Thoughts On Latest Blood Test Results Pls :)

I'd be grateful if folk could let me know if they think I am optimally medicated considering my latest blood results, which are:-

Serum Free T3 level... 4.3 pmol/L (normal range 4.0 - 7.0)

Serum Free T4 level... 23 pmol/L (normal range 10 - 25)

Serum TSH level... 0.02 mU/L (normal range 0.55 - 4.78)

Not quite sure about the T3 and TSH levels!

I am prescribed 100mcg Levothyroxine, but sometimes take 125mcg if feel low intermittently. Considered personally taking Levo & T3 combo prior to results, GP would only consider if not converting T3 from T4, and says results show I am, so that's out via NHS.

Appreciate thoughts, thanks

[SeasideSusie Remembering]

You are not converting very well at all. Your FT4 is almost at the top of it's range but your FT3 is just 0.3 from the bottom.

Good conversion takes place when FT4: FT3 ratio is 4:1 or less. Yours is 5.34 : 1

It's an endo who makes the decision to prescribe T3 initially, not a GP. But it's virtually impossible for anyone to have it newly prescribed now.

[Hidden in reply to SeasideSusie]

Thanks for your thoughts!

They won't refer me to an endo. I am OK on B12 and take all the recommended supplements. I have bought some Tiromel T3 tablets (25mcg) so I can start taking those. Maybe take the 100mcg T4 and the 25mcg of T3 or cut back on the T4 to 75mcg with the 25mcg? They won't test me for Hashimoto antibodies as they say the treatment doesn't change. I am waiting for a gluten intolerence test result. The Dr. says that Hashimoto and coeliac go hand in hand so if I'm ok then probably don't have it. Would taking T3 help with conversion do you think?

Appreciate your advice

[SlowDragon Administrator in reply to Hidden]

According to Isabella Wentz the Thyroid Pharmacist about 5% are coeliac but 88% find gluten free diet beneficial

Even if no other improvement it should reduce antibodies

But for many (including myself) it's significantly better.

If you have gluten issues you probably should resolve that before starting T3

Your vitamin D, folate, ferritin and B12 must be very good levels too

T3 also needs starting incredibly slowly

Split doss twice a day - an 1/8 or at most 1/4 tablet to start with

Dropping T4 by 12.5mcg for 2 x 1/8th

25mcg for 2 x 1/4

[SlowDragon Administrator in reply to Hidden]

The only reliable coeliac test is an endoscopy. Gastroenterologist told me the coeliac blood test is only correct 50% of the time

Gluten intolerance there is no NHS test.

[Hidden in reply to SlowDragon]

Thanks!

[SeasideSusie Remembering in reply to Hidden]

T3 wont help with conversion, it replaces what your body isn't converting from the Levo.

Although I'm not Hashi's myself, I think it's important to test. If you know you have it then you can learn what Hashi's can do - fluctuating antibodies cause fluctuations in symptoms and results - so you know how to deal with it. And whether you're coeliac or not, when you have Hashi's a gluten free diet and supplementing with selenium can help reduce the antibodies.

[SlowDragon Administrator]

Do you have Hashimoto's (high antibodies)

If so then are you on gluten free diet

thyroidpharmacist.com/artic...

Have you got recent tests for vitamin D, folate, ferritin and B12

Chopping and changing Levo dose is probably not helping

Helping gut heal with bone broth, probiotics and fermented foods can help too

[CareyCooper in reply to SlowDragon]

Thank you for the updates

[Hidden in reply to SlowDragon]

Thanks for your thoughts, I have mentioned your questions in my reply to SeasideSusie.

[silverfox7]

I had the same problem as you. I got my VIT D checked B12, folate and ferritin. These all help conversion as well as your general health. Vit D was vey low so was given. Booster dose then maintenance dose for life. If you stop it drops like lead! B12 low do supplements. Folate like you under range and treatment only just put it in low range so I would post those on the PA forum if low and ferritin was good but it took me 6monyhd to do it but it worked!

So all is not lost. You can go it without adding T3 but not overnight and the time will depend on how low you are so get tested then post your results and ranges. Doctors sadly think if in range you are fine but you need to be optimum

[Hidden in reply to silverfox7]

Thank you. I am taking all the recommended supplements/vits with high dose B12 and Vit D. Started taking adrenal support. Been recently tested for B12 and gluten. Fine on B12 and waiting on gluten result. How do you supplement with folate and ferritin? Isn't that just iron? I am not iron deficient.

[SlowDragon Administrator in reply to Hidden]

Get tested either via GP or Medichecks or Blue Horizon

If these are not good first before starting T3 then body can't use it - get in a pickle

[Hidden in reply to SlowDragon]

Thank you!

[silverfox7 in reply to Hidden]

My GP gave me a prescription for folate as I was under range so had a. Purse for 3 or 4 months of 5 mg but as it just scraped into the range I wasn't given anymore. So I rushed to the chemist and bought some as was gong away in a few days and didn't want to stop them. Could only get a minute dose so ended up taking 12 a day! In my return I found I could get the correct dose from Amazon but not sure they still do them. I know you have to. E careful with iron but not the details. I still take the folate every other day so higher in range now. Better check I can still get them!

[SeasideSusie Remembering in reply to Hidden]

If you post your results for vitamins and minerals, suggestions can be made for appropriate doses and what to buy where supplements are needed.

[Hidden in reply to SeasideSusie]

I've only been tested for B12 where they say there is no deficiency. I am just taking over the counter high doses of all the other stuff bar iron. My GP told me not to take that or Iodine. I've been tested for iron deficiency before several times and has been normal. In conclusion ré gluten, is it the general agreement that all low thyroid sufferers should be gluten free for optimum health, whether hashi or not? I still may take the T3 as there no point upping the Levo because my GP says I'm edging towards hyper levels of T4. To be honest I can't afford the full function test privately and the GP only agreed to T3 and B12 test under a lot of coaxing. Think he wants to strike me off his list for killing his budget, jokingly speaking

[SeasideSusie Remembering in reply to Hidden]

Hidden There are two nutrients which should not be supplemented without testing. These are iron and Vit D. The reason being that any excess is stored and will become toxic. There are also important cofactors needed when taking Vit D, mentioned in every reply that comments on low levels and suggests supplementing.

B vitamins are water soluble so any excess is excreted.

High doses of anything are risky, and also a waste of money if they're not needed. This is why testing is important.

Whatever the B12 result was, it needs to be a minimum of 500 to avoid neurological problems, and it's recommended to be at the top of the range, regardless of 'no deficiency' or not.

In conclusion ré gluten, is it the general agreement that all low thyroid sufferers should be gluten free for optimum health, whether hashi or not?

I'm not Hashi's and I'm not gluten free.

The full thyroid panel along with vitamins and minerals will cost £99 with Blue Horizon and £99 with Medichecks although often on special offer at around £79. Maybe you can save up and fit it into your budget. Better safe than sorry, also you may just be wasting money on supplements you don't need.

If you add T3, it's important to retest whilst you are tweaking doses.

[Hidden in reply to SeasideSusie]

Thank you, appreciate it!