Thyroid UK

Please help w-Feedback on Lab Results

Hello Everyone! I was diagnosed with Grave's Disease at least 15 years ago, had radioactive iodine treatment 2x in order to make my Thyroid underactive. I was told this was done because an underactive thyroid is easier to treat. I've been taking Levothyroxine all these years usually around 125 mcg. and have been Over the past years I've begun struggling with extreme fatigue. First, it was only in the afternoon between 2 & 3pm I would get very drowsy, now it's almost all day. I experimented with my medication taking 1/2 a tablet (75)mcg every 3rd day and that seemed to help some. However, when I did lab test and told the doctor (gp) what I did. He said results showed my Thyroid function was worse and he wanted to increase the medicine. The doctor said I should be feeling worse with less medication and better with more. So I don't know how to make sense of this. Right now I'm on 88mcg of Levothyroxine. Still have problems with fatigue. Vita D was mildly low at last test but I don't have the numbers on that to post but Dr. said it was not a concern or cause of fatigue. I saw an endo recently and she offered to give me T3 to supplement the Levo. I delayed making a decision on this because she said T3 has greater risks of side effects. Do my symptoms make sense to anyone? Less tired with less medicine? Also all of my symptoms get worse with PMS and I suspect I'm experiencing premenopausal symptoms as well. Will see GYN soon. I also have severe environmental allergies which may be interfering with all these symptoms as well. I greatly appreciate any and all feedback. Thank you! Here's some of my lab info. I don't know which info from the lab is needed but here's my guess on what's relevant:

In January: TSH = .343

In May: TSH 4.03 (.40-4.5mIU/L), T4 FREE 1.1 (.8-1.8ng/dL), T3 FREE 2.3 (2.3-4.2 pg/mL)

Ferritin 24 (10-232ng/mL), Iron-total 59 (40-190mcg/dL), Iron Binding Capacity 343 (250-450mcg/dL)

Sodium 140 (135-146mmol/L), Potassium 4.2 (3.5-5.3mmol/L),

In August: TSH 2.96 (.40-4.5mIU/L), T4 1.1(.8-1.8ng/dL), T3 2.5 (2.3-4.2 pg/mL)

Sodium 137, Potassium 4.2,

Thanks for any help!

3 Replies
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Your ferritin is too low - it should be around 70 for your Levothyroxine to work properly.

Your TSH is too high - it should be 1 or less. The range for TSH (0.4-4.5) is for diagnosis, not treatment. something like 95% of people with healthy thyroids have a TSH between 0.5 and 1.5. I have a feeling that I have read somewhere on this forum that if you effectively have no thyroid (which might include you, since you have had RAI twice) you can have a TSH as low as zero. The important thing is that your FT4 and FT3 need to be up above mid-range, then you will feel better. Your doctor is right that you need a higher dose of medication.

You also need a healthy level of Vitamin D, and I would be willing to bet money on your B12 being low as well. If your Vit D and B12 levels are low you will feel tired and be unable to make best use of the thyroxine.

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THANK YOU! My B12 was at 799 (200-1100). Since was within range thought it was good. Any thoughts? Will check on my Vita D. Thanks!

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Actually that's a good level for Vitamin B12.

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