Hi here are my results for the last three blood tests.....I would appreciate your comments as I am still feeling very tired and lethargic after dose decrease. I have my blood tests done at approx 8.30am, I don’t eat before. I take my Levo at night, I don’t take it the night before blood test. I had a total thyroidectomy in June 2016 after Thyroid storm...and still I am up and down!! I manage to get some T3 results but have to phone lab to insist they do them.....I think I may have a conversion problem, but has never been mentioned at dr! I take 75mcg Levo each day, at the moment.
These are my results....
15 Jan 2018
TSH 0.18min/L (0.3-4.2)
FT4. 25pmol/L. (12-22)
FT3 4.4pmol/L (3.1-6.8)
Vit D level 46mol/L
I was taking 75mcg Levo on 5 days and 100mcg on two days. Persuaded dr to leave dose as is for time being as feel better when T4 is high and she agreed.
18 May 2018
TSH 0.05min-L (0.3-4.2)
FT4 30pmol/L (12-22)
I was still taking same dose as in Jan 2018. No T3 tested. Had to agree to a decrease to 75mcg each day.
Last blood test done on 5 July 2018
TSH 0.39min/L (0.3-4.2)
FT4 21.8pmol/ (12-22.0)
FT3 3.8pmol/L (3.1-6.8)
Taking 75mcg each day.
I am not due a blood test until Oct, but see my gp this week as I have been having palpitations at night so need to discuss this. I take 20mg propranolol morning and evening, 10mg Amitriptyline each evening, riveroxaban 20mg each evening, Selenium 200mcg each morning, 10mg cetirizine each morning and a complex b vitamin tablet.
I need to discuss my dosage with my gp as I feel my T3 is too low. It has never been higher than 4.4, which I though was ok, now it has reduced to under 4 I am a little worried. My T4 is usually high as I feel better at the top (or just over range) but felt at 30 I had to follow the Drs advice! I know there is no chance of her giving me T3 but what questions do I need to ask her regarding my low T3 result?
Hope someone can advice me.
I just want some energy to enjoy the summer!! I get up quite late and within a couple of hours I am asleep again! My husband just thinks I need to get up and do something, but it shatters me....if I have a shower I have to rest afterwards as I am shattered. If I go out for the day (very unusual) it takes me days to recover and I feel quite ill. I just thought by now, 2years after my op, I would be feeling more lively and able to lead a reasonably normal life! I do try to do things but I get so tired......
Many thanks in advance 😴 💜
Written by
Foxie1234
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First of all - I am really sorry that your thyroid gland was removed and that you haven't been provided with an optimum dose of thyroid hormones which would make you feel much better.
I must state I am not medically qualified but had undiagnosed hypothyroidism and given levothyroxine. My TSH was 100 when, finally, diagnosed by myself - but then levo did absolutely nothing at all as I became far more unwell especially with severe palpitations.
I am now fit and well thanks to Thyroiduk.org.uk before this forum began and am forever grateful
First you've had your whole thyroid gland removed and seem not to have been given an optimum dose of T3/T4. I think if someone has no gland that T3/T4 should be the very basic dose.
First Propropanol can interfere with the uptake of thyroid hormones: excerpt:
propranolol is a beta-blocker, and it’s a highly effective antidote to thyroid hormone. It’s so effective that many patients who are overstimulated by thyroid hormone (as in Graves' disease) use it. Propranolol relieves these patients’ overstimulation by indirectly blocking the cellular effects of thyroid hormone.
I'm always baffled when a doctor prescribes propranolol for a hypothyroid patient. If the patient isn’t taking thyroid hormone, propranolol is likely to worsen her hypothyroid symptoms. If she is taking thyroid hormone, the drug will nullify most benefits the patient would otherwise get from the hormone. Hence, there’s no sense whatever in a hypothyroid patient taking propranolol.
There’s something else, however, you and your doctor should consider. When you’re no long blocking the effects of the Armour with propranolol, your blood pressure may come down to normal without any other medication. Of course, you and your doctor would need to work closely together to make sure your blood pressure does come down.
