Thyroid UK
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Test results exactly the same despite increase in T4

My test results from Oct (75mcg levo) and those from Dec (100 mcg Levo for 6 weeks) are exactly the same in every respect! Totally bizarre. I would welcome any suggestions on why that might be?

Here are the results. It looks to me that I was slightly under-medicated both times. I have since added 6.25 x T3 3 x daily to this. The results suggest that ferritin is a bit low? Is B12 OK or should I supplement more?

Test results in October (and Dec)

TSH: 1.22 - (0.27-4.2)

T4: 17.2 - (12-22)

Ferritin 31 (15-300)

B12 348 (180-700)

Vit D is 90 apparently for Dec, but no lab range on that, so who knows what it means. (I don't have T3, Iron etc.)

Thanks for any wisdom on these!

Lotika

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You really need to know FT3, especially now you have added 3 x 6.25 T3 per day

You'll need to test privately via Medichecks or Blue Horizon

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test (12 hours T3) , delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results

Ferritin and B12 are too low

If supplementing B12 sublingual lozenges it's good idea to also take good vitamin B complex as well, this will keep B vitamins balanced and 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

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

endocrinenews.endocrine.org...

Ferritin, how much ferrous fumerate are you taking? Should take 1000mcg vitamin C with each tablet

Do you have Hashimoto's? High thyroid antibodies?

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Hello SlowDragon,

Thank you :) I have a self-test kit: thyroid + 11, I think from Blue Horizon. I have only been on T3 a week, though, so I'm not sure how long to wait to take the test? Should it be 6 weeks to get a more accurate result?

Good info re Biotin. I am taking that too, so I will stop it before I do the BH test, above.

I have just started taking an iron supplement. I had iron as part of a multivitamin, but I didn't think it was enough, so I ditched that and got hold of the rest separately. New iron tablet is comprised of 6mg Vit B6, 400mcg folic acid, 10mcg B12, 17mg iron, 12 mgb zinc and 1000mcg copper.

Yes, I do have Hashis / high antibodies. Am trying to control these with GF & DF and low sugar diet, curcumin tablets, probiotic, prebiotic, etc.

Lotika.

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Yes you should wait 6 weeks to test

Good you dropped multivitamin, they are useless

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Lotika,

I'm guessing that FT4 didn't rise after increasing dose because the dose increase wasn't sufficient. You've now added T3 so you should expect to see TSH drop and FT4 may drop too. It's a bit reckless to add 18.75mcg T3 which is equivalent to 56mcg Levothyroxine without checking your FT3. If your practice won't order FT3 blood tests you can order from Blue Horizon or Medichecks via thyroiduk.org.uk/tuk/testin...

VitD 90 is replete ie >75. I would continue supplementing until April when ultraviolet light is strong enough to stimulate natural vitD.

B12 348 is probably okay but if you have many of the symptoms in b12deficiency.info/signs-an... go to healthunlocked.com/ for advice.

Ferritin is optimal halfway through range. You can raise ferritin by supplementing iron with 1,000mg vitamin C to aid absorption and minimise constipation. Retest in 4-6 months.

VitD and iron should be taken 4 hours away from Levothyroxine.

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Thanks, Clutter, that makes sense about the increase.

I added the T3 at that level on the advice of an endocrinologist. He doesn't believe in T3 testing on the basis that he thinks its the amount of T3 which gets into the brain which makes people feel better, which he doesn't think is reflected in the blood tests...

I have a test kit here from the private people because I decided that I'm going to attempt to take control of this mess myself but am not sure how long after starting the T3 I should wait to test? 6 weeks?

To be fair, the endo told me to wait until he called (which was supposed to be before Christmas) before ordering and taking the T3. He still hasn't called. He's gone away apparently.

I don't think I always take Vit D 4 hours from levo, so I will amend and make sure the Vit D is in the lunchtime batch of pills!

Thanks again :)

Lotika

Reply

Lotika,

Strange thinking about the FT3 test. I'm surprised endo said to take 18.75mcg in addition to your Levothyroxine dose because TSH will become very suppressed. Yes, wait 6 weeks before ordering the FT3 test.

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Thanks, Clutter :)

I think he wrote the prescription and was hoping to see the lab results and tweak the dose depending... but I was impatient. I'm curious to see what he says when he does call.

He directed 3 x 5mcg a day and I could only get 25mcg tablets, which I quartered. Given they crumble when cut, I like to tell myself I'm close to 5mcg...

So, I'm guessing there's a concern that I could be over-medicating? I feel OK so far, but then I'm only a week in...

Reply

Lotika,

I'm sure you are overmedicating. It will take 3-4 weeks for FT3 level to build up before you feel overmedicated. I would have advised you to start with 6.25mcg unless Levothyroxine dose had been reduced.

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Thanks - even though levo dose was probably 25mcg too low to start with?

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Lotika,

It's nothing to do with your 25mcg starting dose. Your Dec TSH and FT4 results indicate you are adequately dosed on 100mcg Levothyroxine with perhaps a small tweak required so adding the equivalent of another 56mcg is inevitably going to overmedicate you.

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Thanks. Eeeek! I hear you about cutting back but I feel better than I have in ages, so it's an almighty blow... I also understand you to be saying I'll start feeling terrible in a week or so if I don't cut back now...

Thanks for your time with this... tough decision!

Reply

Lotika,

If you do start feeling overmedicated just skip doses for a couple of days and reduce dose.

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