Hi what do you make of my levels?
tsh 0.006
free thyroxine 33.84
t4 168.5
free t6.18
I have had uat for twenty years and been on 300mcg thyroxine for years. whenever my blood tests come back Dr says everything is fine although I feel awful and am unable to lose weight no matter what.I spoke to a Dr online who after looking at my bloods said I needed to add t3 which my dr refuses to do.I have an appt to see Dr Toft next month and hope and pray he has some answers for me.
Do you have the ranges? I'm no expert but don't think the more knowledgeable on this forum will be able to help without the ranges x
tsh 0.006 ranges 0.27 - 420
free thyroxine 33.84 12.00 -22.00
t4 168.5 59 - 154.00
free t 6.18 3.10 -6.80
Ah, so free T3 is still in range, showing very poor conversion. You probably need a reduction in levo and some T3 instead.
Rocky1608
We always need the reference ranges when posting test results. Ranges vary from lab to lab so we need your lab's ranges to interpret your results. However, it's clear that your TSH is suppressed and your FT4 is very high. The highest top end of range I've seen for FT4 is 24.6 so yours is bound to be well over range.
Presumably "free t6.18" is FT3 but we don't know if this is over range. It does show, however, that your T4 :T3 is well over the ideal ratio of 3:1 - 4:1 and indicates that your conversion is poor.
It seems as though you are very overmedicated with Levo and that needs reducing and you need the addition of T3.
The aim of a treated hypo patient generally is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their ranges if that is where you feel well.
GPS cannot prescribe T3, it has to be prescribed initially by an endo and it is very difficult now for new patients to be offered it as many CCGs are trying to ban it due to cost.
Dr Toft has said in a recent article that some patients need the addition of T3 so at least you are seeing an endo who does support it's use. Are you seeing him privately?
private
So Dr Toft will more than likely suggest you need T3, maybe he will offer you a private prescription.
I hope so.Thank you for replying.
My Dr basically said there is nothing wrong with my thyroid.
But you know there is. Your results clearly show you are vastly overmedicated with Levo and your conversion is poor. Many GPs don't know much about hypothyroidism or how to treat it properly. I'm surprised that your suppressed TSH hasn't made your GP reduce your Levo, most GPS are TSH obsessed and want to see it in range.
I tried myself a couple of years ago to reduce my thyroxine to 275mcg to see if I felt any better.I put on half a stone in a week.Im basically twice the size and feel horrendous.
Yes, you would have done, because lowering your thyroxine would have also lowered your FT3, and it's low T3 that causes symptoms like weight-gain.
You are a very, very poor converter, and you need all that thyroxine to get your T3 high enough to feel well. But, it's not the ideal solution, having an FT4 so high. Your rT3 will be very high, and we don't know what effect that will be having. So, you really do need to have a much lower dose of thyroxine, with T3 added. 
You also need to test vitamin D, folate, ferritin and B12 plus both thyroid antibodies
Your FT4 and Total T4 are both very over range, yet FT3 is in range. Probably you are a poor converter, this can be due to high antibodies, low vitamins or gut issues
So for full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies. Plus very important to test vitamin D, folate, ferritin and B12
Likely to have high reverse T3, as Levo dose is so high. it might be worth testing Reverse T3, though it's expensive test.
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies
thyroiduk.org.uk/tuk/testin...
Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.
All thyroid tests should ideally be done as early as possible in morning and fasting.
If on Levothyroxine, don't take in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)
If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
About 90% of all hypothyroidism in Uk is due to Hashimoto's. Low vitamins are especially common with Hashimoto's. Food intolerances common too, especially gluten. So it's important to get antibodies tested.
Professor Toft recent article saying, T3 may be necessary for many
Are you male and what is your weight ?
You have plenty of T4 in the system and your FT3 level is good at 6.18, so at the top of the range.
So your body is turning the T4 into enough T3.
When you get higher T4 levels and higher T3 levels the TSH will shut down. Ideally you want a TSH around 1 and less T4 and T3 floating around in the blood doing not so much.
Your main issue maybe one of absorbing the T3 at the cell level. Disruption in how the adrenals and thyroid work together can cause this. Sometimes just giving more and more T4 is not the answer.
Have you tried less T4 and what happens to you if you have ?
T3 is certainly worth a look at.
As is taking the T4 at bedtime or a good chunk of it.
Now is the time to start to take control over this condition. If you read about it you can make some good improvements. Very often there is not one super fix which will sort you out. It is usually a collection of things which can help to improve the metabolism.
The vitamins and minerals area is important to research. I won't go into what you could be taking, but there is loads of info on here about that.
Finally a good approach to your problems would be to think about the ratio of T4/T3 you may end up on. Don't jump in on big doses of T3, start small. And i mean REALLY small.
The docs think 5mcg T3 is a small starting dose, but try see this as a big dose. 2.5mcg is probably the smallest starting dose you can cut a tablet into (unless you get given the 5mcg size in which case you can go down to 1.25 mcg easily).
It would be better to also try bring down the FT4. High teens is a good place to be, so this means you are going to need to really drop down on the T4. Changes like this must be done slowly though.
