FT3 - low & fluctuating?

[gabby57]

Does FT3 normally vary much from day to day? My latest results from Blue Horizon show I'm deficient, and I know my GP won't want to give me any more levo because of the low TSH.

BH results from last week:-

TSH mU/L 0.05(0.27 - 4.20)

Free T4 pmol/L 13.50(12.00 - 22.00)

Free T3 pmol/L 2.53(3.10 - 6.80)

Ferritin ug/L 198(13 - 150)

Folate ug/L 15.6(8.83 - 60.8)

Vit D nmol/L 95(50 - 175)

Vit B12 ng/L 689(250 - 569)

TPO Abs kU/L>600.0(0 - 34)

TG Abs kU/L>573.0 (0 - 115)

GP's results from 3 weeks before:-

TSH mU/L 0.06(0.27 - 4.20)

Free T4 - not taken!

Free T3 pmol/L 3.50(3.10 - 6.80)

FBC was pretty normal except for:-

White cell count 3.7 (4.0 - 11.0)

Neutrophil 1.6 (2.0 - 8.0)

I was diagnosed with Hashimoto's about 2 years ago & am now taking on average 82mcg levo per day. Following advice here I'm also taking Vitamin D3 5000iu/day, K2, mag. citrate & selenium, am also gluten-free but blow me if I'm going dairy-free too! Both tests were about 8:00am, water only & no levo for 36 hours.

Thankfully, despite the low FT3 my symptoms are much better than pre-levo. I'm gaining weight again, some days I tire easily, hair loss is more than usual & occasionally I pour with sweat for no good reason, but the pain & anxiety I did have are much, much better now.

So, the latest results say I'm not converting very well, but could that low FT3 result be a one-off? B12 is high with no supplements, just trying for a good diet with lots of liver. TPO antibodies are half what they were this time last year, and my Vit D is gradually improving.

Any comments on the results &/or what I should do now would be much appreciated!

[greygoose]

What was your TSH when you were diagnosed? It's incredibly low, considering your abysmal Frees! How much levo are you taking?

[gabby57 in reply to greygoose]

TSH in July 2016 was 51.6! My levo on average is 82mcg per day now & for the last 6 months.

[greygoose in reply to gabby57]

OK, so it's strange that your TSH has gone down so much, whilst your Frees are still so very low. And you're on a very small dose of levo. Even your NHS FT3 was much too low. Were they both done at the same time of day? The only explanation is that you're on the tail end of a Hashi's flare, and your TSH hasn't caught up with the Frees yet.

However, I think your doctor is going to have to make an effort to over-come her aversion for increasing doses, and forget the TSH - which she shouldn't be dosing by, anyway - and increase your levo before you become very ill.

Impossible to tell how well you convert with such a low FT4, so concentrate on the levo for now.

Don't eat too much liver, because your ferritin is already over-range. And also liver contains high quantities of vit A, and you don't want to over-dose on that, either.

[gabby57 in reply to greygoose]

A Hashi flare would explain the sweating, wouldn't it. Noted re the liver, too.

Thank you, greygoose.

[greygoose in reply to gabby57]

People don't normally get symptoms when they have a flare. Sweating could just be under-treatment.

[SlowDragon Administrator]

Your results (apart from TSH) suggest you either need higher dose of Levo or addition of small dose of T3

Have you seen an endocrinologist

Would suspect some degree of central hypothyroidism, as well as Hashimoto's

[gabby57 in reply to SlowDragon]

Just trying to manage my GP is bad enough, but I realise I may have to go & see an endo at some stage.

Thank you.