Got my latest bloods back......

[Zuzka1]

Hi Everyone.

So I am currently on 100mg LEVO. I am seeing my endo on Friday whos said she wants me on 175/200mg of Levo. She wants my TSH to be Zero. I am also on 80mg iron a day. These are the bloods I have had done this morning - How am I doing? Can anyone help me read this please ? the only one flagged up is CHOLRE.

Gly emie A Jeun 4.93 (3.89 - 5.83)

Cholesterol total 4.43 (^6.19)

Creatinine 67.9 (49.0 - 90.0)

debit de filtration Glomerulaire selon CKD-EPI 95 (108)

sodium 139 (136-145)

Pottasium 4.2 (3.5 - 5.1)

CHLORE 107 (98 -107)

Calcium 2.22 (2.10 - 2.55)

Phosphore 1.11 (0.74 - 1.52)

TGO - ASAT 14 (5-34)

TGP - ALAT 15 (5-55)

Ferratine 56 (20-204)

T3 Libre FT3 3.2 (2.6-5.7)

T4 Libre FT4 13.8 (9.0 - 19.0)

TSH Ulta Sensible 2.179 (0.400-3.100)

Vitamine 25 (OH) D2 et 25 (OH)D3 71 (79)

30mg/ml (33)

Plaquettes 264 (150-445)

Thank you for any help at all.

I am tagging greygoose and shaws for your constant help. Thank you thank you thank you x

[Clutter]

Maraphipps,

Most people taking Levothyroxine will be comfortable with TSH 1.0 or lower. You could do with a dose increase to 125mcg for sure to raise FT4 and FT3 which are both low in range.

Ferritin is optimal half way through range so you should continue supplementing iron which is better absorbed when you take it with 1,000mcg vitamin C.

I'm confused about your vitamin D result unit measurements and result. Most people are comfortable around 100nmol/L or 40ng/ml.

[Zuzka1 in reply to Clutter]

Hi Clutter!

I know shes going to up my dose on Friday so I will be on 125 quite soon im sure.

Shes not the person that prescribed my iron so I will point out to her I am taking it - I am taking it with 1,000mcg of Vit C already.

Heres the full bit for Vit D sorry.

First line says this:

Vitamine 25 (OH) D2 et 25 (OH)D3 71nmo/l (79)

Second line says this:

Vitamine 25 (OH) D2 et 25 (OH)D3 30ng/nl (33)

Does that make sense?

Thank you so much x

[Clutter in reply to Zuzka1]

Maraphipps,

Yes, got it. Ignore the D2 it is the D3 71nmol/L which is important. I would supplement 2,500iu daily to maintain level until April when ultraviolet light is strong enough to stimulate natural vitD.

[Zuzka1 in reply to Clutter]

Ok so I need to supplement my Vitamin D. Do I take that at a totally different time to iron etc?

Thank you Clutter

[Clutter in reply to Zuzka1]

Maraphipps,

Take vitD with the fattiest meal of the day and 4 hours away from Levothryoxine. You'll have to check the directions on your iron supplement to see if it should be taken away from other supplements, food etc.

[Zuzka1 in reply to Clutter]

Can I also please ask at this stage with my results would I be converting T4 to T3? Im thinking not.......as my body feels slugish.

[Clutter in reply to Zuzka1]

Maraphipps,

You're feeling sluggish because you are under medicated. Impossible to say whether you are a poor converter while you are under medicated. Poor conversion is shown by low TSH, high in range FT4 and low FT3.

[Zuzka1 in reply to Clutter]

Thank you.

[SeasideSusie Remembering in reply to Zuzka1]

Zuzka1 Good conversion takes place when FT4:FT3 ratio is 4:1 or less. Your ratio is 4.31 : 1 so it's not dire but struggling a bit. Supplementing with selenium helps with conversion.

[Zuzka1 in reply to SeasideSusie]

Gosh ok and when would I take selenium? I have some at home. 200mg. Would this kick start me being able to loose some weight?

[SeasideSusie Remembering in reply to Zuzka1]

As selenium is a mineral, and minerals are generally advised to be taken in the evening, that's when I take mine.

I don't think just starting to take selenium will allow you to start losing weight. Being optimally medicated is key, and you are far from that with those levels. It's said that in a treated hypo patient TSH should be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges if that is where you feel well.

Also, ferritin needs to be half way through range with an absolute minimum of 70 for thyroid hormone to work properly so you've still a fair way to go with your iron supplements. If you are not vegetarian then I would give serious consideration to eating liver once a week as that will give your ferritin a boost. I managed to raise my ferritin with liver only, no iron supplements.

