Blood test results.

[Teddy-Twoshoes]

Hi,can someone give me some further advice, here are my latest test results.Serum T3 3.5. Serum free T4 14.1. Serum TSH 0.47. Have been on Levothyroxine 50 mg , my GP suggested I do 75mg twice a week,and 50mg on the other days, did this for a few weeks and my FT4 rose ,but my FreeT4 level dropped.She said I am probably right in the fact that I am not converting properly,and as they dont prescribe T3 any more suggested I go to Holland and Barret ,and but some Sea Kelp supplements ,which could help to bring the T3 levels up, have bought some and have been taking them for a week, but have stopped,as I am really not sure if this is the right thing to do.Any advice would be appreciated, thanks.

[SeasideSusie Remembering]

Teddy-Twoshoes

"FT4 rose ,but my FreeT4 level dropped."

Have you made a typo? Those are the same thing

"as they dont prescribe T3 any more suggested I go to Holland and Barret ,and but some Sea Kelp supplements ,which could help to bring the T3 levels up"

That's basically iodine. We shouldn't take iodine unless tested and found to be deficient. Rather foolish of your doctor to suggest that in my opinion. Kelp can't substitute for T3. Holland and Barrett own brand supplements are full of rubbish anyway, best avoided.

You haven't put the reference ranges for your results, always best to do that so we can interpret them. No idea where your free Ts lie in their range but if conversion is poor then optimising vitamins and minerals is the first thing to address so ask for the following to be tested

Vit D (needs to be 100-150nmol/L according to the Vit D Council)

B12 (should be at the very top of it's range)

Folate (should be at least half way through it's range)

Ferritin (should be half way through it's range)

Once these are optimal thyroid meds have a better chance of working.

Also, supplementing with selenium can help conversion, and a good level of zinc is needed if your GP can test that.

Would your GP support you if you sourced your own T3?

[Teddy-Twoshoes in reply to SeasideSusie]

Hi , thanks for getting back, My Free T3 is 3.5 reference range is 3.50 -6.50. My Free T4 14.1 ref is 11.00-23.00. My TSH is 0 .47 ref is 0.35 - 5.50. she did say I could source T3 but was wary about what was available on the internet, I wasnt happy with the idea of the sea kelp, but she is one of the more senior GPs in the surgery so went with it. Have just got D3 8001U to optimise my D levels and have been on taking iron supplements.Many thanks.

[SeasideSusie Remembering in reply to Teddy-Twoshoes]

Teddy, you could ask on the forum for information on where to obtain T3, and members will reply by PM if you give information about your results and the fact that your GP is willing to support you. Make a new post about that if you are interested.

Your FT4 is very low in range so you could do with an increase in Levo. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it is needed for FT4 and FT3 to be in the upper part of their respective reference ranges. When on thyroid replacement, the TSH is irrelevant, It's the free Ts that are important, particularly FT3 as T3 is the active hormone that every cell in our bodies need.

What was your D3 level? 800iu daily isn't even a maintenance dose for someone with a decent level.

What's your ferritin level, and were you on iron supplements for low ferritin or iron deficiency anaemia? Are you still taking iron? If so then take each tablet with 1000mg Vit C to aid absorption and help prevent constipation, and take them four hours away from thyroid meds and two hours away from any other medication and supplements as it affects their absorption.

[Angel_of_the_North in reply to Teddy-Twoshoes]

So you are just undermedicated on levo as your Free T4 should be >=20! 800iu won't do anythingmuch for your vit D as it is a maintenance dose for a child. Most adults need at least 2000iu to stay in the same place unless out in the sun every day.

[Teddy-Twoshoes in reply to Angel_of_the_North]

Going to have to book another appointment to see my GP,and ask about increasing the dose,and will double my D3 dose,many thanks Angel.

[helvella Administrator Thyroid UK in reply to Teddy-Twoshoes]

" she did say I could source T3 but was wary about what was available on the internet,"

OK - so she is was wary. Did she have any other suggestions as to how you can source T3 yourself? Like going on a holiday round various countries in which T3 can, with luck, be purchased without prescription?

Or was it just a ridiculously pathetic attempt to ensure that she could not be held responsible for any consequences?

You are finding out that seniority does not equate to proficiency in anything, least of all thyroid issues.

[Teddy-Twoshoes in reply to helvella]

Thanks Hellvella, feel very let down by the way I am just left to fumble around not just by her but by GPs in general who really seem to be a bit clueless when it comes to treating anyone with a thyroid condition,

[helvella Administrator Thyroid UK in reply to Teddy-Twoshoes]

I am not at all surprised that is how you feel.

I try not to lash out when I read of the ignorance of doctors - especially GPs - because they cannot know everything. When they come up with essence of sewage responses you have reported it is unforgivable.

If she thinks you need T3, then damn well prescribe it. If she gets sacked for doing so, take those who sacked her through whatever professional and legal channels there are. But don't feign concern over internet purchases. Don't push kelp without any form of iodine testing and without advice as to dosing.

I do so wish you had a good recording of her "advice" to you.

[Teddy-Twoshoes in reply to helvella]

Totally agree it is negligence , but it is happening all the time, wish I had recorded it too,thanks Helvella.

[Teddy-Twoshoes]

Thank you Seaside Susie, will ask on the forum, she didnt do my D levels they are usually around the 50 mark going by previous tests, also did not do iron,but know that my iron stores in my liver tend to be on the low side so buy 200 mg Ferrous sulphate from chemist but dont take them all the time. Do you think I should up my levo to 75 mg daily? Really appreciate you taking the time to answer me, dont really feel the medication is doing a great deal, best wishes.

[Angel_of_the_North]

How is seaweed going to increase your T3? T3 is made by REMOVING an iodine atom from T4, so extra iodine isn't going to help (unless you are iodine deficient, but you haven't been tested for that). Optimal B12, folate, ferritin and D3 and improvng gut bacteria and liver function *might* help, but kelp isn't going to do any of those things. you don't have enough T4 to convert into much T3 - your free T4 needs to be in the top quarter of the range (probably about 19, depending on the range) - so you need an increase in levo. Do these GPs have shares in H&B? Surely they shouldn't prefer one brand over another (and H&B aren'teven particulary good quality).

[Teddy-Twoshoes in reply to Angel_of_the_North]

Thank you Angel of the north I had my doubts when she suggested it but she is one of the top GP's in the practise ,only took it for a week, then common sense prevailed ,feel like I am knocking my head against a brick wall at times trying to get well. Have had B12 injection recently ,paid for it,on iron,and D3,many thanks for your response,