Latest results help please - am I on the right dose or do I need an increase?

[MiniMum97]

Hi all

Help with latest results please. Diagnosed in May, I am currently on 100mcg of levo. About 4 weeks ago my fatigue lifted and I have been able to do some exercise (2x3mile walks and 2x6mile walks) without a massive thyroid slump afterwards (yay for me – very exciting!). Still have some other symptoms though although everything is improved. Haven’t lost any weight although hoping that might get better with introducing some exercise and not eating so much as I don't feel so exhausted. Had a number of people saying to me that I look well! ☺

Ok so results. Had NHS and Medichecks one done on same day (I’ve put the last test results I had after 6 weeks on 75mcg of levo in square brackets after each test):

NHS:

TSH – 0.14 (0.27 – 4.2)

T4 17.5 (12-22)

Medichecks:

TSH – 0.15 (0.27-4.2) [Last test: 1.09]

Free thyroxine 17.1 (12-22) [15.5]

Total thyroxine 102.0 (59-154) [89.5]

Free T3 4.67 (3.10-6.8) [4.39]

Antibodies still negative – about 6th test now.

Annoyingly Medichecks have changed their thyroid ultra vit B12 test to an active b12 test so I don’t have a serum b12 update to know if I am supplementing correctly.

Folate – 7.88 (2.91-50) [7.39]

Vit D 75.5 (50-200) [68.9]

CRP 3.4 (0-5) [1]

Ferritin 31.6 (13-150) [31.7]

I am currently taking the following supplements: b12 1000mcg, B complex (Metabolics - 1 tablet only), 2 x spatone with 1000mg vit c (I know this isn’t enough but was trying it as unable to tolerate any other supplements or liver), vit D3 5000iu with 100mcg K2 mk7 (on and off during last 6 week period as I stopped for a while due to a potential clotting disorder), 350mg Magnesium.

Thank you!

[SeasideSusie Remembering]

MiniMum97 That's really good to see that both NHS and Medichecks tests, done on same day, have given virtually the same results, dispels any doubts people might have that these private tests aren't accurate!

Things seem to be improving for you, your conversion is good although both FT4 and FT3 might be better higher up their ranges if you feel you still need to improve.

As for your vitamins and minerals:

Folate – 7.88 (2.91-50) [7.39]

You need to be taking 2 x Metabolics B complex. When you come to the end of your current supply, you will find that they have almost doubled in price. I'm coming to the end of my pack and I will probably be changing back to Thorne Basic B. 1 x Thorne Basic B gives the same doses as 2 x Metabolics B Complex. When I first started taking B Complex, I used Thorne Basic B and it raised my folate level from very bottom of range to very top of range in 2.5 months taking 1 capsule daily.

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Vit D 75.5 (50-200) [68.9]

You're now in the replete range but still short of the level recommended by the Vit D Council (100-150nmol/L).

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Ferritin 31.6 (13-150) [31.7]

You have such a long way to go with this and it's most important to reach 70 for thyroid hormone to work properly and conversion of T4 to T3 to take place. Someone mentioned the other day a supplement called Blood Builder amazon.co.uk/MegaFood-Daily... It is from food source (vegetables/yeast). I don't know if that would be suitable for you. I don't have any personal experience of it yet, I have some on order to try it.

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B12

As this was in the 400s when last tested, I would continue with your 1000mcg daily. You wont need a higher dose, and you want to get to 900-1000 and keep it there. Mine is around 1000 and I take B12 4 or 5 days a week as a maintenance dose.

[MiniMum97 in reply to SeasideSusie]

Thank you SeasideSusie for such a helpful and comprehensive response. Can I ask about my TSH as have read conflicting things? Does it matter if it goes very low? How low is too low?

[SeasideSusie Remembering in reply to MiniMum97]

Doctors will tell you of the dangers of a suppressed TSH - artrial fibrilation, osteoporosis, strokes, etc.It's all scaremongering. If so, how come all those thyroid cancer patients who need a suppressed TSH haven't all been afflicted with all these ills? I'm sure we'd have heard about them if they had!

Dr Toft, past president of the British Thyroid Association and leading endcrinologist, mentions that sometimes a suppressed TSH and over range FT4 is needed to feel well, and that's OK as long as T3 is in range:

Dr Toft states in Pulse Magazine, "The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the article by emailing [e-mail] if you think you might need it for future reference. It is Question 6 in the article.

I don't know how low the labs can measure. Mine has been suppressed for donkeys' years (much to the dismay of my TSH obsessed GP). Results from Blue Horizon (only tests I've had done for 3 years) show either 0.01, <0.01 or <0.005. I did have NHS tests in 2006 and 2007 which showed TSH at <0.02, my last detectable TSH was in 2004 and it was 0.07. I'm not dead yet although I nearly was when I saw an endo who didn't like suppressed TSH, messed with my meds until TSH was 0.4 (0.27-4.20) but then my FT3 was 2.8 (2.8-7.1). He was such a happy bunny, I was a total zombie! Never again!