Endocrinologist information please

[goofball]

Hi,

I am asking for some more advice please.

These are my latest blood results;

Serum TSH level 6.5mu/L (0.27-4.2)

Serum Free T4 level 21.2pmol/L (12.0-22.0)

Serum free triiodothyronine level 3.3pmol/L (3.1-6.8)

Thyroid peroxidase ab's 107ku/L (<60)

Serum vitamin B12 level 335ug/L (180.0-914.0)

Serum folate level 4.7ug/L (3.0-20)

Serumtotal 25 hydroxy vitamin D level 33.9nmol/L

<30-50nmol/L Vitamin D insufficiency, consider replacement

Am guessing my antibodies are outside the range and are positive and I have a lowish amount of Vitamin D, and the T3 is just within range.

So I have been prescribed more Levothyroxine 75mg from the 50 mg and some Vitamin D tablets. Will more Levothroxine help? obviously the vit D will and should I be asking for any more supplements.

I have now got my referral to an Endocrinologist but this is not until the end of February. I was interested to know if anyone knows how much a private consultation would be approximately, and is it worth trying to do, as three months seems a long time to wait.

Any thoughts would be gratefully received.

Thank you.

[greygoose]

No, an increase in levo will not help. Your FT4 is already at the top of the range, and your FT3 is still dragging along the bottom. You have very bad conversion. What you need is a reduction in levo, and some T3 added to your dose.

Your B12 is also too low, but I doubt your endo would be interested because it's in-range. Best do some supplementing on your own.

I'm afraid I don't know anything about private endos.

[goofball in reply to greygoose]

Thank you. Should I revert back to 50 mcg as only been on 75 for approximately a week.

[greygoose in reply to goofball]

Oh, I thought those labs were on 75. I wouldn't revert to 50 until I'd got some T3 lined up, if I were you. Doubtful an over-range FT4 would do you any harm, it just won't do you much good, because you can't convert enough of it.

[goofball in reply to greygoose]

Ok thank you . I’m guessing a 4 month wait for T3 is rubbish, but who knows how long I’ve already been out of range with it all so maybe not that bad, just annoying. Thanks again

[greygoose in reply to goofball]

You're welcome.

[jgelliss in reply to greygoose]

greygoose , Your response is so "SPOT ON " . High FT-4 can complicate when adding any amount of T-3 to the mix . It can exasperate pain and not be able to convert properly to T-3 that is so much needed .

[greygoose in reply to jgelliss]

I don't know if high FT4 has any effect on pain, but conversion will be worse when the FT4 is too high, because the T4 will be converting to more rT3 than T3.

[jgelliss in reply to greygoose]

I can tell you from my own experiences that shoulder pain and back aches and pain was with high FT4 as some others who experienced the same as I read on some forums . It's very possible that my RT-3 was higher too at the time .But I can tell you that Lowering my T4 has made a huge difference for me and others . Knowing ones Free's is very important . I learned from my experiences that I'm comfortable with FT-4 at 1-1.1. FT-4 at 1.2 starts personally for me being uncomfortable .

[greygoose in reply to jgelliss]

But, if your FT4 was high, and your rT3 was high, then your FT3 was probably low, and that could be why you were experiencing pain. Unless you had your FT3 tested at the same time, you cannot say that it was the high FT4 that was causing the symptoms.

[jgelliss in reply to greygoose]

I'm speaking from my own experience with one of my lab results my RT-3 was 13 and my FT4 was 1.2 and FT-3 was 2.9 . I experienced shoulder and back pain with these results . Lowering my T-4 a bit made a huge improvements for me . Coincidently raising my NDT for my T-3 did not work for me either . It's possible that I'm more sensitive to thyroid hormones and just need less . It might be how one metabolizes their thyroid meds . It might also depend as we get older our metabolism slows down some what too and may require less T-4 . Diet and nutrients exercises might also play a roll in this too .

What I'm saying is this might not work for everyone that feels well on higher T4 doses . This is my own experience and others too that I read on some thyroid forums . That's why knowing ones Frees values is very important too . Cellular is very telling with symptoms we experience . Cross referencing with our thyroid lab values can have the answers as to why we are experiencing what we are experiencing .

I hope this helpful .

[EbonyEvans]

Hi Goofball,

How are you feeling?

Do you think you will be okay to wait until February for your Endo appointment. Private consults range from £180 upwards. Depending on where. But this doesn’t guarantee you a decent one. If you email Dione at thyroid U.K. she will email you a list of Endos if you put the area. Or you could look through the list if you don’t mind travelling.

Be aware some won’t prescribe as some are mainly trained on diabetes. I can’t remind you about recommendations enough.

[goofball in reply to EbonyEvans]

I’m feeling ok thank you surprisingly! But who knows how I should be feeling if you get what I mean! Thanks for the help on Endos. I can probably wait but it seems a long time when you know what would help and it’s just an appointment not a major operation or anything!!

[Marz]

Docs usually prescribe too little VitD - how much are you taking ? B12 - take a pot of Jarrow Methylcobalamin B12 5000mcg and then reduce to the 1000 mcg pot for maintenance. Also a good B Complex to keep all the B's in balance and raise your Folate to at least mid-range. No Ferritin result - if low this could be affecting your conversion of T4 into T3.

[goofball]

Hi.

She prescribed me 20 ug of vitamin D tablets but the Pharmacy gave me 25ug.

Sorry Ferritin also low30ug/L(10.0-307.0).

Should I also be taking a supplement for this too ? You mention that this may help T4 conversion to T3.

I take the vitamin B12 as well as the B complex that you talk about?

Thank you so much. I don’t understand why just because I am just in range she didn’t tell me to do any of this.

[silverfox7]

I don't think you will get a private Endo any sooner. But you have a conversion issue as FT4 is much higher in its range that FT3. You steady know Vit D is low but Vit D B12, Folate and Ferritin all help to make your thyroid work better. They also help conversion issue and get also alleviate other symptoms and are pretty good for general well being. I was fortunate that I managed to reverse my conversion issues by working on my low levels though it's not a quick fix and depends on how low levels are. If you need to supplement then it's for life as levels drop quickly if you stop though you might find a maintenance level.

The plus point of going the supplement route is that some taking T3 don't always get it to work well if the supplements are low plus getting someone to give you T3 can be a lottery or if you have to source it yourself then it's going to work out cheaper if with supplementing you don't need as much but whilst you are waiting to see an Endo you might aswell give it a try. SeasideSusie is our expert in this so look at her posts to see what levels you are aiming at and how best to do it. As I said it cantake time but well worth the effort.

[goofball in reply to silverfox7]

Thank you

[rachelleigh73]

Hi goofball - you will almost certainly get to see a private Endo sooner than your NHS appointment - bypassing waiting list times is one of the main reasons people pay privately. I've been quoted £250 for the consultation - plus you may need to pay privately for tests if your GP surgery is unhelpful. Good luck!

[goofball]

Thank you