Please help with my blood results

[cherylwadey]

Hi. I seem to have gained even more weight lately which is really depressing and really uncomfortable and my hairloss is just the same. The iron tablets made my constipation worse causing bloating and pain despite taking 3000mg of Vit C daily. having had one appointment with an endo he discharged me after raising my Levo from 50mg to 75mg. My blood results from last week are as follows:

TSH 1.49 0.30 - 3.94

FT4 15.5 12.30 - 20.20

FT3 4.3 3.70 - 6.70

Folate 7 ug/L >3.8 ug/L

Feritin 39 13.00 - 150.00

How can I stop this awful weight gain and hairloss and shed this excess weght? I eat really healthily and I exercise regularly. Should they increase or decrease the Levo or should I buy some T3? I would really appreciate your help once again. Please I really hope someone can help me as I have no idea where to turn next. Many thanks,

[Clutter]

Cherywadey,

Ask your GP for another dose increase as there is scope to increase FT4 and FT3 and to reduce TSH.

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.2 - 1.0 with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email [e-mail] if you would like a copy of the Pulse article to show your GP.

Try iron bisglycinate which is gentle on the stomach. Take iron 4 hours away from Levothyroxine.

[cherylwadey in reply to Clutter]

Thank you Clutter. Your knowledge and help are most appreciated.

[SlowDragon Administrator]

You need to also test vitamin D and B12

Vitamindtest.org.uk £28 postal kit if don't want to ask GP

Ask them to test B12 when retesting thyroid after next increase

Folate is on low side, ferritin too

If you like liver, eating once a week will help improve ferritin

Do you have Hashimoto's also called autoimmune thyroid disease diagnosed by high thyroid antibodies?

About 90% of all hypothyroidism in Uk is due to Hashimoto's

Very important to know

Ask GP to test antibodies if not been done

All thyroid tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

Is this how you did the test?

Your results suggest you are still not on high enough dose. Ask GP to increase dose by 25mcg

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 at

[e-mail]

Also request the list of recommended thyroid specialists

Professor Toft recent article saying, T3 may be necessary for many otherwise we need high FT4 and suppressed TSH in order to increase FT3 high enough

rcpe.ac.uk/sites/default/fi...

Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine

(Many of us need TSH nearer 0.2 than 2.0 to feel well)

See box

Thyroxine replacement in primary hypothyroidism

pathology.leedsth.nhs.uk/pa...

Low ferritin is linked to hair loss.