I have asked for advise before. I had a TT in 2009. My range of symptoms fluctuates and very similar to menopause symptoms. Following an episode of 6 months off work last year (very high TSH) I was put on anti-depressants but have stopped taking these as I don't feel that that's the answer and feel no different for it. I am prescribed 175mg Levo but actually take 200mg as I feel I cannot cope on anything lower. My worst symptom presently apart from my fluctuating mood is my eye sight. I am waiting to see an ophthalmologist at hospital but most days I can not see properly blurred double vision and headaches. Eye test shows no change so assuming connected to condition. Last bloods taken in Dec can someone please advise best way forward.. I've asked for T3 before but no joy so far!
TSH 0.05 mu/L
Free T4 17pmol/L
Serum free T3 4.2 pmol/L
Folate 2.8 ug/L Vit B12 347ng/L
LFT - total protein 62g/L
Immunoglobulin G 6.2 g/L
Immuno.. A 0.49 g/L
Immuno.. M 1.47 g/L
Immunofixation - normal, no paraprotein detected.
U&E's all normal Bone profile - normal Coeliacs - normal FBC - normal
HBA1C 35mmol
With Thanks
Written by
Capri71
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Can you please add reference ranges for your results so that they can be interpreted. Ranges vary from lab to lab so we need the ranges from your own lab.
Your folate looks pretty low and your B12 is lower than recommended, but you really need Vit D and Ferritin tested to get a full picture of your nutrient levels.
Thankyou for your reply - Ill try list everything. My understanding is that Vit D is tested under the bone profile and Ferritin under the FBC - I will list further.
Your FT3 is on the low side. You might find further increase in Levo helps, or need addition of small dose of T3
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
tukadmin@thyroiduk.org
Professor Toft recent article saying, T3 may be necessary for many otherwise we need high FT4 and suppressed TSH in order to have high enough FT3
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