First post

[LizzieO]

Help with current results. First time posting,diagnosed hypo in March with TSH of 50 (0.3-4.7) and FT4 of 3 (7.7-20.6) I also have Autoimmune Neutropenia (static around 1.5 (2-8) . Bloods taken six weeks ago TSH 1.17 and FT4 14. Bloods this week show TSH 0.17 and FT4 of 13. My Folate is 10, B12, 413 and Ferritin 128. My Ferritin is good as a result of iron injections, started at 17! Unfortunately my neutrophils have now plummeted to 0.8. I am taking 125 levothyroxine and seeing the gp tomorrow. I think she will want to reduce my levothyroxine but I’m still symptomatic, fatigue, hair loss and sooooo miserable. Funnily enough wasn’t at all depressed until I started on Levothyroxine. My pulse rate good at 65 and blood pressure 100/70 Any thoughts or help much appreciated thanks

[SlowDragon Administrator]

Welcome to the forum

Can you add the ranges on these results, each lab has different ranges

You likely need dose increase, not reduction

You also need vitamin D tested. Has it been?

Presumably you have Hashimoto's also called autoimmune thyroid disease diagnosed by high thyroid antibodies. Have you had TPO and TG thyroid antibodies tested? If not request they are

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

[e-mail]

[LizzieO in reply to SlowDragon]

Thank you for your reply slow dragon. Ranges and results are TSH 0.17 (0.3-4.7) and FT4 13 (7.7-20.6) My last vitamin D test was good at 93 (>50 sufficiency) I take vitamin d, b12 and selenium thanks to the forum. I will discuss the antibody test with my GP tomorrow I think it’s highly likely it is auto-immune given the fact I already have an autoimmune disease. I’m lucky my GP is very good and listens I just want to make sure I turn up with the correct information for her. I definitely feel I need more not less levothyroxine. Thanks again

[SeasideSusie Remembering]

LizzieO

Bloods this week show TSH 0.17 and FT4 of 13

Presumably the reference ranges are the same with TSH (0.3-4.7) and FT4 (7.7-20.6)

I think she will want to reduce my levothyroxine but I’m still symptomatic, fatigue, hair loss and sooooo miserable.

So you tell her this and you point out that your FT4 is well within range and your TSH is not suppressed. Also tell her that you can't possibly be overmedicated and you would want FT3 tested before even considering lowering your dose of Levo as you can only be overmedicated if FT3 is over range as mentioned in Dr Toft's article that SlowDragon has mentioned.

[LizzieO in reply to SeasideSusie]

Thanks for your reply SeasideSusie. One Autoimmune disease is enough and now I feel very frustrated trying to navigate through (possibly) another! This forum is a God send and fortunately my GP is very good and listens. I will point out I’m still symptomatic and ask her to test FT3 before any change is made. Could you tell me what is considered a suppressed TSH ? Also If I was overmedicated surely I would have different/other symptoms too? I want to make sure I go armed with good information and I’m positive she will try and help. Thanks again

[SeasideSusie Remembering in reply to LizzieO]

My understanding is that suppressed is <0.1

My TSH is always suppressed, usually recorded as <0.01 (FT4 and FT3 always in range)and I've had it recorded as <0.005 when my FT3 was just over range.

[LizzieO in reply to SeasideSusie]

Thanks. I’ll definitely get FT3 checked then