This week's test results - comments would be appreciated, thanks.

[Achilles_Pain]

Two weeks ago I went back to my GP because my symptoms had started to reappear after moving from 2x50mcg to 1/100mcg levo last September so he put me back on 2x50mcg and requested another blood test. That took place on Tuesday, early morning on a (very!) empty stomach. He had a gazillion different tests done, most of which look fine to me (being non medically trained). I've included a select few here. Unless they just aren't online yet no vits have been tested this time.

free T4 16.5 (10-18.7) (16.6 last September)

free T3 6.1 (2.5-5.5) (first ever test so no idea if it's ever been outside range before)

TSH 0.05 (0.3-5.0) (0.29 last September, first time below range ever. Above range numerous times)

AST Serum 51 (7-40) (this has been over range almost every time it's been tested for the last 12 years. I did a quick google and found that it can be caused by, amongst other things, muscle damage. Coincidentally all the highest readings have been the day after a long run so I'm guessing that it's perfectly ok and just my body recovering from the exercise)

Lymphocyte count 1.09 (1.10-4.5) No idea what these are, but I've always been towards the lower end of the range, previously below range only once, in 2015)

In the fortnight since the GP changed me back to 2x50mcg all (and I mean ALL) the symptoms have been improving, most have gone completely, just the pains in the legs stubbornly remain, but they are 75% better than a fortnight ago - I went trail running last night. I couldn't have walked it three weeks ago.

I don't want to be over medicated, as the free T3 would suggest, but could that just be my body reacting to being under medicated previously and "catching up" and will soon drop back to within range, or are ranges for T3 also variable depending on the person? I don't feel ill, don't appear to be having any new symptoms, not that I'd know what to look out for, so any comments would be appreciated as I expect the practise will call me in because of the T3?

I can't believe how many tests I've had over the last 12 years. I've just exported all my results from Patient Access in pdf format and it's 20 pages long! Pity I can't attach it and give you all a laugh.

[Sybilla14]

Oh wow, what an impact from a change of pill dosage. Great news that you are now getting better, back to the previous regime.

Are the 50mcg pills from the same brand, what are you taking? And how about the 100mcg? I seem to be also noticing differences in the strength of various pills, even within the same overall dose. I suspected that mercury Pharma 25mcg was not delivering for me but now I am not sure as it may have been the almus 50mcg I took alongside to make up 75mcg. Now on Actavis 100mcg and not having any spectacular results so maybe it was the almus/Actavis that is weaker than needs to be....

[Achilles_Pain in reply to Sybilla14]

No, they are the same make. When the GP suggested moving from 50 to 100 it was me that opted to start at 75, taking 1x50 + 1x25, before moving to 1x50 + 2x25, then when I had no 25s left I took 2x50, and when they were finished I moved to 1x100, which is when the symptoms returned. All this time it was the same manufacturer (though not always the same brand name). The 50s are Almus, the 100s were Activis, but I presume Almus is just a brand name of Activis (the box says so, and the tablets are in a push out with the name Activis on it!), unless they are made by a different company under licence?

[Sybilla14 in reply to Achilles_Pain]

Thank you! Yes you are right that actavis and almus are the same, almus is just a brand box but the actual blister inside is actavis. I wonder if the potency is different I.e. I remember reading that the tolerance level for manufacturers is -15% and +5%, so if the 100mcg effectively delivers only 85mcg but the 2x50mcg we're delivering 110mcg you could be looking at a 25mcg drop in the dosing. When I was on 75mcg I used a combo of MP 25mcg and either MP 50mcg or Almus 50mcg - in 6 weeks my tsh moved only from 4.04 to 3.58 hence I suspect the potency was dodgy somewhere. My observations don't quite tally with yours so no easy answers for me yet😉

[Achilles_Pain in reply to Sybilla14]

Yes, I still don't see how it can make a difference. But how much, physically, is 100mcg? s it 1% of the tablet or 90% of the tablet? So in a 50mcg tablet that would be 0.5% or 45%. Could it be I don't digest the filler as well so with a 100mcg tablet there's less filler to digest before I get the drug and was over medicated, but with 2x50 I don't get as much of the drug as there's more filler to digest before they pass through the system?

Obviously I'm making wild guesses here as I have no information to go on, all I can say is it appears to be working as I'm getting better every day. My legs are aching today, but that's because I ran 4.5 miles on hilly, uneven, muddy/boggy trails last night in the dark with just a head torch to guide my way, my longest run in months after 6 weeks off. A fortnight ago I couldn't have walked it in the daytime.

[Sybilla14 in reply to Achilles_Pain]

Yes it really is puzzling, isn't it! Main thing is you knew what caused the problem for you and you've been able to address this.

No wonder your legs are aching after your run. That's pretty impressive distance especially after having a break and feeling unwell!

[Clutter]

Achilles_Pain,

It could be FT3 being over range which is making you feel unwell. Perhaps you could reduce dose to 75/100mcg alternate days to see whether symptoms improve.

[Achilles_Pain in reply to Clutter]

Sorry, confused here. I don't feel unwell, I feel fine.

My achilles and associated muscles and tendons are still painful, but that's because they are still improving since moving back to 2x50mcg - I'd say they're 75% better than a fortnight ago when walking 250 yards was enough to make me limp in pain. Or do you mean it could have been moving to 100mcg in the first place which caused the problem? When I was taking 1x50 + 2x25 and then 2x50 I was improving for almost 2 months before going on to 1x100, after which the symptoms started to return.

[Clutter in reply to Achilles_Pain]

Achilles_Pain,

I was suggesting it was the build up of T3 going over range which made you feel unwell but if you felt better after switching back to 2 x 50mcg it can't be.

[Achilles_Pain in reply to Clutter]

Unless the 100s were working more efficiently and now I'm back on 2x50s I'm not receiving the same amount of the drug into my system? When I was having the blood drawn on Tuesday I said to the nurse it was a pity I hadn't had a blood test before the switch over and another afterwards to see if there was a difference in the results.

[greygoose]

Have you tried taking magnesium and/or zinc for the muscle aches?

[Achilles_Pain in reply to greygoose]

No I haven't, but it's something I'll consider. When I was on 2x50 I got to the point I had no pain in my Achilles, even when I first got out of bed in the morning, for the first time in over 20 years, which would imply my vits etc are ok. This took about a month. Now I'm back on 2x50 everything is improving so I'll give it a month, see if I get back to the same, pain free state. But I eat plenty nuts (always have, nothing new) which hopefully should suffice, but if not I'll try it.

[greygoose in reply to Achilles_Pain]

It won't suffice if you have low stomach acid - which many hypos do. But, you're right, give it more time, and see how you go.

[silverfox7]

More years ago than I like to remember I was given my Levo three packets at a time and then often it changed each time. I was very sensitive to Levo and realised quite quickly that some seems too high for me and some much lower. Then I read on an American site that each tablet is made which in a certain range do a 100 mcg would have to manufactures between certain levels. I asked the pharmacist but she had no idea but said to stick to the one brand though she thought it could be fillers. So we picked one most readily available in 25's, Goldshield. This is now Mercury Pharma. So for years I was on that and pretty stable. The 25's took up so nych room as I'd been asked by the pharmacy to work up to getting a month in hand in case she had a problem getting any. So I finally decided to get less 25's and get some 100's, take up less space and also a little. Heaped for the NHS! Now I was using one one lot you if some.be are obvious to me that 4x 25 was a different strength to 1x 100 so I would advise anyone to get 25's to be consistent.