As for your Vit D result it appears to have been given as a total of D2 and D3 and in both units ie

Vitamin 25 (OH) D2 and 25 (OH) D3 - 71nmol/

Vitamin 25 (OH) D2 and 25 (OH) D3 - 30ng/ml

nmol/L is the unit we usually see in the UK and the recommended level is 100-150, the equivalent level in ng/ml is 40-60.

[Zuzka1 in reply to SeasideSusie]

Wow. Thank you seaside susie! I'm a long way away aren't I! But, this actually makes me feel really positive as I know I'm getting there. All be it slowly! I know my Levo is being upped on Friday. -am I right in saying the most it can go up in one go is 25mg? Thank you so much.

[SeasideSusie Remembering in reply to Zuzka1]

Yes, 25mcg is the normal dose increase, then re-test after 6-8 weeks.

Do think about the liver, if you eat it once a week as well as taking your supplement then you will reach optimal level more quickly than just iron tablets alone.

[Zuzka1 in reply to SeasideSusie]

I'm more than happy to eat the liver and will probably go and get some tomorrow! How do you cook yours?

[SeasideSusie Remembering in reply to Zuzka1]

I get fresh lamb's liver from the butcher, that way I know it's local Welsh lamb. I gently fry some onions in butter, cut the liver into thin strips (I soak mine in milk overnight, usually about 100-120g liver and just cover with milk and leave in fridge) and gently fry the liver (butter again, good fat rather than oil). Some people coat the liver in flour, I don't bother. That's it, nice and simple.

Sometimes I roast some tomatoes, and serve with mashed potatoes and peas, sometimes I serve it with rice and a veggie mix. I dare say there's lots of exciting recipes on the 'net, but I'm a lazy cook

Chicken liver is supposed to have more iron than any other type but I like lamb's.

[Zuzka1 in reply to SeasideSusie]

Can I just eat some foie grais? I live in France btw....

[SeasideSusie Remembering in reply to Zuzka1]

I've just looked that up and apparently a 1oz serving of foie grais has 1.56mg iron and 1oz of liver has about 5mg iron.

[Zuzka1 in reply to SeasideSusie]

😢

[humanbean]

If you take levo (T4) your body has to be able to convert the T4 (a storage hormone) into T3 (the active hormone). The higher the TSH the more T4 gets converted into T3.

A TSH of zero would be fine for someone who takes T3 only, but if you need conversion to happen then you need some TSH. How much you need really depends on how well you feel.

[Zuzka1 in reply to humanbean]

Hi human bean (love the name btw) but now I'm more confused. Sorry. I thought.....taking levo, which my Endo has told me to take will lower my tsh and 'hopefully ' will mean I start converting my T3 which will in turn give me my metabolism back and a spark of libido? Am I wrong??

[humanbean in reply to Zuzka1]

helvella greygoose Have I got the wrong end of the stick?

Yes, you are right, Maraphipps. Levo will reduce your TSH. But nevertheless you do need some TSH because it encourages T4 to convert to T3.

Unfortunately people don't all convert at the same rate. So, some might do very well with a TSH of 0.01, some might do well with a TSH of 1.0. People have to find out what works for them.

To improve conversion from T4 to T3, getting vitamins and minerals to optimal levels helps. Poor adrenal function can reduce conversion too. There are other things affecting conversion, I'm sure, but I can't think what they are off the top of my head.

Hopefully your doctor will take account of your symptoms not just your blood test results. Being dogmatic about the numbers is what keeps patients ill.

[Zuzka1 in reply to humanbean]

So now I'm going to sound really stupid....but....how will I know? How will I know I'm at the right level? Coz I feel good? Coz I have a libido? Coz I can try and loose weight? Feeling confused. Sorry 😢

[Muffy]

You could possibly need to take T3 along with your thyroxine.

[Zuzka1 in reply to Muffy]

Hi Muffy, would my Endo prescribe that for me? I am quite sure she's going down the route of up to 175/200mg of levo.....

Would a combination be much better?

[Muffy in reply to Zuzka1]

Hi,

I think it's worth following the route that your endo wants to take, but if you don't feel better after that, it would be worth discussing the addition of T3 or even NDT (Natural desiccated thyroid), but the latter would probably be difficult to get from your Endo.

Anyway, certainly give the higher dose of thyroxine a go as you may do well on that. Hope all goes well.

[Zuzka1 in reply to Muffy]

Thank you Muffu 😊