Blood Results help please? - Including Gene tests carried out 6 months ago - Taking only 50mcg/day T3 Tiromel for 2.5yrs

[jbthyro]

Hi all,

I am seeing my GP at 11.40am this morning....

I was diagnosed with Hypothyroidism eventually several years ago, took ages as usual to convince the doctor who eventually prescribed T4 Levo but only 25mcg initially, then 50mcg but would not increase anyway. I have spent years trying to get my head around it all.

At that time I had found this forum, researched immensely as we do, and taken much advice from the amazing people on this forum to support us on our journey.

I stopped taking the Levo about 3 years ago and have been taking T3 Tiromel, self-medicating, initially just 25mcg in the early morning but for a year have added a midday dose of 25mcg so I take 50mcg/day now. This helped the fatigue in the afternoon and some slight symptoms but I still have a way to go.

My body temp in the morning is regularly still 36.5, and rarely changes through the day to be honest whatever time I take it (between doses and just before next dose etc).

My blood pressure is regularly between 105/69 and 116/74, so the dose of T3 does not affect it very much, minimally anyway, through the day.

Pulse is between 70 & 80 regularly.

I have Celiac Disease, so have been totally gluten free for 8years.

I have recently cut the carbohydrates down in my diet and increased lots of salad and even more vegetables and do eat meat.

I work, can carry out a normal day, but just feel older than I feel I should do at 50yrs!

I have a positive outlook to life so am thankfully not affected by depression or low mood but some days are tough.

I have recently had the GP take some more bloods to check so would like others to just pass their eye over them for me if that is possible?

I asked for my progesterone, Oestradiol and Cortisol plus the FSH, and my cycle was at day 12 after ovulation (if these are relevant to the result).

I also asked her to include the antibody tests for thyroid (as they have not been raised previously) but the pathology lab only did the TPO-Ab as you will see below.

I am not supplementing anything else at the moment to see where they are all sitting.

I know the vit D needs topping up, and I think Folate need supplementing.

As far as I can see the Iron is not bad but the ferritin is lower than maybe should be.

I get so confused with them all!

Genetic testing - April 2018

I had a gene test done last year and confirmed that I have poor conversion of T4 to T3 (I think, if I have understood the results correctly!)

D101

It says I have 'lower D101 activity and probably decreased clearance of rT3 from circulation, and lower conversion of T4 to T3.

D102

It showed increased D102 activity, to present as lower T4 and rT3 and higher T3 levels.

(but my T3 levels are low despite taking just T3 Tiromel!)

PDE8B - TSH signalling

Says that I have decreased response of the thyroid gland to TSH stimulation

Other gene defects showed that I run the risk of developing Graves or Hashi as inflammatory markers were present (tests were ok in 2016 but should probably re-run the set of these again now).

Also showed less responsive negative feedback mechanism, explaining that may show higher circulating TSH:T3/T4 due to delayed reduction of TRH and TSH and that my thyroid is likely to have a less efficient response to changing thyroid hormone requirements!

Would it be beneficial to get the rT3 tested? It costs much more to include this in the test so only want to test this if it would help to work out the puzzle?

Results:- October 2018

Folate - 10.4 (<31 ) low? Top up?

Phosphatase - 37 (30-130)

- is it important to keep phosphatase higher?

D3 - 62.7 (80-100)Top up

?

globulin - 22 (17-35)

creatinine - 65 (45-84)

B12 - 652 (1000)Top up

a little

iron - 20.5 (6.6-26)

should this be higher or ok in this range?

Ferritin - 48 (13-150)Top up ?

Transferrin - 2.61 (2-3.6)

Transferrin %index - 35% (15-50)query?

magnesium - 0.9 (0.7-1)

TSH - 1.31 (0.27-4.2)

FT4 - 5.1 (12-22)Too low (should be top ¼)

FT3 - 4.1 (3.1-6.8)Too low (should be top ¼)

TPO Anti b - 14 (<34)

Progesterone - 16 (Ovulation phase: 0.385 - 38.1 nmol/L)

Ostradiol - 278pmol/L

(Ovulation phase 151 - 1461 pmol/l)

Cortisol - 395 (for 9am cortisol level of > 350 nmol/L makes adrenal insufficiency unlikely.)

FSH - 18.4 iu/L (Ovulation Phase: 4.7-21.5 U/L - if >30 = menopause)

Last menstruation 27/9/18 (14th day ovulation)

Follicular stage is day 1-5 ovulation (1-10)

Celiac testIgA0.9 (0-7)

- gluten free for 8yrs

Sorry for the long post!

Thanks for any advice offered about my next option either for medication or further testing to have done!

Julie

[jbthyro]

I forgot to ask should I get MTHFR gene test done?

Mainly as I may have an absorption issue looking at the gene tests that I had done already?

[greygoose]

I'm afraid I know nothing about genetic testing. I would just like to say that no, it's not worth getting the rT3 tested. It's one of those tests that tell you if there's a problem, but don't tell you where it is. Sometimes rT3 is high because FT4 is high and not converting. But, with your low FT4, it wouldn't be causing high rT3. So, if your rT3 was high, you wouldn't know why. Could be so many things to do with iron, cortisol, infections, etc. So, it won't add any pieces to the puzzle, I'm afraid.

FT4 - 5.1 (12-22)Too low (should be top ¼)

No, it shouldn't be top 1/4 because you're taking T3 only, and your thyroid obviously isn't making much. It should be top 1/4 when taking T4 only, but adding T3 to it changes things, and the FT4 will be low. So, don't worry about that.

Your folate and vit D are too low, but your vit B12 is ok unless you have symptoms of B12 deficiency. I'm afraid I don't know about the others.