Test results fine, but still feeling tired?

[Lotika]

Hi -

I got diagnosed as hypo about 2 months ago.

I felt better when the medication settled in but in the last 3 weeks, seem to have gone back to feeling tired all the time. I had a blood test a couple of weeks back and thought that the results would suggest my dose is wrong... but they are perfectly normal, apparently! What next?

Here they are:

T4: 17.2 (range 12-22)

TSH: 1.22 (range 0.27-4.20)

No T3 test - the test print out says "not needed". They tested lots of other things as I asked if we could investigate why my hair is still falling out, but I can't say I understand what they all were. No folate result (it says "unavailable due to haemolysis"?) but they did test B12 which is fine apparently.

What should I do next?

Thank you for listening - it's an annoying old thing!

Warm regards,

Lotika.

[Lotika]

Oops, forgot to say that I followed the advice here on booking the test for the morning, fasting beforehand and not taking my levo until afterwards!

[greygoose]

Well, your FT4 is only just mid-range. Most people on thyroid hormone replacement need it higher than that. And, although doctors think that FT3 testing is superfluous, it actually is essential. You might not be converting that T4 to T3, in which case, you will still be hypo - which is what hypothyroidism is : low T3.

And, if I were you, I wouldn't accept your doctors opinion that your B12 is 'fine'. Doctors have been known to be wrong, on that score. So, best to post the actual number here and let's have a look.

How about ferritin? It's often low iron that causes hair loss.

[SlowDragon Administrator]

So did you manage to stick on the 75mcg starting dose.

What about testing for thyroid antibodies, was this done?

If you have Hashimoto's then gluten free diet can help improve symptoms

You definitely need to know results and ranges for vitamin D, folate, ferritin and B12 too.

[Lotika]

Hi - thanks so much for this.

So, here are the bits and bobs which I do have results for::

Ferritin: 31 ug/L (15-300)

B12: 348 ng/L (180-700)

They didn't do vit D oddly. I say "oddly" as it was low vit D which got me diagnosed originally.

SlowDragon - yes, that's correct - I originally got told 75mg Levo, but found it made me feel quite unwell as a starting dose, so I knocked down to 50 and back up to 75 about 2 months ago.

I don't see a test result for thyroid antibodies either.

OK - so, we have a plan: call the doctor and ask to be tested again for the things they missed:

- Vit D

- thyroid antibodies

- T3

- Folate.

I struggled with tummy pains when I first started on the levo (I really did struggle with it at first and it's very discombobulating that you read about it nowhere!) but that settled, fortunately and my tummy feels better than it did before levo, so I'm not having any issues I would attribute to gluten presently.

Let me know my plan makes sense and if there are other tests missing which I should be asking for. So far the doctor has been very good in giving me what I ask (tests for hair falling out, letting me up the dose to the original 75mg when I phoned and asked) so fingers crossed for the same from him again!

Warm regards,

Lotika.

[Lotika]

Hi - A quick update:

I spoke to a different GP on the phone yesterday and had some mixed results:

They will retest for T3 and folate. They won't retest for Vit D (apparently they don't test for this unless someone fulfills specific criteria - I guess having been diagnosed as Vit D deficient before isn't one of them) and they won't test for thyroid antibodies as "it doesn't tell them anything". It's odd as I expected them to argue about T3 but not about the others!

I've never had a face-to-face conversation with a doctor about my hypo: I was told I had it over the phone and everything else has been done that way since. I'm tempted to trigger a private referral just so that I can speak to someone about it, just to get some reassurance and a grasp on how to manage it, but I feel as if I'd be wasting everyone's time. I sense that things are not quite right, but also, that things aren't terribly wrong... I don't know.

I lost track of what was me and what was the brainfog / sense of hypo "meh" a long time ago!