Any comments on my most recent blood results would be appreciated, please :-)

Hi, just looked at my most recent bloods online and they look good to me, but would appreciate comments as no doubt my new doctor will want to see me (he seems to know what he's talking about and also appears to be proactive, unlike my previous GP, who had taken me off levo after 6 years, said I had sciatica and put me on painkillers for pain in Achilles and said all other symptoms were coincidence).

New GP put me back on 25 mcg levothyroxine in November 2015 after I developed double vision, increased it to 50 in December, and 75 in June (while suggesting I may be better off on 100), all dose changes coming just after the blood test results below.

Free T4 12.2 (25/11/15) and 16.6 (yesterday, 09/09/16), range 10-18.7 for both

TSH 4.41 (15/10/15), 9.49 (25/11/15), 2.75 (15/02/16), 4.64 (22/06/16), 0.29 (yesterday), range 0.3 to 5.0 for all tests.

25/11/15 was 1st time I had ever been tested early doors, 22/06/16 was when I went back and asked for a test as my symptoms had returned - GP increased my dose as the TSH had started to creep up, which it shouldn't do (he said).

I'm guessing I'll be called in because TSH is ever so slightly below range, at 0.29 The doctor had upped my dose to 75, saying I may be better off on 100. I opted for 75, saying I'd see how it goes and maybe increase to 100 at a later date. For a fortnight after starting on 75 my symptoms improved, then they levelled out. For the next 7 weeks I didn't get worse, but got no better, so started taking 100. I started to improve straight away, and I am still improving 2-3 weeks later. Dr doesn't know I've increased to 100 yet.

As well as this my Vit D was tested and he told me it was a little low, at 39, and should ideally be 50 or higher. I've been taking 2 D3 tabs a day from H&B and yesterday's test is 80 (I also take 1 Vit K2 & 2 Vit D12 a day) D3 are 1000 iu each, K2 are 50mcg and B12 are 500 mcg.

Basically, I'm feeling better than I have for several years, the pain I've had for 20+ years is going, I'm back running again (just got back from NW Relays in Delamere Forest, blimey was it tough!), my joints hardly ache (except my fingers in my right hand), my skin is no longer so dry it cracks and flakes off, my digestion is no longer uncomfortable - the list goes on, all positive).

What I want to know is whether it's safe/advisable to remain on 100 with an ever so slightly suppressed TSH when everything else looks/feels so much improved, or should I reduce it to 75 if my GP suggests that would be better?

Thanks in anticipation :-)

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  • The TSH is from the pituitary gland and many holistic doctors ignore the TSH in preference for treating patients' symptoms.

    Thyroid hormone doses used to be higher before blood tests were introduced (about 200mcg and 400mcg) and hormones were increased until symptoms were relieved and patient felt well. An excerpt from link below and it's a pity more Endos/GPs aren't sufficiently knowledgeable in treating the patient instead of the result of blood tests. Excerpt from link below:-

    Dr John Lowe has searched in vain for scientific evidence proving that imposing a TSH normalising dose of thyroid hormone really does result in normal thyroid hormone levels in the cells - which is what really matters - and concluded that this is merely a scientifically unproven assumption made by endocrinologists. In fact, John Lowe's next book is to be entitled 'The Tyranny of TSH'.

    A full picture of your thyroid health cannot be obtained by checking only your TSH level any more than the health of a business can be obtained by looking only at the bank balance. Whilst an 'abnormal' TSH level may sometimes provide some idea of your thyroid health - this is a bit like trying to decide when a stopped clock is telling the correct time - it will not pin-point where the problem is. Finally, it is interesting to note that the ELN Laboratories point out, in the information sheet that accompanies their Urine Test Kits, that "TSH is grossly in feedback with serum T4 only, not so much with serum T3, while the patient's well being depends on the free T3 that is disposable inside the cells."

    thyroiduk.org.uk/tuk/thyroi...

  • Really helpful information here, thanks.

  • The TSH is irrelevant once you are on thyroid hormone replacement, because you don't need it anymore. Thyroid Stimulating Hormone, that's all it does. It stimulates the gland to make hormone. If you're taking a decent dose of replacement hormone, you don't need to stimulate your gland, do you.

    More important is your FT4 - and that gives you room to increase even further. But, even more important than that is the FT3 - which, of course, the NHS rarely tests! Your levo (T4) has to convert to T3, and you may not be very good at that. So, a good investment would be to get your own private labs done, to see what's happening with your conversion. But, in any case, ignore the TSH unless it goes high. :)

  • shaws >> doses used to be higher before blood tests were introduced (about 200mcg and 400mcg) <<

    I've even heard of 600 mcg and NDT by handful ...

    Makes me ask if the influence of ferritin-B12-Dvit-folate have been widely unknown. A study last year told that ferritin deficiency is the most frequent cause of symptoms in Finland

  • Thanks all for your comments, much appreciated.

    To add to my original post, I only moved to my new GP in October 15 when I found out I could move from my prev GP without having to move house (I'd wanted to change for a long time but wasn't aware I could, but had instead been hoping he'd take early retirement)

    I have had B12, ferritin and folate tested previously...

    B12 459 (170-730, 08/03/16)

    Ferritin 116 (21/09/15) and 102 (08/03/16), range both times 22-320

    Folate 6.7 and 6.9, dates as above, range 3-19

    Ferritin and folate are iron related, aren't they? I eat plenty of fruit and veg, eggs and fish, drink plenty of milk and I have been tested a couple of times (dates as above)

    Serum iron 20.7 and 12.5, range 8-32

    Saturation iron binding capacity 58.7 and 60.5, no range given

    Unsaturated iron binding capacity 38 and 48, range 27.8-53.7

    Transferrin saturation index 35% and 21%, range 20% - 50%

    I've had a gazillion other tests done over the years, and they pretty much all came out right slap bang in the middle of the ranges (except my Mean Platelet Volume, whatever that is, which has almost always been above range)

  • Your TSH levels are fine. Not too low at all for some one on Thyroxine. Congratulations on achieving euthyroidism (balance)!

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