Blood results - is my dose right - what should I do next?

Hi, I have just found a complete record of blood / hormone results, I forget the initial dose of Levothyroxine, but it was increased gradually to 150mg, until Sept this year, when I was told it was far to high and decreased by half to 75mg. I have been referred to an endo...(appt in Feb) since the reduction in dose, many of the other symptoms that I suffered (which had gone away completely in the last year after losing weight) have returned including weight gain and increase in dress size. I have asked that the dose be adjusted, but I'm told my bloods are within normal so they won't. Any advice would be appreciated. I do remember asking about T3 readings early on in my diagnosis, but felt that Dr know best, what should I be asking for, and why please?

03 Oct 06Serum free T4 level13.6 pmol/L10.8 - 19.3pmol/L

19 Dec 06Serum free T4 level21 pmol/L Abnormal result10.8 - 19.3pmol/L

27 Feb 07Serum free T4 level22.3 pmol/L Abnormal result10.8 - 19.3pmol/L

01 Oct 07Serum free T4 level20.1 pmol/L Abnormal result10.8 - 19.3pmol/L

20 Nov 08Serum free T4 level13.9 pmol/L10.8 - 19.3pmol/L

03 Jul 09Serum free T4 level24.5 pmol/L Abnormal result10 - 19.8pmol/L

03 Jul 09Serum free T4 level24.5 pmol/L Abnormal result10 - 19.8pmol/L

16 Jun 10Serum free T4 level19.9 pmol/L12 - 22pmol/L

09 Mar 11Serum free T4 level20.5 pmol/L12 - 22pmol/L

06 Mar 13Serum free T4 level22.8 pmol/L Abnormal result12 - 22pmol/L

31 Jan 14Serum free T4 level21.9 pmol/L12 - 22pmol/L

06 Nov 14Serum free T4 level19.6 pmol/L12 - 22pmol/L

28 Jun 16Serum free T4 level29.1 pmol/L Abnormal result12 - 22pmol/L

06 Oct 16Serum free T4 level27.8 pmol/L Abnormal result12 - 22pmol/L

25 Nov 16Serum free T4 level19.9 pmol/L12 - 22pmol/L

and

03 Oct 06Serum TSH level9.3 mu/L Abnormal result0.5 - 4.2mu/L

19 Dec 06Serum TSH level0.2 mu/L Abnormal result0.5 - 4.2mu/L

27 Feb 07Serum TSH level0.1 mu/L < Abnormal result0.5 - 4.2mu/L

01 Oct 07Serum TSH level0.1 mu/L Abnormal result0.5 - 4.2mu/L

20 Nov 08Serum TSH level6.8 mu/L Abnormal result0.5 - 4.2mu/L

03 Jul 09Serum TSH level0.1 mu/L < Abnormal result0.5 - 4.2mu/L

03 Jul 09Serum TSH level0.1 mu/L < Abnormal result0.5 - 4.2mu/L

30 Nov 09Serum TSH level0.9 mu/L0.5 - 4.2mu/L

16 Jun 10Serum TSH level0.04 mu/L Abnormal result0.27 - 4.2mu/L

09 Mar 11Serum TSH level0.07 mu/L Abnormal result0.27 - 4.2mu/L

31 Jan 12Serum TSH level2.24 mu/L0.27 - 4.2mu/L

06 Mar 13Serum TSH level0.03 mu/L Abnormal result0.27 - 4.2mu/L

31 Jan 14Serum TSH level0.12 mu/L Abnormal result0.27 - 4.2mu/L

06 Nov 14Serum TSH level0.05 mu/L Abnormal result0.27 - 4.2mu/L

28 Jun 16Serum TSH level0.02 mu/L < Abnormal result0.27 - 4.2mu/L

28 Jun 16Serum TSH level0.02 mu/L < Abnormal result0.27 - 4.2mu/L

06 Oct 16Serum TSH level0.02 mu/L < Abnormal result0.27 - 4.2mu/L

25 Nov 16Serum TSH level0.19 mu/L Abnormal result0.27 - 4.2mu/L

I also found a history of weight and despite being told "it's ok" it's well above the graph I found in my records of my ideal weight. BMI at it's highest was 33 (normal range 18.5-24.9) it's currently 27.55kg/m2 normal range N/A

I would add these results have never been explained to me......

2 Replies

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  • Well, your next step should be to get full testing done. Because, although your FT4 looks ok, you don't know if it's being converted into T3, the active hormone. I know the NHS is very bad about testing - no-one really understands anything about thyroid in the NHS - so you're going to have to do some privately.

    What you need are :

    TSH

    FT4

    FT3

    TPOab

    TgAB

    vit D

    vit B12

    folate

    ferritin.

    The TSH is actually irrelevant when you're on thyroid hormone replacement, unless it goes high, so best to do it, anyway.

    FT4 (storage hormone) and FT3 (active hormone) need to be tested at the same time, to see how well you are converting.

    TPOab and TgAB are antibodies, to see if you have Hashimoto's. If so, there are things you can do to help.

    Vitamins and minerals are often low in hypos, because of low stomach acid. They need to be optimal for your body to be able to use the hormone you're giving it. Plus, low nutrients will add to your symptoms.

    So, when you have all those results, then you will know what to do next. :)

  • Welcome to the forum, Yvostick.

    TSH (Thyroid Stimulating Hormone) is a pituitary hormone which responds to thyroid hormone levels. T4 and T3 are the thyroid hormones. The pituitary gland increases TSH when low circulating T4 and T3 is detected. TSH drops when sufficient T4 and T3 is circulating.

    TSH is flagged as abnormal when it is either above or below the lab ref range 0.27 - 4.2. Many doctors think patients are over medicated when TSH is below range but as long as FT4 and FT3 (if tested) are within range the patient isn't over medicated.

    FT4 is flagged as abnormal it is either above or below the lab ref range 12-22. FT4 was over range in June and October 2016 which is why your Levothyroxine dose was reduced. Halving dose was drastic. It's usual to adjust dose in 25mcg increments every 6-8 weeks.

    Your November results for TSH 0.19 and FT4 19.9 indicate you were adequately dosed.

    thyroiduk.org.uk/tuk/about_...

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