Could you comment on my results please x

[mambo69cat]

Hi, I'm on 75 levo and I still don't feel 100%. Predominantly, the muscles in my legs ache and I sometimes get cramp in my leg or foot. It does come and go and last couple of days is fine. Occasionally I have difficulty walking up stairs but fine at mo.

I have difficulty get to sleep and I feel exhausted after walking not over long distances, plus some depression.

Any help would be appreciated.

Thanks, Chris x

TSH 2.11, range 0.27 to 4.2

Vitamin D 25 hydroxy

B12 659, range 180 to 866

Iron 91, range 30 to 400,

Serum folate 7.4, range 3.9 to 26.8

Unfortunately, in Cornwall, T3 and T4 etc. are not tested.

[Clutter]

Mambo69cat,

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 1.0 or lower with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email [e-mail] if you would like a copy of the Pulse article to show your GP.

B12, folate and iron look fine. You haven't included the result for vitD.

Muscle cramp can be due to lack of salt and low magnesium. You could add a pinch of salt to a tumbler of water or orange juice for 2-3 days when you get a cramp and supplement magnesium or use magnesium oil spray on your legs or take an Epsom Salt bath to relieve muscle aches.

[mambo69cat in reply to Clutter]

Hi thanks for quick reply. Vitamin D is there,

Vitamin D 25 hydroxy

[Marz in reply to mambo69cat]

Yes but no result 😊

[Clutter in reply to mambo69cat]

Mambo69cat,

Vit D 25 hydroxy is the name of the test, it's not the result.

[mambo69cat]

Ah, will have to query that! That's what I was given on the phone and I did ask her to repeat it. She said there was no number there. Thank you guys x

[Hidden]

Is there no way you could have FT3 and FT4 tested, for instance, through a private lab? However, since your TSH is above 2, my guess is they are still lowish, as optimal free T levels usually result in a rather low TSH (1 or even lower, possibly even suppressed).

[mambo69cat in reply to Hidden]

I can definitely look into that. I will be making a visit to the doctors as hope that I can get my levo increased to 100. Will that make a difference?

[Hidden in reply to mambo69cat]

If your FT4 levels are suboptimal, probably, unless you have a conversion problem (not converting enough T4 to T3).

Unfortunately, most doctors don't seem to understand thyroid disease or treatment. Everyone is different, but most people with an under active thyroid on T4 drugs only seem to feel best with a rather low TSH (around 1 or lower), and FT4 levels close to the upper normal limit. This is so to that enough T4 gets converted to T3, the active thyroid hormone (provided you don't have a conversion problem).

If you have problems converting T4 to T3, you will remain hypothyroid, no matter how much T4 you have in your system. In that case, T3 + T4 treatment works best (synthetic T3 and T4, or NDT) or, in some cases, T3 alone. You never know until you've tried them all...

Anyway, don't give up. You are just at the beginning of a long process, and I am sure you will figure it out in the end. You are still on a low dose of T4, and I'd be surprised if you felt good on that if suffering from full-blown hypothyroidism.