Further Advice Please before GP Appointment - Thyroid UK

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Further Advice Please before GP Appointment

potter5
potter5

Hello, I contacted the group 3 months ago for advice on bloods before GP app, thanks for all those who gave me all the information I needed before app. Could you please give me your thoughts on the thyroid results I got a couple of days ago. I had levothyroxine increased 3 months ago from 50mcg daily to 62 1/2 (50mcg one day then 50 plus 25mcg every other day. Sounds confusing, The thyroid results look well improved to me but I have not much experience and need to be prepared.

October 2018 January 2019

Free T4 17.9 pmol/L (10.6 - 23.2) Free T4 21.6 pmol/L (10.6 - 23.2)

TSH 1.79 mU/L (0.3 - 4.2 ) TSH 0.98 mU/L (0.3 -4.2)

Free T3 3.7 pmol/L (3.1 - 6.8) Free T3 4.3 pmol/L (3.1 - 6.8)

Folate 17.2 ug/l (3.9 - 26.8)

Ferritin 67.0 ug/l (13 - 300)

Serum Iron level 13.7 umol/L (10 - 30)

Should I be asking for a further small increase say up to 75mcg daily or should I keep levothyroxine at same level for now. Thank you o much again. Kind regards Potter 5

9 Replies
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SeasideSusie
SeasideSusieAdministrator

How do you feel Potter5?

If you feel well, leave well alone.

If you feel symptomatic it's because your FT3 is quite low in range at 32% and your FT4 is 87% through range. They are unbalanced and generally should be in balance with both in the upper part of their ranges when on Levo only.

Serum iron is a bit low, optimal level is 55%-70% through range (higher end for men) and yours is 18.5% although your have a reasonable amount in your iron store (Ferritin). Ferritin is recommended to be half way through range but for a female I've seen that 100 is fine, a bit higher for males.

potter5
potter5 in reply to SeasideSusie

Hello SeasideSusie, thank you for replying. I do feel less tired being on levothyroxine but never feel really well but I think that's because every day neuropathy symptoms are different. If I increased the levothyroxine to 75mcg daily would that lower the TSH too much or raise the T3. I don't want increasing if it could swing things but trying to get levels right. I think GP would say keep the levothyroxine at same level so need to be prepared. Thanks again for help SeasideSusy. Kind regards Potter

SeasideSusie
SeasideSusieAdministrator in reply to potter5

If you increase the dose of Levo then it's likely the TSH will lower, the FT4 will increase and the FT3 may increase slightly as well, but your FT4/FT3 will still be unbalanced.

You have a conversion problem, there is not enough T3 being made from your T4.

Conversion be helped by optimal nutrient levels:

Vit D: 125nmol according to the Vit D Council

B12: top of range for serum B12, over 70 for Active B12 (below 70 suggests testing for B12 deficiency)

Folate: at least half way through range

Ferritin: minimum of 70 for conversion

Selenium and zinc levels should be adequate for conversion.

potter5
potter5 in reply to SeasideSusie

Thanks again SeasideSusy, I think then, I may be better to leave things as they are for another few months. My vitamin D is 66mol/L so I really need to get this up, and ferritin up as well. B12 over 2000 as I have weekly injections. I will look into selenium and zinc and try and increase T3 this way. Best wishes Potter

If you increase your levo, it could make your conversion worse, because more T4 would convert to rT3 and less to T3. So, your FT3, instead of rising, would drop a little.

potter5
potter5 in reply to greygoose

Thank you Greygoose, probably better to hold off and just increase Vitamin d and Iron supplement and retest in maybe another 3 months. Thanks again Greygoose. Best wishes Potter

greygoose
greygoose in reply to potter5

You're welcome. :)

Thank you reallyfedup, my vitamin d is 66 and ferritin 67 so yes I do need these levels up and hopefully this will help lift t3. My folate is 17.2 so that's probably ok and b12 always over 2000 as I have weekly b12 injections. I hadn't realised that vitamin d and ferritin levels effected t3 so I will wait for a few months and have bloods done again. Thank you so much for your help. Kind regards Potter.

Thank you reallyfedup I am at surgery with plenty of good advice 😊 kind regards Potter

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