Hi I went back on 50 mcg levothyroxine still felt bad and gp wouldn't increase it so I reduced to 25 as I was gonna come off it altogether.These are my results in Feb 18 on 25 .
Tsh 2.73 (0.27 -4.2)
Free thyroxine 12.3 (12-22)
Total t4 79.8 (59-154)
Free t3 3.69 (3.10-6.8)
Thyroglobulin anti <10 (0.00-115)
Peroxidase 2.72 (0.00-34 )
Active b12 104 (25.10-165)
Folate serum 2.93 (2.91-50)
Vit d 41 (50-200)
Crp 3 (0-5)
Ferritin 106
I then stopped taking levothyroxine for 8 weeks my tsh went to 4.78 so my GP agreed I could go back on 50 for amonth and then increase to 75 for two months these are my results after that ( took visiting D in between cos levels low.) July 18
Tsh 0.072 (0.27-4.20)
Free thyroxine 18.400 (12-22)
Free t3 4.26 (3.10-6.80)
Active b12 109
Folate 4.07 (2.92-165)
Vit d 71.1
Ferritin 151 (13-150)
The GP said I need to reduce thyroxine to 50 ( back where I started or alternate 50 one day 75 the next I'm doing this at the moment but still have aches and pains
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Lavellekelly
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Your results suggest you are poor converter. Not over medicated..
GP is only looking at low TSH. But FT3 is too low.
Your low vitamin levels won't be helping conversion
Vitamin D is still too low. Aiming to improve to around 100nmol. Vitamin D mouth spray by Better You is good as avoids poor gut function. Suggest you supplement for 2-3 months and retest. It's trial and error what dose each person needs.
Once you Improve level, very likely you will need on going maintenance dose to keep it there. Retesting twice yearly via vitamindtest.org.uk
Also read up on importance of magnesium and vitamin K2 Mk7 supplements when taking vitamin D
Your folate level is also very low. Supplementing a good quality daily vitamin B complex, one with folate in not folic acid may be of benefit
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
GP is wrong to adjust dose according to a TSH result. The lower a TSH after we're diagnosed the better we feel except doctors believe we are becoming hyper - thyroid due to a very low TSH. This is ridiculous. We are either hyper-thyroid or hypo-thyroid. We can feel 'hyper' if we take too much levo but are still hypothyrod. We'd reduce dose I think without seeing a GP for confirmation.
These two were fine and FT3 could be a little higher:-
Free thyroxine 18.400 (12-22)
Free t3 4.26 (3.10-6.80)
Excerpt:-
Dear Thyroid Patients: If you have thyroid gland failure--primary hypothyroidism--your doctor is giving you a dose of levothyroxine that normalizes your thyroid stimulating hormone (TSH) level. Abundant research shows that this practice usually does not restore euthyroidism--sufficient T3 effect in all tissues of the body. It fails particularly badly in persons who have had their thyroid gland removed.
IF you continue to suffer from the symptoms of hypothyroidism, you have the right to demand that your physician instead give you T4/T3 (inactive/active) thyroid replacement therapy. Your physician can either add sufficient T3 (10 to 20mcg) to your T4 dose, or lower your T4 dose while adding the T3. The most convenient form of T4/T3 therapy, with a 4:1 ratio, is natural desiccated thyroid (NDT-- Armour, NP Thyroid, Nature-Throid). If you have persistent symptoms, you can demand that your physician change you to NDT and adjust the dose to keep the TSH at the bottom of its range-- when you have the blood drawn in the morning prior to your daily dose. This may be sufficient treatment, but IF you continue to have hypothyroid symptoms, and no hyperthyroid symptoms, demand that your physician to increase the dose to see if your symptoms will improve, even if the TSH becomes low or suppressed. You can prove to your physician that you're not hyperthyroid by the facts that you have no symptoms of hyperthyroidism and your free T4 and free T3 levels are normal in the morning, prior to your daily dose.
They may even be below the middle of their ranges. Your free T3 will be high for several hours after your morning T4/T3 dose, but this is normal with this therapy and produces no problems. You should insist that testing be done prior to your daily dose, as
recommended by professional guidelines. It's simple common sense. TSH is not a thyroid hormone and is not an appropriate guide to thyroid replacement therapy. The hypothalamic-pituitary secretion of TSH did not evolve to tell physicians what dose
of levothyroxine a person should swallow every day. A low or suppressed TSH on replacement therapy is not the same thing as a low TSH in primary hyperthyroidism. If you have central hypothyroidism, the TSH will necessarily be low or completely suppressed on T4/T3 therapy; your physician must treat you according to symptoms and the free T4/free T3 levels.
In the UK GPs only know that the TSH has to be kept within range (we the patients feel best when it's 1 or lower. GPs know very little excdept to look at the TSH and T4 and FT4 and FT3 are rarely tested.
They will only prescribe levothyroxine nowadays. A while ago they prescribed NDT or added T3 to T4 and many recovered their health.
Folate is too low and others who are more informative than me wll respond re your other results:-
Thank you .I had been waking with palpitations at night when on 50 mcg but when I came off all medication I still had occasional racing pulse and palpitations ( had ecg and echocardiogram all ok) .I often find it hard to take a deep breath thought this might be the levothyroxine.would it help to get reverse t3 checked?
Too low a dose of 50mcg can cause the above symptoms because our heart and brain need the most T3 and ask for an increase of 25mcg. Breathlessness can also occur and I'll give a link about that.
I think your dose of 50mcg is too low - we used to get does of NDT (natural dessicated thyroid hormones (200 to 400mcg) when no blood tests were available and it was slowly increased until all symptoms were resolved.
I think your dose is pitifully low which is causing your symptoms. Levothyroxine is T4 alone it has to convert to T3 - 50mcg wont give sufficient (I believe). T3 is the Active Hormone and we have millions of T3 receptor cells. Your GP should test your Free T4 and Free T3 levels (probably wont) but you can get these done privately if you wish.
We used to get doses of between 200 anfd 400mcg of NDT - whatever relieved symptoms but nowadays doctors only look at the TSH result and if its somewhere in the range they do nothing. Neither do they seem to be aware that all clinical symptoms have to be resolved. That's the purpose of taking thyroid hormone replacements.
This is from TUK and is self-explanatory. I think both your FT4 and FT3 will be too low:
FT4 = FREE T4
Thyroid hormones not bound to proteins. FT4 lowers when the thyroid is struggling.
The approx. reference range for this test is 10 to 24
FT3 = FREE T3
T4 converts to T3 and is the only thyroid hormone actually used by the body's cells.
The approx. reference range for Free T3 is 4 to 8.3
We at Thyroid UK believe that you need to know your Free T3 level too because this will often show low if you are not converting, and high if you have blocked receptor cells. Even if you are converting, the body needs the extra T3 that a normal thyroid produces. There has been some research to show that people feel better on a mixture of Thyroxine (T4) and Triiodothyronine (T3). Effects of Thyroxine as Compared with Thyroxine plus Triiodothyronine in patients with hypothyroidism – The New England Journal of Medicine Feb.11, 99 Vol. 340. (Click here for this article). #
Yes these were the results while on 75 a day now on 50 one day 75 the next probably need to be back on 75 each day but if it isn't converting well will it make any difference
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