Advice please on results

[KittyAO]

Hello everyone, hoping you can help me as I have been fine on 50mg Levo (apart from Teva) since 2012 but gradually feeling v tired with a slump in the afternoon. Problems with tight feeling around my throat, sore tongue, headaches and joint pain around elbow and calves. Tests always done and Levo taken as advised by your wise guidance.

Asked for small increase in Levo, ie 25mg and I was going to split tablet, ie 62.5mg to try how I felt but Dr refused by saying I couldn't have an increase and gave me treatment for oral thrush which I still have. I should add my last test at the Docs a month before was TSH 2.5, sorry I cannot find the ranges at the moment.

Thank you

TSH 3.24 mIU/L (0.27 - 4.20)

FREE THYROXINE 14.8 pmol/L (12.00 - 22.00)

TOTAL THYROXINE(T4) 112.0 nmol/L 59.00 - 154.00

FREE T3 4.35 pmol/L 3.10 - 6.80

REVERSE T3 *26 ng/dL 10.00 - 24.00

REVERSE T3 RATIO *10.89 15.01 - 75.00

THYROGLOBULIN ANTIBODY 14.200 IU/mL 0.00 - 115.00

THYROID PEROXIDASE ANTIBODIES <9.0 IU/mL 0.00 - 34.00

ACTIVE B12 54.9 pmol/L (25.10 - 165.00)

FOLATE (SERUM) *2.76 ug/L(2.91 - 50.00)

VITAMIN D *36.9 nmol/L (50.00 - 200.00)

Inflammation Marker CRP - HIGH SENSITIVITY 0.8 mg/l (0.00 - 5.00)

Iron

FERRITIN *242 ug/L (13.00 - 150.00)

[fibrolinda]

You need an increase, TSH too high and t3 and 4 too low. What is your d*ck of a GP doing about your dire vitamin d and Folate? Has he done an iron status check, your FERRITIN is high?

[KittyAO in reply to fibrolinda]

Thanks for replying, I am waiting to see Dr with results. I am concerned about the high Ferritin and low levels of Vit D and Folate. I wasn't sure what the thyroid results mean.

[Nanaedake]

You need to have a dose increase. You've probably become more hypothyroid over time due to the thyroid antibodies. I think thrush can be related to low thyroid levels but may also be linked to low vitamins.

What are you taking for low vitamin levels?

[KittyAO in reply to Nanaedake]

Hi 1 x 800 tablet a day of Colecalciferol. My level was low previously and i asked gp about a higher dose but she told me it was fine.

[Nanaedake in reply to KittyAO]

800 iu is not enough to bring your levels up but if in the UK, the doctor may not give loading doses as the guidelines say to give loading doses if result is lower than 30 and yours is just above. It means you may have to buy your own to add to what the doctor gives. SeasideSusie gives good suggestions on vitamin D supplementation.

I would though, ask your doctor why she thinks that your vitamin D has not risen into an acceptable range if she thinks 800iu is enough and ask what she's going to do about it? After all, what's the point of the NHS having a range if doctors are going to ignore it?

B12 is low and folate is below range. Don't supplement with folate until you've had B12 checked out investigated as folate supplements can mask B12 deficiency. Post your B12 and folate results with a bit of background info on the HealthUnlocked Pernicious Anaemia forum to get advice before visiting your doctor.

Your TSH needs to be 1.0 or a little lower as that is where most people feel well but you probably won't feel well until you've got your vitamin levels sorted.

Ferritin needs checking out as you've already noted.

[KittyAO in reply to Nanaedake]

Thank you for your help will follow up when i have been to Docs.

[Nanaedake in reply to KittyAO]

If your vitamin D level was below 30 previously you should have been given loading doses. Point your GP to the NICE guidelines which they are required to follow. There will also be CCG local area guidelines for vit D supplementation which will be similar to NICE guidelines.

cks.nice.org.uk/vitamin-d-d...

[Angelone]

Hi I've had the condition all my life. However since taking the new formulation medication fom TVA . I don't feel they are

[Angelone]

Oops aren't as efftive. Headache feel tired coincidence I think not

[KittyAO in reply to Angelone]

Teva gave me a headache and sore neck so i have gone back to Mercury Pharma. You can ask for a brand name from your pharmacy and yellow card Teva if you in the UK. I hope changing brand will help you, it did for me, just now increasing dose of levo after GP visit and getting vitamins right. Good luck with changing levo.

[roxanaleah]

Hiya, KittyAO,

I think your request was an impressively sensible one.

Knowing everything I now know (from my personal experience), if you sought my advice, I would actually suggest adding 5mcg of t3 rather than any more t4, at this time.

I have just discovered data suggesting that high serum t4 impairs systemic t3 production. And although your serum t4 is not close to being "high", I would be very interested to see if the addition of a modest dose of t3 improved your overall wellbeing.

If you accept the 3/1 potency of t3 to t4, then such a change would put you at 65mcg, which is quite near what you had in mind.

Those are my thoughts, coming from a place of absolute best intentions for you.

Whatever you choose, I hope your improvement is noticeable and timely!

[KittyAO in reply to roxanaleah]

Thank you