I know consultation with a doc is the key. Just wonder if anyone have the same experience. I have total thyroidectomy for papillary thyroid cancer 5 years ago on thyroxine replacement. I recently experience dizziness and imbalance and mild headache. My TSH is 0.06 with T4: 28. Does this explain my symptoms?
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adrkcy
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Your TSH is obviously below range, but you haven't given the ranges so we don't know where your FT4 lies, although I guess it's over range. You also need FT3 testing because with a very high FT4 you need to know if you are converting T4 to T3.
Dizziness and imbalance could possibly be low B12 so you need nutrients testing as well
Vit D
B12
Folate
Ferritin
You may not get them all done by your GP, very unlikely to get FT3 done actually. So you might need to do them with a private home fingerprick test with Medichecks or Blue Horizon.
Full thyroid panel plus all those vitamins and minerals:
Ah, there you are then. Your FT4 is way over range and your FT3 far too low in range which means you are not converting very well. My results used to be very similar. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo.
Good conversion takes place when FT4:FT3 ratio is 4:1 or less. yours is 28.59/4.7 = 6.08 : 1
As your conversion is so poor, you need less Levo and the addition of T3. It's unlikely that you will get T3 prescribed on the NHS.
It would also be a good idea to get those nutrients tested to see if you have any deficiencies, I had severe Vit D deficiency, low in range folate and ferritin and the only half decent one was B12. All need to be optimal (not just somewhere in range) for thyroid hormone to work.
Have you had thyroid antibodies tested? Do you know if you have autoimmune thyroid disease aka Hashimoto's?
It's unlikely your dizziness and imbalance is return of cancer. Your FT4 being over range could be a cause as could low vitamin levels. Your yearly cancer checkup should reassure you that you are clear. Are you taking any other meds that might alter absorption and do you stick to one type of Levothyroxine?
Professor Toft, past president of the British Thyroid Association and leading endocrinologist recent article saying, T3 may be necessary for many. Note especially his comments on current inadequate treatment of patients following RAI or thyroidectomy.
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