Proton pump inhibitors (PPIs) have also been reported to reduce levothyroxine absorption, presumably, through an increase in gastric pH, thus reducing dissolution of the levothyroxine tablets. The bulk of evidence suggests that PPIs reduce levothyroxine absorption,2-4,6 although one small study failed to find an interaction between levothyroxine and omeprazole.7 In the outpatient study cited in the introduction, almost 70% of the interacting drugs were PPIs. One study found that replacing levothyroxine tablets with an oral solution improved levothyroxine absorption in the presence of PPIs.8
Now, to address your rheumatologist’s assertion that T3 is dangerous, and his implication that amitriptyline is not. I think the best way to reply to him is to quote publications that are available to him. In the USA, when patients get their prescriptions filled for T3 (usually the brand Cytomel), the pharmacist usually gives them a leaflet on the product. The leaflet contains the following statement:
This statement makes a fact perfectly clear: When used sensibly, T3 is extraordinarily safe among prescribed drugs. When I say extraordinarily safe, I’m comparing T3 with drugs such as the amitriptyline which your rheumatologist prescribes for you. Below is a list of potential harmful effects of amitriptyline. This list comes from the Physician’s Desk Reference, 53rd edition, Medical Economics Company, Inc., Montvale, 1999, page 3418
First, you take thyroid hormones when we get up and wait an hour before eating. Food interferes with the uptake of the hormones. Also you have to wait sometime before we take additional medications and you have to check whether the ones prescribed interfere with the uptake of levo or other thyroid hormones we may take.
What our husbands and millions of others are unaware of is that our bodies cannot function at all if we don't have sufficient T3 circulating in our bodies.
Levothyroxine is T4 only - inactive hormone. It has to convert to sufficient T3 - the only active thyroid hormone. T3 is needed in our millions of T3 receptor cells in our body and all need T3 for everything to work, especially heart and brain which need the most.
Doctors and endocrinologists do not diagnose by clinical symptoms any more so they know none of them. The also prescribe 'other' medications instead of ensuring the both Free T4 and Free T3 are at an optimum level and that TSH is 1 or lower. The aim is relief of all clinical symptoms - not to add to ours.
Request a combination of T3 to your T4 - it is usually in a 1 to 3 or 1 to 4 basis. T3 is not being prescribed in the UK at present but you can source your own.
All blood tests for thyroid hormones have to be at the earliest possible fastng (you can drink water) and allow a gap of 24 hours between last dose of levo or whatever other thyroid hormones you may take, and take after test. This keeps the TSH at its highest (this is between hypo sufferers) as doctors seem to be unaware it drops throughout the day and may mean an unnecessary adjustment in your dose.
Always get a print-out of your results with the ranges and post if you have a query.
Thank you for replying to my questions....I was not aware that propranolol were PPIs.
‘Particularly the only Active Thyroid Hormone is T3 - Excerpt:-‘......................
I take propranolol for my palpitations, given to me by my cardiologist....I was originally on 40mg three times a day as my heart rate was over 180! Since thyroidectomy he has reduced them to 20mg twice a day. I am still getting palps, but nothing like they were.
I did take PPIs for many years, but have not taken them for about 18 months now.
With regard to Amitriptyline....I take a very small dose in the evening to help with muscle pain, which I used to get at night....it does help.
Are you saying that I should not be taking these at all? Don’t think I could cope with no beta blocker as I have AF, a bi product of the thyroid storm!
I am sure my gp will not prescribe T3, but I will ask the question when I see her.....I am a little afraid of sourcing myself as I have been really ill and would not want to upset my Drs, who I have a good relationship with (at the moment). I was in hospital for 11 weeks and wouldn’t want to go back there again!!
Thanks for the support, hopefully more reading and understanding might help me!
You cannot stop medication for your heart. I, too had palpitations, constant when on T4 - one I recorded was 143 bpm.
When I stopped T4 and tookT3 alone, all palps stopped but I am not saying that would work for everyone.
If your heart is going too fast it has to have some method of control.
I wonder..... if NDT would suit you because it is made from animals' glands so might be more conducive to our human body. This is just a guess.
My cardiologist was puzzled about my palps and was going to put something in my heart to record but I haven't seen him since I dropped T4. I had umpteen ECGS. Heart would jump into severe action at any time, any where etc etc.
TSH, T4, T3, Free T4, Free T3 and thyroid antibodies.
B12, Vit D, iron, ferritin and folate.
We have private labs which will do the whole of the thyroid ones and you can ask GP to test vits/minerals. Remember all as early as possible and fasting.
NHS usually only do TSH and T4.
The 'frees' have to be near the optimum of the range.
Hey I’ve had amitripytline Ann’s it knocked me around sooooo badly! I had it for fibromyalgia pain but it changed me as a person. Made me very lazy, can’t be bothered to speak to anyone to do anything I ended up hating everyone and severely depressed and shattered. The doctors took me off them after a month and I can say it was the worst month of my life! I’ve read up on it and this is quite common for this drug.
Maybe ask your doctor to change your amitripytine to something else?
Thanks for this info....I am on a very small dose 5mg in the evening.....I will talk to my gp and see if I can stop them and see if it makes any difference.
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