4th Blood results on 100mcg Levothyroxine advice please

[Peanut31]

Can someone please give me some advice as I’m due back to see my GP next week and I’ve accessed my latest blood results.

Some of my symptoms has gone but, I’m left with feeling exhausted in the mornings despite sleeping right through the night, I’m still cold, temperatures in mornings averages 36.0 to 36.5.

I’m still losing hair, and I’m been suffering terrible neck stiffness and shoulder stiffness.

I already sounded my GP out about T3 as I have Hashimoto’s (I’m gluten and dairy free) and he basically told me that every one converts T4 to T3, so I think we may hit a brick wall on that one.

Obviously he isn’t going to like my TSH results either, but my T4 isn’t really improving and neither is my T3.

Someone posted me a really handy research paper about fibromyalgia and improving with T3, as last week my neck was locked solid.

Now I haven’t been diagnosed with that but, my neck stiffness and shoulders have never improved.

In the letters from my Endocrinologist he mentions my neck stiffness and reckoned it was due to Epstein Barr virus, which I was given anti virus tablets. It didn’t help. Looking at this document I can relate to this (Dr Lowe).

I ordered some T3 ready but, I want some advice and what’s happening with my results and what you think the GP will say and what I should tell him.

March 18 results before any medication. Taken 8am.

TSH 12.2 (0.27-4.5)

T4 10.2 (11.0-23.0)

T3 4.12 (3.1-6.8)

Started on 50mcg of Levothyroxine then bloods taken 6 weeks later, no Levothyroxine, no eating and water only.

April 2018 8.30am

TSH 4.1 (0.27-4.5)

T4 14.2 (11.0-23.0)

T3 4.51 (3.1-6.8)

Increased to 75 mcg Levothyroxine

May 2018

TSH 1.6 (0.27-4.5)

T4 17.4 (11.0-23.0)

T3 4.58 (3.1-6.8)

Increased to 100mcg

July 2018 8.30am

TSH 0.24 (0.27-4.5)

T4 17.7 (11.0-23.0)

T3 4.71 (3.1-6.8)

Vitamins levels

B12 185 (25-165)

Vitamin D 105 (50-200) I’m supplementing again as they have dropped since before as I was over.

Iron 17.18(6.60-26.00)

Ferritin 96.5(13.00-150.00)

Best wishes

Peanut31

[SeasideSusie Remembering]

Peanut

Your conversion is actually pretty good at 3.75 : 1 (17.7/4.71) and doesn't show a need for T3 with those results.

With your FT4 at only 55% through the range, and FT3 only 43% through range, you might be better increasing your dose of Levo.

The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo if that is where you feel well. Do you have a copy of Dr Toft's article in Pulse magazine where he says that

"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 article by emailing Dionne at

[e-mail]

print it and highlight question 6 to show your doctor when asking for an increase in Levo.

[Peanut31 in reply to SeasideSusie]

Thanks for your reply SeasideSusie.

I may hit a brick wall with him on an increase of Levothyroxine, I’ve got Dr Toft artice somewhere in my thyroid paperwork.

I’ll dig it out and take it along.

I’m taking hubby with me as well as back up.

I’m still suffering symptoms which effects my day to day routine so I’ll make sure he’s aware of that.

Best wishes

Peanut31

[beh1]

Gp might whinge about tsh, but if he’s sensible he’ll let you stay on that dose. I wouldn’t hold out much hope for an increase. To me your conversion doesn’t look too bad at all. I’m sure others will disagree, but I will just say that once you are on the right dose it can take months for your symptoms to gradually disappear so I’d wait a good while before trialling t3. T3 can be a tricky customer to get right. But I understand you may be impatient to feel better. Just my view. See what others think.

[Peanut31 in reply to beh1]

Thanks beh1

I doubt he will increase it.

I’ve still got loads of symptoms so if he doesn’t increase it, I’ll going to hit a brick wall. I still don’t feel right

Best Wishes

Peanut31

[SeasideSusie Remembering in reply to Peanut31]

Peanut

Actually, after reading the reply by beh1 , I see you've only been taking Levo since March. It can take many months to feel well, and test results can look good before we feel as good as the results. As I said, your conversion is good, it's early days and you show no signs of needing T3 with your current results. What you do need is for your FT4 and FT3 to be pushed further up the range and an increase in Levo will do that. That's what you should be pushing for, with Dr Toft's article to back you up.

[Peanut31 in reply to SeasideSusie]

Thanks again for your reply, it’s greatly appreciated.

Yes, I’ll go there armed with all my documents, I’m certainly not going to be fobbed off and staying on 100mcg of Levothyroxine.

I’ve got some 25mcg extra I can increase from tomorrow.

Once again thanks

Best wishes

Peanut31

[roxanaleah in reply to Peanut31]

Hi, Peanut,

I wonder if you will indulge me and identify a few of your most pressing symptoms?

I have been experiencing the Hashimoto's rollercoaster for upwards of 1.5 years now. I have read and researched and experimented with medication. I am beginning to form an hypothesis and I am interested in anecdotal evidence.

Much thanks,

Roxana