Guidance after blood test results

[link11]

I was diagnosed with hypothyroidism in November 2016 before being put on a starting dose on Levothyroxine and then having it upped to 100 mcg. I've been on that dose for around 4 months now, but cant say i feel much better as the cold intolerance ,brain fog,memory and energy shortage problems are still as bad as ever. I have never been tested for T3 even though i asked specially for it to be included in my latest test. My recent blood reading is as follows.

Serum TSH level <0.01 (0.35-5.50)

Free T4 level 18.1 (10.00-19.80)

My gp has already told me that he is reducing my medication. The thing is i hardly feel any better at all! I am so confused and don't know what to do.I should mention that i am b12 deficient and taking methylcobalamin each day. Could the reason I still feel so bad be something to do with my T3?

[puncturedbicycle]

Yes, it could be t3 and/or it could be iron, folate, d, have any of those been tested?

[link11 in reply to puncturedbicycle]

My iron and vitamin d levels were in range but folate was a little low.

[puncturedbicycle in reply to link11]

The range is too broad so even when in range you can feel awful and have symptoms. Do you have a copy of your results and the lab ranges?

Let's say hypothetically that the lab range for iron is 10 - 100. If you're below 10 you may be prescribed an intravenous infusion of iron. The way you feel when you need an IV infusion (9) and the way you feel when you're 'normal' (10) is no different. Your iron levels should be closer to maybe (again this is a hypothetical range) 50.

[link11 in reply to puncturedbicycle]

Unfortunately I only have serum iron level because the lab rejected my b12 and folate this time and ferritin wasnt checked. I can give you past results but i'm not sure if that will be of much use as they are obviously outdated. I should have mentioned before that i am also taking vitamin d pills as i was initially low in that area though i've been told i am now fine.

[puncturedbicycle in reply to link11]

Well if they were low and you weren't supplementing then they will still be low. The more current the results the better but if something was wrong it would not have got better on its own if you see what I mean.

Again, they will tell you you're fine but it's immaterial as you're here saying you're not fine. Ideally you need a copy of results and ranges every time you have a blood test. It is the only way to keep your own records.

[SeasideSusie Remembering]

link11 There's no way you'll know if your problem is anything to do with T3 unless you have FT3 tested at the same time as FT4. If your GP can't get FT3 done (and it's very unlikely as the lab rarely does it even when requested) then you might want to do a private test with Blue Horizon or Medichecks.

As you are B12 deficient, have any of your other vitamins and minerals been tested? Vit D, Ferritin, Folate? What is your B12 result and how much methylcobalamin are you taking? Are you taking a B Complex with it to balance all the B vitamins?

Are you taking your Levo correctly - on an empty stomach, one hour before or two hours after food, with water only?

Are you taking any other medication or supplements within two hours of taking Levo? Some can affect it's absorption.

Your GP wants to reduce your Levo because your TSH is suppressed and he thinks that means you're overmedicated. However, your FT4 is in range, and you can only be overmedicated if your FT3 is over range. Unfortunately, doctors don't seem to know this.

[link11 in reply to SeasideSusie]

My vitamin d levels,iron and ferritin are all within range. i also take the levo an hour before breakfast. I am on 150 mg of amitripyline at night but im not sure if that will have an effect. It looks like I may have to get a private blood test then unless i can convince my gp. Thanks for the help.

[SeasideSusie Remembering in reply to link11]

'In range' doesn't necessarily mean optimal, and it's optimal levels that we Hypos need. What are your actual results? Ferritin in particular has to be at least 70 for Levo to work.

[steviecat]

Free T3 test - you need Free T3 testing!

[SeasideSusie Remembering in reply to steviecat]

At the same time as FT4 though, otherwise you wont know how well T4 is converting to T3.