Confused

Hi,

I had hyperthyroidism for 5 years and then had radioactive iodine treatment. Subsequently I became hypothyroid and am on 100mcg levothyroxine. I feel quite symptomatic and my most recent results are-

Free T4 21.8

TSH 4.14

Free T3 3.8.

I am going to see my gp tomorrow because on paper those levels are within normal limits but I don’t feel ‘normal’ . In your experience is T3treatment appropriate to ask for or an increas in thyroxine? Vit and B12 levels never tested.

Many thanks,

Nicky

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I'm sorry, but we need the ranges for those results to make any sense of them. However, your TSH is much too high for someone on thyroid hormone replacement. It should be one or under.

It looks as if you're a bad converter, but would need the ranges to confirm that. If that's the case, then just increasing your levo wouldn't help much, and adding T3 would be the appropriate thing to do.

Have you had your vit D, vit B12, folate and ferritin? If they are low, it will affect your conversion.

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Thank you for your reply. The T4 range is 12-22 pmol

TSH range 0.27 - 4.2 mU/L

Free T3 3.2 - 6.8 pmol.

I have never been given good advice from any gp when I was hyperthyroid and now hypothyroid. I will request endo re-referral as well but symptoms are definitely worsening.

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No, I have never had vit or ferritin folate testing.

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You really should get them tested.

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No, you wouldn't get any good advice from them, because they don't know much about it. Neither GPs nor endos. And you won't get much joy from an endo, now, either. 99% of endos are diabetes specialists, and know nothing about thyroid. They often end up making people worse, rather than better, so be careful who you see!

Your symptoms are worsening because, as I feared, you're a very bad converter. Your FT3 is much too low, and it's low T3 that causes symptoms. Nothing to do with the TSH, as doctors seem to think. Your TSH is too high, anyway, as I said. It's only just in range. But, increasing your levo is not going to help much. What you need is some T3 added to your levo, but only an endo can do that. However, finding one that knows anything about it/is willing to prescribe levo, is difficult.

So, send and email to :

dionne.fulcher@thyroidUK.org

requesting the list of patient-approved endos, and see if you can get your doctor to refer you to one of them, rather than just take pot-luck. :)

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Thank you so much. I will request vit levels etc as they may be inhibiting my conversion and go from there. 😊

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You're welcome. :)

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