I thought I had posted this yesterday, but it seems to have disappeared. I asked for some advice from this great forum a few months ago, posting my blood test results at the time. As suggested, I requested a slight increase in my levo (I was on 50mcg three days a week and 75mcg on four). TSH 1.28 (0.27 - 4.20) Free T4 15.43 (12 - 22) and my GP reluctantly agreed. I have also been following the vitD protocol for several months. I actually was feeling a little smug that I hadn't succumbed to any nasty bugs this winter until about 6 weeks ago when I picked up a cough/throat virus. At the tail end of this I donated blood which may have been a mistake as I still wasn't 100% but as I knew stocks were low I would have felt guilty for cancelling. Immediately following this, I felt terrible - really awful fatigue and just not well. My more recent blood test (November 2017) was TSH 0.088 (0.38 - 5.33) and free T4 11.1 (7.0 - 16.0) This with me taking 75 mcg daily and now taking the meds in the early hours as I always wake up around 3 a.m. The TSH was marked below range but the GP has not commented on this. On checking symptoms of hyper, I realise I have some, such as breathlessness and fatigue and wonder if I should maybe cut back a little on the dosage or would it not make any difference. It's hard to know if the fatigue is because of giving blood when I felt a bit under the weather, or perhaps a post viral thing, or of course if I have altered the levo too much. I would request a blood test at the surgery but I doubt I would even get an appointment to make the request for a good few weeks. I did have a Blue Horizon test done in the past but thought I would ask for some advice here first before doing this again. I would appreciate any opinion offered.
Over medicating now?: I thought I had posted this... - Thyroid UK
Over medicating now?
No, you're not over-medicated because your FT4 is only about mid-range. A low TSH means nothing on its own. In fact, it's pretty much irrelevant once you are on thyroid hormone replacement. The most important number is the FT3, but failing that, look at the FT4.
Thank you. It’s not a good idea to reduce my Levo back down then obviously.
No. I would have thought you actually need an increase in dose.
Breathlessness can be due to low nutrients. Have you had your vit D, vit B12, folate and ferritin tested?
I will give you a list of clinical symptoms but breathlessness can also be due to too low a dose of levothyroxine. Doctors don't test our Free T3 and Free T4s and we do need these and I'll also give a link to read why these two are particularly important. If GP wont do them (I believe they think that TSH and T4 is sufficient but if we don't feel well it is not sufficient. We have two private labs which will do both the frees and they are home pin-prick tests. If you've not had antibodies tested I'd get these too.
thyroiduk.org.uk/tuk/about_...
thyroiduk.org.uk/tuk/testin...
Many take their thyroid hormones in the middle of the night and definitely nothing will interfere with the uptake.
Thank you for your reply.
My blood test before the last one was Blue Horizon (July 2017) Was trying to scan a copy on here but not sure if that's possible. From the list of symptoms I do have quite a few but up until a few weeks ago have been manageable. My Free T3 was 4.45 (3.1 - 6.8) and Free T4 15.43 (12 -22). This was when I was only on 50 mcg per day. As my latest test in November was via GP I can't imagine she would authorise an increase, given the note saying below range. Perhaps I should get a further Blue Horizon test? I do have antibodies Anti-Thyroidperoxidase 78.5 <34 and ANti-Thyroidglobulin 434 <115
Yes you have antibodies, although not too high. You have an Autoimmune Thyroid Disease, also called Hashimoto's more commonly. Going gluten-free can reduce the antibodies.
Have your had B12, Vit D, iron, ferritin and folate tested. All have to be optimum. The aim is to have a TSH of 1 or lower. (not within the range as most doctor wrongly believe.
B12 and vitamin D both good (601 & 115). Serum Folste last July was 17.35 (8.83 - 60.8) so have been supplementing with gentle iron since then but haven’t re-tested since.
Not sure with Hashimoto's wether you are well enough to be giving blood, and may no longer be suitable either. Need to check with Blood service.
Are you on strictly gluten free diet as you have Hashimoto's?
Busybird55, These results definitely don't show over medication. I would say you could do with an increase, as the freeT4 is less than halfway up the range.
