Blood results advice

[House_stark]

Hi guys, I'm hyper on block and replace (40 carbi and 150 levo) which I've been on about 3 months. Am due back at endo in a few weeks but would like to know what to aim for.

Initial bloods TSH <0.01 (0.3-4.5); FT3 21.7 (3.1-6.8) ; FT4 50.6 (11-22).. Having shakes, palpitations, insomnia, mild TED.

After the carbi for 6 weeks

TSH <0.05 (0.3-4.7); FT3 4 (3.5-6.5); FT4 12.9 (9.5-21.5).. At this point started levo as well.. TRAb 4.5-not sure what the range is.

After about 10 weeks TSH <0.01; FT3 6.0; FT4 28.7 (ranges as per first set).

Not sure what the ratio between ft3/4 should be and if mines ok. To me it looks like I'm starting to be over medicated and I've recently started with mild shakes and insomnia again which would confirm that.. Is that right?

My ferretin dropped from 80 to 40 ,is this to do with medications? Last but not least, my b12 was 189 so after reading other posts bought some supplements online (solgar 5000units). How long do I take them before getting retrested please?

Current meds: as well as levo and carbi- d3 20000units 3x weekly (loading dose for level 20 at the end of summer), b12 supplements; calcium supplements x2 daily (solgar with vit k) as I believe carbi leaches it; boots hair skin and nails x2 daily for the selenium for TED (selenium 100mcg x2 as recommended by endo) and a general multi vit (centrium) for iron (5mg)/general top up.

I take levo first thing, carbi, selenuim x1, vit d, vit b12 about 30 mins later and the rest in the evening.

Sorry for the long post and thanks for your help.

[Clutter]

Welcome to the forum, House_Stark.

You are over medicated on Levothyroxine. You could reduce Levothyroxine to 125mcg now and retest just before you see your endo. FT4 should be <22 and FT3 <6.8. When FT4 drops TSH may start to rise but recovery of TSH in hyperthyroid patients can take a long time and sometimes it does not recover.

Having TED means you have Graves disease which is autoimmune hyperthyroidism.

Hyperthyroid patients 'burn up' vitamins and nutrients so your ferritin dropping is unlikely to be anything to do with Carbimazole and Levothyroxine and is more likely due to your hyperthyroidism. Ferritin is optimal >100 through to halfway in range. You can supplement iron taken with 1,000mcg vitamin C which aids absorption and minimises constipation. The mg iron in the multi-vit isn't enough. Ferrous Fumarate 210mg is better. Take iron 4 hours away from Levothyroxine.

B12 189 is low but without the range I can't tell whether it is deficient. Ideally you would have intrinsic factor tested to rule out pernicious anaemia. If you haven't started supplementing I would have IF tested first. It would also be an idea to have folate tested as B12 and folate are co-dependent. healthunlocked.com/pasoc are the experts on B12 and folate deficiency and PA.

Make sure you take vitamin D and calcium supplements 4 hours away from Levothyroxine too.

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I am not a medical professional and this information is not intended to be a substitute for medical advice from your own doctor. Please check with your personal physician before applying any of these suggestions.

[House_stark in reply to Clutter]

Thanks for the reply Clutter. I think the range for B12 was 150-1000, i remember that it was lower in my area then is commonly posted here (which is 180-1000). I'll take a look at the link you said... GP said no need for iron supplements which is why I'm on the centrium. Wonder if endo will recheck my levels when I see him?! Contacted endo yesterday about reducing levo, he's not got back to me yet but think I'll miss today's dose and start 125 tomorrow unless he says otherwise. I can always take it later if he says to take something today... Thanks again.