep about not seeing an endo. Most of them are pretty useless!

But, did I understand that right? Is your GP saying that if your TSH came back under two, he would no longer be able to treat you? Would he stop your levo if your TSH were under two? Surely I must have misunderstood, no? As it is, 2.1 is too high for someone on thyroid hormone replacement. It should be one or under. And your FT4 is a bit on the low side. And, no, you can't get any useful information from a TT3 - except that it is rather low, so your FT3 will probably be low, too. But, that's just guessing.

[queenmabroo in reply to greygoose]

Yes - if my TSH came back at under 2.0 he wouldn't consider a dosage increase. He'd leave me on 75mcg Levo.

I think the literature of 1 and under for TSH is Dr Toft's Pulse article? I know I've got it printed in something!

Does Low-ish T4 and potentially low T3 suggest a conversion problem?

[greygoose in reply to queenmabroo]

No, high FT4 and low FT3 indicates a conversion problem. I don't think you've got enough to convert! Can you change your doctor? This one really knows nothing about thyroid.

[Clutter]

Queenmabro,

The goal of Levothyroxine is to restore the patient to euthyroid status and for most patients that will be when TSH is <1.0 with FT4 in the upper range. Read Dr. Toft's comments in Treatment Options thyroiduk.org.uk/tuk/about_... Email [e-mail] if you would like a copy of the Pulse article to show your GP when you request a dose increase.

If you've been supplementing iron, vitD and calcium for 8 months your GP should retest to check levels.

B12 is optimal around 1,000. I would supplement 1,000mcg methylcobalamin and take a B Complex vitamin too.

__________________________________________________________________________________________

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.

[queenmabroo in reply to Clutter]

Ah, thank you! Pretty sure I have a printed copy of Dr Toft's Pulse - let's see if it works.

I'll check the BetterYou spray that I've bought. Next Docs appt 4th July - independence day for me?!

[Clutter in reply to queenmabroo]

Queenmabroo,

BetterYou Boost is 1,200mcg. Perfect!