It sounds like your big problem is a doctor who won't dosr you properly and increase until you feel better - on T4 mono therapy many people need a T4 right at the top of the range.
FreeT3 is the most important of the numbers. You need a freeT4 high enough to raise the freeT3.
SilverAvocado, your are so correct. I struggled to get my Gp to even refer me to an endo and when she did, I had to have a meltdown to get a prescription from her also. She said that I would be going back more and more asking for an increase in dose when it wasn't necessary so I know that this avenue would be a waste of time. I went armed with information from this site (about four years ago) and when mentioned the anti-bodies and the fact that I understood I should be medicated her response was that they were not very high. Maybe I should consider going down the private endo route.
Going private or self medicating are always options. You could buy a little Levo to top yourself up, and see how you feel then.
So strange that the Endo knew you would need more andd would come back, butt she doesn't make the connection that that is because you are still sick.
It's a terrible position to be in to have such Lunk head doctors around 
Many people get better treatment on the NHS, but it's a roll of the dice whether you get a sadistic one like you have has the misfortune to end up with!
I believe the endo was referring to patients in general, pretty much saying that they think medication is the cure-all and then find it isn't. In my case I felt better very quickly after starting levo - even my husband who isn't usually that observant noticed I was very different. After the three month follow up she assigned me back to the GP as I guess she felt her job was done. My GP is very kindly but she obviously doesn't see what I try to tell her and to be honest, I've given up with that particular avenue. I think you are right about trying to top up a bit and then perhaps a private test to see what transpires. Thank you for your suggestions.
If you got substantially worse following a virus and then giving blood, then I would suggest that one possibility for your symptoms (breathlessness and fatigue) is iron deficiency.
I haven't given blood for many years but when I used to there was a finger-prick test done to check for anaemia before they would take blood. Do they still do this? Assuming you had this done, it suggests that you aren't anaemic. But people can be very fatigued and breathless with low iron without being officially anaemic. To check your iron and ferritin levels, if you can afford it, you can get this test done :
medichecks.com/tests/iron-s...
If you've never used Medichecks before, then to find out how to use their service, go to this link :
If it turns out that you are low in iron there are lots of choices of iron supplement available over the counter or in pharmacies. You can even buy the supplements that doctors prescribe, no prescription required, if that appeals to you.
I don't know whether you are menstruating or not, but this link may be of interest :
ncbi.nlm.nih.gov/pubmed/227...
It is to a research paper with the title :
Effect of iron supplementation on fatigue in nonanemic menstruating women with low ferritin: a randomized controlled trial.
Yes, a fingerprick test is still done. I have been supplementing with Solgar's Gentle Iron (iron bisglycinate) for several months. I do eat red meat, although not as much as I used to. I am menopausal and use bio-identical HRT. Thank you for the links. I will have a good read of them.
If you are low in iron and/or ferritin then Solgar's Gentle iron may be insufficient to raise your levels of iron and ferritin. (I'm assuming you take just one a day). I looked them up and they only have 25mg of iron in them.
When I was treating my own low iron I was taking a total of 207mg of pure iron per day in the form of one x ferrous fumarate 210mg, three times a day. It still took me nearly two years to get my ferritin up to mid-range. I'm not alone in having such a poor response to iron supplementation. It is quite common in people with thyroid problems.
I probably went for these as they were a known brand and marked as 'gentle iron'. Do you think it would be okay to maybe double up on these until I buy some replacements? I wasn't very low on iron, but I had also obtained these for my daughter who has congenital hypothyroidism and was having a problem losing hair after childbirth (seems fine now) as her results were lower than mine.
I wouldn't suggest taking iron supplements at all unless you know for certain that your iron and ferritin levels are too low. And once someone started supplementing then testing should be done fairly regularly - particularly at the start to discover the speed at which levels rise. Having too much iron in the body/blood is dangerous - it is poisonous.
I do know that some people take more than one iron bisglycinate tablet a day, but for anyone taking thyroid meds this might be a problem because iron reduces absorption of thyroid meds quite dramatically.
Yes, we have both had blood tests but not since supplementing. My husband has iron overload so I am aware of the dangers. I could probably do with some of his blood that he has removed on a regular basis!
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