Free triiodothyronine 3.2 (3.8-6)
TSH 1.79 (0.35-3.5)
Free T4 12 (8-21)
Medication Levothyroxine 125 mcg magnesium, Vit b complex, sertraline 150 mg, everol 50 patch HRT vit D
Partial thyroidectomy May 18 as high chance Cancer. Turned out normal thankfully!
Symptoms-tired all time, piled on weigh, brain fog, low concentration. Body aches and painful joints. Low mood
Many thanks in anticipation
I think you need to increase your Levothyroxine dosage. TSH should be 1 or lower and for FT4 it’s better when it is in a higher range. I have little knowledge of FT3 and supplementing for it, so cannot advise you on that, but your FT3 should be higher
SeasideSusie and SlowDragon would you have advice? I'm not sure how much an improved T4 dose would increase T3 enough?
jessjbf
TSH 1.79 (0.35-3.5)
Free T4 12 (8-21)
Free triiodothyronine 3.2 (3.8-6)
You are undermedicated.
TSH needs to be down to 1 or below, with FT4 and FT3 in the upper part of their reference ranges. Your FT4 is 31% through range and your FT3 is below range. You need an increase in your Levo, 25mcg now, retest in 6 weeks to check your levels. Further increasing/retesting at 6 weekly intervals until your levels are where they need to be. Once your FT4 is higher up in the range, we can see how well (or not) you convert T4 to T3.
For thyroid hormone to work properly, nutrient levels need to be optimal. Please post your current results and say how much supplement you are taking for the following:
Vit D
B12
Folate
Ferritin
Do you take your Levo correctly? On an empty stomach, one hour before or two hours after food? With a glass of water only and water only for one hour each side, no tea, coffee, etc? Do you take your other medication and supplements well away from your Levo? Some need 2 hours, some need 4 hours (magnesium, Vit D, iron, calcium), some need as far away as possible.
My current results are in original post. (Oct 18) Need some more blood test done. GP was reluctant to increase last time! My thyroid has been on the back burner as concentrated on my Mum who we lost on 7th Jan and 2 days later my dog.
Yes I take my Levo at least 2 hrs after eating with water and the supplements and sertraline in the morning.
Vit D3 3,000 iu daily
Vit B complex containing ( B1 1.4 mg, B2 1.6mg, B3 18mg, B6 2 mg, folic acid 200mcg, B12 1 ug, biotin 150 ug, B5 6 mg and PABA)
Magnesium not sure of dose
Thank you so much for taking the time to help. Jess
I know our thyroid results are in you opening post, which I have commented upon, I asked for current results for nutrient levels 
You need testing for the 4 nutrients that I listed.
Symptoms
tired all time - could be because undermedicated, could be low ferritin, could be side effect of setraline
piled on weight - could be undermedicated, low T3 means you can't lose weight
brain fog - could be undermedicated
low concentration - could be undermedicated
Body aches and painful joints - could be low Vit D
Low mood - could be undermedicated, could be setraline
Your thyroid results show undermedication. Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine, the magazine for doctors:
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.
But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).*"
*He recently confirmed, during a public meeting, that this applies to Free T3 as well as Total T3.
You can obtain a copy of the article by emailing Dionne at tukadmin@thyroiduk.org print it and highlight question 6 to show your doctor.
Aside from what SeasideSusie said (which I wholly agree with), be aware than some SSRIs, especially sertraline can increase requirement for thyroid hormone.
In several studies, hypothyroid patient treated with sertraline needed a higher Thyroxine dose to maintain a euthyroid state.
You definitely need a medication increase, follow the 25mcg/6 weeks advice above. Be aware that if and when you stop the sertraline, you should get retested after 4-6 weeks to see if your dose is still right.o
Optimise T4 to the upper 1/3 of the range first, this should bring your TSH to between 0.2 - 1.0. I've had to maintain my fT4 at 24 pmol/L, a little over the top of the range to get my TSH down and T3 up; as well as feel healthy.
Once this is done, you will hopefully begin to feel better. Once you are on a stable dose of thyroxine, get fT3 retested also.
All I can add is that depression is a common symptom of hypothyroidism.
So you may find you can decrease the sertraline when your thyroid levels improve. But get the doctor's advice on the best way to come off it slowly.
This is a valid point - I was very depressed and used several SSRIs over that long period as well as Mirtazapine. They helped a little, but could not overcome the mental and physical misery that hypothyroidism caused. I am now coping well without antidepressants, however in hindsight I should have stayed on them a little longer once I achieved euthyroid state.
Obviously only stop the SSRI once you have been feeling better for several months, and only under the guidance of your GP or Psychiatrist.
Treating hypothyroidism properly (raising your fT4 , which will hopefully raise your fT3 also) could result in a much reduced severity of depressive symptoms. It will likely take a little longer to get your mind back to "normal", as even though the involved neurotransmitters may normalise quickly once the underlying cause (e.g. hypothyroidism) is treated; the neurological rewiring and psychological habits can take a little while to shake off.
BEFORE seeing any thyroid specialist we always recommend getting FULL Thyroid and vitamin testing
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Ask GP to test vitamin levels
You may/probably need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
Is this how you do your tests?
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies
thyroiduk.org.uk/tuk/testin...
For thyroid including antibodies and vitamins
Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random
Email Dionne at Thyroid Uk for list of recommended thyroid specialist endocrinologists who will prescribe T3
Vitamin levels really need to be optimal BEFORE starting on T3
Thank you so much 😊
Help with results please
Help with results please!
Help with results
Help with Results please
