Your FT4, TT4 and FT3 private tests all show you are under medicated
FT4 should be near 20
TT4 at least over 100, ideally higher
FT3 above 5
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, 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 articles from Thyroid UK email print it and highlight question 6 to show your doctor please email Dionne: tukadmin@thyroiduk.org
Prof Toft - article just published now saying T3 is likely essential for many, otherwise many must run suppressed TSH in order to get adequate treatment if on Levo only
Many thanks for all the info ( as said in my last post). My GP wanted all the bloods respected in a ‘reputable and accredited lab’ so that’s the recent ones. I have printed the articles to take but she did say about the possibility of referring to an endo depending on this T3 result.
I am confused as to how they all link together and whether I can demand treatment for my ferritin as it appears to be within range even though I feel rotten?
TSH is largely irrelevant. Free T3 and free t4 are too low - in fact free T3 is under range so you need an immediate 25mcg increase in levo. Ferritin is bad, should be taking 3 x 210 ferrous fumarate per day. You need a loading dose of vit D as you have a severe deficiency. Folate isn't great either. B12 is just OK.
You could self treat the vitamin D, but really they should acknowledge and prescribe
Adding a good daily vitamin B complex (with folate, not folic acid) would improve folate.
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
So the GP has prescribed me a loading regime of Vit D 60,000 units a week ( I think). Says that my ferritin isn’t low enough to need supplements as my hb is good. Apparently the lab didn’t do the T3/4 despite it being requested so just waiting on those now.
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