2nd set of test results - would appreciate some advice please

[Saraband]

Hi everyone, I would really appreciate some advice in advance of seeing my gp next Friday. I have just had my 2nd set of results, 10 weeks after the first tests. At that time my gp agreed to trialling 50mg levo for 3 months. I also had a private set of tests at that time which correlated nicely and also provided a T3 result. This latest set are NHS - and do not include T3 (though I'm fairly confident my GP would have asked for it; it's just not been done.)

THS (June) 5.9 (0.35-4.94) (Aug) 2.9 (0.35-4.94) [BH test in June 5.64 (0.27-4.2)]

Free T4 (June) 12 (9-19) (Aug) 12.3 (9-19) [BH test in June 15.66 (12-22)]

Free T3 (BH test in June) 4.49 (3.1-6.8)

Antibodies were tested in June and August and remain negligible so it would seem I do not have Hashi's.

The free T4 has scarcely changed and remains in the bottom quadrant of the 'normal' range; is it usual to see the TSH level fall with little change in T4?

I'm frustrated at not having a T3 result. it would have been helpful to see if there had been any change in T3.

I have wondered about getting another private test done in advance of seeing the GP but I don't think I'd get it back in time and I don't want to change the appt as the levo from my initial prescription will be finished very soon.

Although I do feel better than I felt before starting the Levo, I wonder how much of that is because I am lucky enough to be able to modify my lifestyle to accommodate the fatigue etc. I still feel a long way from properly well. My energy and ability to think clearly are improved but still limited and I have to pace myself carefully. My sleep quality has improved but I still need a lot of rest and sleep and have to prioritise this. My general mood remains low.

4 weeks after I started taking the Levo I suddenly felt hugely better - amazing change! It lasted 2 weeks before sliding downwards again. It did remind me of how I can feel - it would be wonderful to get there and stay there!

Any guidance would be much appreciated. Thank you!

[diogenes Remembering]

TSH can fall very slowly after starting taking T4 but yours is still way too high. From your results, you are a good converter of T4 to T3 and I wouldn't have expected much change in the FT3 if the FT4 hasn't changed. You are on a long journey of discovery and its essential that you keep a good dialogue with the GP. Ideally you should aim for a T4 dose giving TSH eventually stabilising at 1 or less. This should raise your FT3 towards the upper half of its range where it sits best.

[Saraband in reply to diogenes]

Thanks Diogenes, that's helpful. I really wasn't sure what to make of the similarity in T4 results when looking at the June & Aug results. I know that ideally we need to have TSH below 1 and T4 & T3 in the upper end of the range so no real change in T4 seemed disappointing. Maybe I'm expecting too much too soon from what you're saying? I'm hoping the gp will increase the dose from 50 to 75 when I see her.