After battling with my GP I have finally got hold of my full blood results which were taken at the end of May and am posting them here in the hope that someone can tell me why I still feel so crappy.
I am not sure whether to go back to my thyroid consultant and see if she will increase my levo by 25mcg as I can't understand why my TSH levels were so good in 0.5 in Jan this year and my T4 was 19 and I felt the most well I have felt for years. Roll on 5 months and I feel like I'm going down hill again and now my thyroid levels have changed to 1.25 for my TSH and my T4 has dropped to 13. Do you think she would try an increase in the Levo with these levels? I just don't feel right again and I know my gp is putting it down to the menopause which I am half way through I felt so much better than this a few months ago.
I was also doing well with my weight loss a few months ago but now I am really struggling to stop the weight coming back on again and I am following a proper diet. I asked if there was a different thyroid medication I could try (gp) but they say they are only allowed to prescribe Levo nothing else.
Any ideas would be gratefully received.
Thanks again Lori
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lorilou107
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Impossible to read the bottom right hand results even on my PC's large screen.
From what I can see your B12 is too low at 248 (120-900). Do you have any signs of B12 deficiency - check here b12deficiency.info/signs-an... If you have you need to list them and see your GP, ask for further testing for B12 deficiency/pernicious anaemia.
I have read (but not researched so don't have links) that BCSH, UKNEQAS and NICE guidelines recommend:
"In the presence of discordance between test results and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment."
And an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
If you have no signs then you could supplement with methylcobalamin sublingual lozenges along with a good B Complex to balance all the B vitamins.
As far as your thyroid function test is concerned, TSH and FT4 look good at 1.24 and 13 (7.9-16). Some people do feel best when TSH is below 1. As for your previous result where FT4 was 19, was the range 7.9-16? If so then it was over range BUT you need to know your FT3 result because you need to know if you are converting T4 to T3. FT4 and FT3 must be done at the same time to know that. Also, have you had thyroid antibodies tested - Thyroid Peroxidase and Thyroglobulin?
I can't read your ferritin result but it should be half way through range.
My ferratin levels are 61 within a range of 15-300 May 2018
In January they were 80 (13-150)
My T4 in January 18 which was 19.14 was within a range of (12-22) she was happy with my results of that and 0.5 for my TSH (0.2-4.2) and I finally felt well again.
I'm sure it's because my TSH has gone up to 1.5 (0.3-5) and my T4 has dropped to 13 (7.9-16) that I feel unwell.
In August after surgery my TSH was 12.14 and my T4 was 13 and my T3 4.9. ONLY time it's ever been tested. This is when my consultant finally agreed that I needed thyroid medication even though I had felt Ill for months before. He also diagnosed me after the partial thyroidectomy that I had lymphocytic thyroiditis after the gland that was removed had features of this, but he also said the blood test was negative for this (but they didn't give any figures or ranges.
I really think I'm going to have to my consultant again privately because it's impossible to get an appointment on the nhs, but I feel so unwell again, absolutely no sex drive amongst all the other symptoms
You likely need dose increase. You need FT3 tested. NHS often refuses to test FT3 or antibodies
Do you have Hashimoto's also called autoimmune thyroid disease diagnosed by high thyroid antibodies?
B12 is too low. A good quality daily vitamin B complex with folate in rather than folic acid will help B12 and folate
Push GP for vitamin D testing. Low vitamin D strongly linked to hypothyroidism
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
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies
Medichecks Thyroid or Blue Horizon Thyroid are the most popular choice.
If you can't get FT3 tested on NHS, test TSH, FT4 and FT3 together, plus antibodies if not been tested
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 are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .
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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