Help with interpretation of blood results please

[ChronicTonic]

Hello!

My GP says my blood test results (attached in the photo) are looking fine, but after 15-20 years of mismanaged hypothyroidism I’ve lost my confidence in the system, so I thought I’d double-check: your thoughts would be most welcome!

I’m taking:

75mcg Levothyroxine

40mcg T3 Liothyronine (which my GP’s not happy about, but which has changed my life for the better!)

Many thanks for your valued input,

Abi.

[greygoose]

Your FT3 is still a little on the low side, but the TSH and FT4 are fine. And your sodium is a bit low. Apart from that, all is well.

[ChronicTonic in reply to greygoose]

Thank you greygoose I shall address the sodium issue.

How do I improve my FT3 level? I have no idea how this works!

Thanks Lovely Lady and have a great long weekend,

Abi.

[greygoose in reply to ChronicTonic]

You perhaps need to increase your dose of T3. But, you're already taking a decent dose. So, how do you take your hormone? Do you take it on an empty stomach and wait at least an hour before eating or drinking? Do you take any other medication or supplements with your hormone?

[ChronicTonic in reply to greygoose]

greygoose thank you for asking:

I take both thyroid meds with water first thing in the morning, along with my ADHD medication Elvanse (LisDexamphetamine), as I need to take them both as soon as I wake up.

Happily, I read a study which said ADHD meds improve the absorption rate of thyroid drugs. Which is handy!

I wait at least an hour for breakfast and a cuppa.

I then take my second dose of T3 - half a 25mcg tablet - at 4pm. Again, with water and no food either side. I tried taking the T3 at bedtime but it interfered with my sleep.

Maybe I should take a whole tablet at 4pm?

Thanks for your time,

Abi.

[greygoose in reply to ChronicTonic]

You should only increase by 6.25 mcg at a time. Or did you mean take the whole pill at 4 pm, rather than half in the morning? I don't think that would make that much difference.

Are you absolutely sure about ADHD meds improving the absorption of thyroid meds? I find that very strange. Why not do a little experiment and try taking both your levo and your T3 at 4 pm, so that it's well away from the LisDexamphetamine, and see if it makes a difference? I don't completely trust these studies, they often have their own agenda.

[ChronicTonic in reply to greygoose]

As recommended I hadn’t taken the LisDex the day of my blood test, or my thyroid meds, supplements or anything as per the usual protocol on this forum.

I thought maybe to take the second half of the T3 - or maybe only an extra quarter - at 4pm? It’s when I naturally have an energy dip, and it’s not too late to stop me falling asleep later.

I thought thyroid meds had to be taken first thing in the morning? Or am I mistaken?

Thanks Lovely greygoose for your input today. Hope you get out and into the sunshine soon!

[greygoose in reply to ChronicTonic]

Thyroid 'meds' can be taken any time you like, as long as it's on an empty stomach.

[ChronicTonic in reply to greygoose]

Thanks Lady!

I’ll try taking them later, and if not I’ll hop up a dose of T3 in the afternoon.

Abi.

[greygoose in reply to ChronicTonic]

You're welcome.

[SilverAvocado]

Hi Abi-Abster, someone commented on a comment if left for you 2 years ago, so I thought I'd look through and see how you're doing. This is from a year ago now, so you may have got things improved, but I'll tell you what I think.

The thought goal of thyroid hormone replacement (in terms of blood tests), is to get freeT3 high in the range. This is where most people feel best. In these results your freeT3 is about two thirds through the range, so there was room for an increase.

Symptoms are the most important thing, so if you felt great on this dose it's fine to stay there. I agree that these blood tests do seem a tiny bit low given the dose you're in, which is fairly high. But this doesn't necessarily indicate a problem, as some body's are just not as good at processing hormone. I am one of those who is not so good

[ChronicTonic in reply to SilverAvocado]

Thanks Lovely for checking up on me - that’s really thoughtful of you.

Hypothyroid-wise I finally feel better for being on the T3 for a year or two, although my overlapping hypothyroid/ Fibromyalgia/ ADHD symptoms (all formally diagnosed) still flare-up for the week before each period, and I’m not sure how to improve this from a thyroid angle other than by taking more T3. Thoughts?

I’m actually due an NHS blood test - incl Free T3 - this month. Think I may have finally got my GP onside. He’s even thinking of referring me to an endocrinologist - about time after nearly 20 years on Levothyroxine!

So thank you, I will ask you lovely people again again once I’ve taken the test and the results are through. Can’t currently get to the surgery as I’m having a Transverse Myelitis flare-up and the inflammation in my skull and neck are absolutely killing me. Awaiting the results of an brain MRI last week - though of course it wasn’t so bad then! Argh.

Anyway. I really appreciate you asking for an update, SilverAvocado Heartfelt thanks.

[SilverAvocado in reply to ChronicTonic]

You're very welcome! Good luck with the test next week. Sorry to hear you're having painful symptoms

I also tend to get a flare up in hypothyroid symptoms around my period. I think it's because all these hormones are connected. It's also a common trigger for pregnancy or menopause to set off being hypothyroid, so it works both ways.

It's possible that it's a final sign of being undermedicated or needing tweaking somewhere (I'm still not optimally medicated). Although I think it might go on even once optimally dosed, because sex hormones are changing, and our thyroid hormone in tablet form can't adjust to coordinate in the way it would if we had a healthy thyroid.

Hopefully the new blood test will give useful info!

[ChronicTonic in reply to SilverAvocado]

Thanks again - and couldn’t agree more re: hormones!