Final question is do you monitor your blood pressure at home ? What is it ?
I imagine you have a high BP due to the high Ft4 level.
I take my thyroxine at night. Weight wise I am in the high teens.. twice the weight I was.I have tried to reduce my thyroxine but immediately put weight on .
forgot to add I'm female
HI Rocky
Regarding your weight it might be worth going completely gluten free. Also it’s v hard for people with Hashimotos to digest grains of all sorts. So going carb free and eating good fats (butter, olive oil, coconut oil) full fat yoghurt and thinking about improving your gut bacteria with cider vinegar and fermented foods is the way to go . The idea is to keep your sugar levels as low as possible. So limit fruit and if you do have some balance it up with some protein to slow the sugar release. Nuts can be your best friends when you’re feeling snacky!
Also try and lower stress levels with meditation and slow breathing. There’s a brilliant free app called Insight Timer on there with some great teachers. And if you’re finding all of this a bit hard to manage stress wise which would not be at all surprising you could ask your GP for a referral to a counsellor who has specialist knowledge of weight issues who can support you. Good luck. X
What you're basically describing here is the ketogenic way of eating plus the gluten-free. I started this for initially weight loss but then a new autoimmune disorder diagnosis and my levels of prednisone sent my cholesterol and other markers through the roof. Keto is evidence-based to reverse this. Also, I no longer have a thyroid following two thyroidectomies in 2009-2012. I have lost 11 lb this month. The prednisone causes my thyroid levels to swing from one extreme to the other.
thank you
Hi rocky1608'
I really empathise with you on the weight issue.I tried all the 'usual' NHS guidelines on losing weight to no avail.When I finally received a diagnosis of hashimotos last year, my sugar levels were also at pre-diabetic range, so I decided to follow the diabetes uk forum 'low carb high fat' diet and haven't looked back.I was so conditioned by the standard view put forward that any fat is bad for you, that it was really hard to change my diet at first without feeling really guilty and 'wrong'! But I soon lost those feelings when the diet began to work.Over 3 months I lost 1.5 stone, my sugar levels went down and my good cholesterol went up as the baddies went down. Of course I can only say how this diet worked for me, when everything else failed, but I hope it encourages you. (incidentally my doctor thought the diet was a very bad idea, eat less exercise more was her advice,but I was already doing this and still putting on weight). Hope you find the answers you need, we have a lot of members with expert advice on here.Good luck.
I agree. Please see my response to Janeroar above.
Yes, I decided to try a high saturated fat diet after gaining 38 pounds since November 2013. At between 40 - 50% fat calories with a total caloric intake of around 1500 I've lost 27.4 lbs (Jan 8 - May 26) without ANY exercise.
Typical foods I eat: butter, eggs, beef, sausage, dark chocolate, sweet potatoes, whole milk, whey protein isolate powder, tangerines, cheese, larabars. It's not keto but I still managed to drop my body fat percentage from 24.7% to 21.2%. Again, no exercise whatsoever.
Doctors don't really know much about nutrition; it's not in their curriculum of study. They will, however, give you their opinion (it's called opinion-based medicine) derived on what Ancel Keys managed to force into American, then UK dietary guidelines.
Hi you could try to self medicate with NDT it is cheap to buy and could give you the help that you require.
Blue Horizon (Thyroid No 11) is a good blood test to start with post all of your results with the ranges for help. Don't forget the blood test has to be on an empty stomach and leave off the Levo for 24 hours prior to the test.
Once you have this it's the basis for many answers to your questions
thank you
It's hard to tell without ranges, but I'd say you were a bit over medicated with those results - I suspect both Free T4 and free T3 are over range, which can make you feel just as bad as being undermedicated.
I'm so glad I found this group.I thought I was going mad as nobody listened to me .I kept telling my Dr I felt awful but was told there was nothing wrong with me and my levels were fine.Ive tried every diet going and lost nothing but put on weight to the point I am scared to eat properly. I even contemplated getting a gastric band but was told it wouldn't work as I didn't eat enough.I know I keep saying thank you but thank you .
I tried to get T3 as well from my doctor, but he did change me over to Nature Thyroid which has T3and T4, see if he will do that.
I’m having problems loosing weight to , I’ve always been so thin.
I actually went behind my doctors back went on line and ordered T3, but never took it because Nature Thyroid is really helping
Excellent advice above, I will just add one more thing. Measure your Selenium (Se) level, Se is the catalyst for the T4 to T3 conversion, if you have hardly any Se, nothing is going to happen. IF your Se is low, get Se from a supplement or (as I do) eat 2 Brazil nuts per day. Your problem is quite obviously that of conversion.
Dont think youre such poor converter. Think your body did the right think because you were SO OVERmedicated. Too much T4 the body has to raise Reverse T3 just to balance and it kept you in range for FT3. Im bit amazed how UK are overmedicating even the ones who don't have any thyroid disease. For all those on T3 only please look up how T4 is needed just to get active B2 or FAD which will help your mitrochondria produce energy and enables your body to absorb folate. There are lot more reasons for T4 to be taken with T3 or just as a stand alone med.
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