Help please as my tsh seems all over the place!

[emmylou71]

Hi. Could somebody help me with my results? Feeling really rubbish right now. So cold and tired.

April 17

Tsh 2.68 (0.3 -5) - 75mcg levothyroxine

Sept 17

Tsh 0.038 (0.3-5)

Free t4 22.8 (10-18.7)

Reduced to 50mcg & 75mcg on alternate days.

Dec17

Tsh 11.03 (0.3-5)

Free t4 17.8 (10-18.7)

Levothyroxine upped to 62.5mcg and 75 on alternate days.

Thanks so much

[shaws Administrator]

When you have a blood test for thyroid hormones, do you have the earliest possible appointment? Fasting? (you can drink water). Do you allow a gap of 24 hours between last dose of levo and the test and take it afterwards?

[emmylou71 in reply to shaws]

Yes I've done that each of those times which is why I can't understand why it keeps changing. Before that it was pretty steady for about 9 years.

[shaws Administrator]

Did your doctor diagnose you in April '17 and then not test every six weeks thereafter with a dose adjustment?

The following:

Sept 17

Tsh 0.038 (0.3-5)

Free t4 22.8 (10-18.7)

Reduced to 50mcg & 75mcg on alternate days.

I believe if a FT4 is tested so should the FT3. It is T3 alone which is the active thyroid hormone and you don't know if you are converting levo into sufficient T3 especially if your FT4 is higher in range. If we don't have enough T3, our body cannot function as it is T3 which is the only active thyroid hormone. T4 is inactive.

If you cannot convert T4 into T3, then you need a combination of T4/T3.

Bear in mind I'm not medically qualified and had undiagnosed hypo.

Your Dec results show that you are on insufficient thyroid hormones as TSH is over range again.

[emmylou71]

No I was originally diagnosed in 2005 and was put on 50mcg straightaway as my tsh was 34. It stayed pretty steady at around 2 until the last year. Always felt tired but not like this. Don't think they've ever tested t3. They only do t4 if tsh is out of range. Thanks for your help.

[SlowDragon Administrator]

Would suspect you have low vitamin D, folate, ferritin and/or B12

You need these tested or post results and ranges if you have them

Also need TSH, FT4 and FT3 tested

NHS will not normally test FT3 so you will probably need to do privately

See Thyroid Uk website for info on private testing

[emmylou71 in reply to SlowDragon]

Thanks I'll look into private testing.

Serum c 1(0.1-6), vit d 64.7(50-250), b12 644(170-730). Dec17.

Ferritin 46(10-290) not tested since Apr 17.

I'm taking redoxon vit c with zinc & vit d. Also b12 and magnesium. I take this about an hour after Levothyroxine. Is that long enough?

Thanks so much.

[SlowDragon Administrator in reply to emmylou71]

Magnesium should be at least 4-6 hours away from Levothyroxine. Best taken in evening, (or afternoon if you take Levo at bedtime)

Vitamin D, if you are using mouth spray, probably ok. But if taking tablets, should be 4 hours away

B12 presumably is mouth spray or sublingual lozenges so is fine

Are you also taking a good vitamin B complex that has folate in. Often recommended on here to keep all the B vitamins balanced

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

How much vitamin D are you taking? Level is still too low. Aim for around 100nmol.

Ferritin was too low. It needs to be half way in range or at least above seventy

It's ok to take just vitamin C near Levothyroxine, in fact it can improve uptake, but not sure about vitamin C with zinc. Probably make sure not near taking Levothyroxine

academic.oup.com/jcem/artic...

Typical Post with detailed suggestions on supplements for Low vitamins due to under medication

healthunlocked.com/thyroidu...

[emmylou71]

Thanks for all the information. Really helpful. I'm currently taking 10ug of vit d. How much do I need to take of vit d+ b?

[helen28]

Hi emmylou71

I don't know much about the numbers but I was also put on alternate dosages and it didn't work for me. My levels have been up and down for a long time. I kept asking the doctor to refer me to an Endocrinology specialist which she only did when she couldn't figure out why my levels weren't stable. I'm now taking 175mcg daily. I am constantly tired also. I can only advise you to keep going back to the doctor and having tests until they get it right or refer you. An alternative would be to do a test yourself through a website called letsgetchecked.com. They do finger prick tests for Thyroid but it would cost money. Just an idea for an independent opinion if you are able to. Sorry to not be much help

Helen

[emmylou71]

Thanks for that I'll try to get an appointment this week. They have me splitting tablets to make up the right dosage and it's def not very accurate! Had enough of feeling rubbish.