I got some advice earlier in the week about my latest blood results which looked like I was not converting enough T4 into T3 with my T4 just over the average range but T3 in the lower quartile.
I spoke to a nurse on the phone quite in-depth when trying to make an appointment for other blood tests to rule out other causes of my extreme fatigue, muscle pains, pins and needles, weakness etc. Interestingly she can see from my notes that free t3 has been measured before so now I have a direct comparison of my t3 on 175mcg and 200mcg of levothyroxine.
Results April 2017 (200mcg Levothyroxine)
TOTAL THYROXINE(T4) - 143 nmol/L ( 59 - 154 )
THYROID STIMULATING HORMONE - 0.47 mIU/L ( 0.27 - 4.2
FREE THYROXINE - *22.4pmol/l ( 12.0 - 22.0
FREE T3 - 3.9 pmol/L ( 3.1 - 6.8 )
Results March 2016 (175 mcg Levothyroxine)
FREE THYROXINE - 12.4pmol/l ( 12.0 - 22.0
FREE T3 - 4.6 pmol/L ( 3.1 - 6.8 )
Sorry, these results are not full as they were just given over the phone and I only asked how my t3 had changed over time.
So even though I felt very unwell at 175mcg and was very low and suicidal enough for GP to raise my levo up as a trial to see if my symptoms improved, it does appear that I was able to convert better T3 at this dose so not necessarily a conversion issue as I first thought? Maybe this is, as somebody else suggested, excess t4 being converted into rT3 and so not biologically viable.
So I feel unwell on a dose of 175mcg, and feel even worse on a dose of 200mcg as less t4 to t3 conversion is happening at this dose.
The nurse has suggested a full appointment with a GP to discuss all my symptoms with an open mind as admittedly I went in for my recent one totally focused on the thyroid dose and convinced my results would show hypothyroid so did not consider other tests. Are there any I should ask for apart from b12, folate, ferritin? I'm still hoping there is something the GP can easily spot and work to fix before I go down the route of self-medicating.
Thank you all for your sage advice, as always