I am trying to work out why I was overmedicated when I was on 150
TSH 0.03 (0.2 - 4.2)
FT4 21.1 (12 - 22)
FT3 4.0 (3.1 - 6.8)
Actually, you weren't overmedicated. Your FT4 and FT3 are within range, in fact your FT3 is far too low and ideally you should have been given T3 added to a slightly reduced dose of Levo because your conversion of T4 to T3 is rather poor. Your doctor panicked because your TSH was suppressed and unfortunately most doctors dose by TSH because they don't understand thyroid disease. See thyroiduk.org/tuk/about_the... > Treatment Options
Dr Toft 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)."
Dr Toft is past president of the British Thyroid Association and leading endocrinologist. You can obtain a copy of the article by emailing dionne.fulcher@thyroiduk.org print it and highlight question 6 to show your doctor.
By reducing your dose from 150mcg to 25mcg you can see how much damage has been done, you are now hypothyroid with an over range TSH so you need an increase in dose as per the above quote from Dr Toft
TSH 4.98 (0.2 - 4.2)
FT4 14.6 (12 - 22)
FT3 3.7 (3.1 - 6.8)
Changes to dose should only ever be made in 25mcg increments, never as much as 150mcg down to 25mcg.
Have you had thyroid antibodies tested? Thyroid Peroxidase and Thyroglobulin? Were they raised?
Did you know that raised antibodies confirm autoimmune thyroid disease aka Hashimoto's? This is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results.
Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.
You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks. You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.
Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.
Hashi's and gut/absorption problems tend to go hand in hand and can cause low nutrient levels or deficiencies. Have you had vitamin and minera tests carried out?
Vit D
B12
Folate
Ferritin
If so please post the results, along with their reference ranges, say if you are supplementing, for how long, and the doses you are taking.
For thyroid hormone to work (that's our own as well as replacement hormone) ferritin needs to be at least 70, preferably half way through range. As you have been taking iron tablets since March 2017, it's obvious that (1) one tablet is not enough or your level would be higher after 12 months supplementing and (2) absorption is not all that good.
Are you taking your iron tablet with 1000mg Vit C to aid absorption? Are you taking it 4 hours away from thyroid meds and 2 hours away from any other meds and supplements (necessary because iron affects their absorption)?
You can also help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...
Were you ever tested for iron deficiency anaemia, did you have an iron panel and full blood count?
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Vitamin B12 543 (190 - 900)
If you find you flag between injections you can always top up with sublingual methylcobalamin lozenges.
Folate 3.8 (4.6 - 18.7)
Your folate level is dire. B12 and folate work together and folate should be at least half way through it's range. Yours is below range. Has your GP prescribed folic acid? If not then point out to him/her that your level is below range and you need it treated appropriately.
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Vitamin D 58.2 (50 - 75 suboptimal)
If I were you I would increase the dose to 6000iu daily
for a couple of months and retest in May. The Vit D Council recommends a level of 100-150nmol/L, once you have reached this level you can reduce to a maintenance dose which you will need to find by trial and error. Retest twice a year when supplementing to keep within the recommended range.
There are important cofactors needed when taking D3
D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds.
Magnesium helps D3 to work and comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds
TSH 0.03 is suppressed but FT4 and FT3 were within range so you weren't overmedicated. Even if you were overmedicated the correct response would have been to reduce dose by 25mcg and recheck levels after 6 weeks.
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