this lady was on t4 and was not well on that alone so commenced t4 /t3. Last year she went onto armour. current thyroid replacment.
ft4 is 11pmol/l
ft3 is 4 pmol/l
as tsh is suppressed the risk of atrial fibrillation is increased. atrial fib significantly increases risk of strokes. therefore th eaim i sto maintain tsh concentrations within normal range but at least above 1.0 mlu/l
despite her current thyroid replacemnet thi slady remains very unwell with difficulty concentrating, profound fatigue, ongoingsever alopecia.
she is on b12 supplematation b12 is currently 1440ng/ml which is above normal limit of normal. this is not harmful but additional boluses of b12 are not currently required. ongoingb12 mainentance is recommend evry 3 months (injection).
treatmant plan is reduce armour to 75 mg daily. ( how can he do that when i take 6 one quarter grains a day and it dosent even add up to 75mg????