Advise Please

[lmoore]

Please see below test results which are 'normal' but I feel anything but normal

[Karenk13]

You Vitamin D level is low that can cause many symptoms including fatigue and feeling like your becoming sick or have a cold developing. Getting that into a better range might make you feel better as your thyroid levels and iron look good

[shaws Administrator]

There's no history in your Profile but I've looked at a couple of your previous posts and note you had a partial thyroidectomy over 30 years ago. I am assuming you've been on levothyroxine for all those years and I don't think you have felt really well since then?

Your FT3 is far too low - below the bottom of the range so you're not converting your levo into sufficient T3. Levothyroxine (T4) is an inactive hormone and liothronine (T3) is the only active one. T3 should be nearer the top of the range

Why were the doctors so miserable that they couldn't prescribe a T4/T3 combination. I'd ask for T3 to be prescribed for you after all these years on too low a dose.

Doctors and endocrinologists just love 'normal' and immediately dismiss any clinical symptoms the patient has due to too low a dose which prevents the T3 receptor cells to be flooded with hormones. They mistake 'normal' as optimal - two very different effects. Oh - they might give another prescription for the symptom rather than a decent dose of thyroid hormones.

Ask for some T3 to be added to T4. Probably wont as it has been withdrawn altogether but I think you are an exception. Do doctors know nothing at all about how to treat patients ? Yes - otherwise there would be no members on this forum. We are here because we didn't get well on levothyroxine, some people never diagnosed and both groups have disabling symptoms.

Other members will respond re your other results.

thyroiduk.org.uk/tuk/testin...

[lmoore in reply to shaws]

After my partial thyroidectomy at age 22yrs old I started taking thyroxine about 10years later & at they were gradually increased to me taking 300mcg daily until we moved to North Wales 5 years ago at age 60 yrs old & I was having occassional palpitations so they gradually reduced my level to 125mcg - even though I was fit & healthy - which is what it has been for nearly 2years & I have to say that I have had problems ever since

[greygoose]

I agree with shaws , your FT3 is too low, and that is what's causing the symptoms. Although your low vit D won't help, either!

[SlowDragon Administrator]

Your TSH is too high, your FT3 too low and room for increase in FT4

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo 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)

Is this how you did the test?

Ask GP for 25mcg dose increase in Levothyroxine

Your looking to improve FT3 to at least over 5.

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]

Vitamin D needs improving to around 100nmol

There's no folate result, ask for it to be tested or just supplementing a good quality daily vitamin B complex with folate in, not folic acid would likely help and would improve low B12 too

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...