Help with results please

[MCAL]

I have been on meds for 8 weeks. Doctor put me straight on 100 levothyroxine as serious heart disease in family. Recent result shows I am now out of range and dose may need lowered but I have not felt any better since on meds and more often have felt worse

Test result 22nd Jan 2018

Serum TSH level 4.88 mu/L [0.3-4.7]

Outside reference range

Serum free T4 level 13.0 pmol/L [9.5-21.5]

Test result 1 March 2018

Serum TSH level 7.95 mu/L [0.3-4.7]

Outside reference range

Serum free T4 level 12.7 pmol/L [9.5-21.5]

Test result 30th April 2018

Serum TSH level <0.05 mu/L [0.3-4.7]

Outside reference range

Serum free T4 level 24.6 pmol/L [9.5-21.5]

Outside defence range

[SeasideSusie Remembering]

MCAL

It an take many months to feel well after starting Levo and often results look good before we feel well.

It was rather a high starting dose, maybe 50mcg would have been better for you, with increases of 25mcg every 6 weeks after retesting.

You appear to be slightly overmedicated to have FT4 over range, but it would be helpful to have FT3 tested as well to see if you are converting the T4 to T3 well enough.

Have you had thyroid antibodies tested? That would be helpful. Also vitamins and minerals need to be optimal for thyroid hormone to work properly so I would ask for

Vit D

B12

Folate

Ferritin

[MCAL in reply to SeasideSusie]

Thank you for your reply. My first tests were more detailed. What would a thyroid antibodies test appear as. As I had two siblings die of heart attacks aged 21 & 37 my gp decided to start me on a working dose rather than start low. I have initially felt worse and tho I have begun to feel a little better this past week there isn’t any particular improvement from how I felt when first went to the doctors in January. I was very surprised to see my results as kind of thought that with numbers in that kind of range I would have expected to have felt some difference.

[SeasideSusie Remembering in reply to MCAL]

MCAL

Antibody tests would say

Thyroid peroxidase

Thyroglobulin

[MikeM46]

Just to say that from the cardiology perspective, low T3 is a recognised cofactor

In heart failure, i.e. T3 is very important for heart muscle contractility.

Given your family background I would strongly recommend investing in a full panel test of thyroid plus vits & mins & antibodies. But identifying your FT3 level sooner rather than later seems worthwhile.

If you find your FT3 is low, despite this relatively high dosage with T4 then it would seem quite possible that you have a conversion issue, but to cover all the ground, yes, get those other non-thyroid levels checked as well. But again, with your family background sooner rather than later.

Just to add, only found out about this aspect myself a couple of years or so ago when my own heart started to fail!

[MikeM46 in reply to MikeM46]

Btw, what were/are your symptoms?

[MCAL]

Thank you, that is a worry. I had various symptoms, which I put down to age & menopause (I’m 53). Tiredness, sleeplessness, brain fog, low mood. I went to the doctors after my sister insisted I go. I had got back into fitness at 50 & made major lifestyle changes to look after myself better which appeared to work very successfully for a couple of years but the previous 6 months I was going backwards particularly with cardio work as getting breathless very easily. I generally felt unwell all of the time, almost like I was coming down with something e.g. aching, cold etc. It wasn’t until she said she would test thyroid that I looked it up & realised I had many of the symptoms.

[MCAL]

Apologies by she I mean GP