Hello wonderful Thyroid UK people. I've posted a couple of times and your response was great. I just got results of yesterday's labs and trying to prepare for a conversation with my Dr. I'm afraid he will ignore the lower Ft3 and reduce the levo. Any thoughts are greatly appreciated.
2/4/19
TSH .75 (.40-4.40) previous 2.09, 2.73, 1.75
Ft4 1.3 (.8 - 1.8)
Ft3 2.5 (2.3 - 4.2) previous 2.65
Is this hypothyroidism or possibly something else? Thank you so much!
I am sure that the great minds are going to ask you to confirm your current levo dose as well as confirm if you tested in am, no food/drink, 24 hours after last dose of levo. They will also ask you to confirm what, if anything, you are supplementing and dose 
Thanks for the reminder soupybp. I've been taking 50 mcg of levo since November 2018.
I had the test before my levo that morning, and fasting. Also supplement with D3, B12 and Magnesium which I stopped 2 weeks before the test.
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 Thyroid antibodies are raised
As you have fibromyalgia this is often linked to low FT3
Good you did test as recommended
I.e. as early as possible in morning and fasting. Do not take Levothyroxine dose in the 24 hours prior to test, delay and take 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)
Ask GP to test vitamins and antibodies
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins
thyroiduk.org.uk/tuk/testin...
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
If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
About 90% of all hypothyroidism in Uk is due to Hashimoto's.
Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .
Link about thyroid blood tests
thyroiduk.org/tuk/testing/t...
Link about antibodies and Hashimoto's
thyroiduk.org.uk/tuk/about_...
thyroiduk.org.uk/tuk/about_...
Understanding Hashimoto's
hashimotoshealing.com/under...
List of hypothyroid symptoms
thyroiduk.org.uk/tuk/about_...
Thanks SlowDragon. I haven't had those tested recently but a few years ago all was normal. I'm particularly concerned that my tsh dropped from 1.75 to .75 while my ft3 also dropped from 2.65 to 2.5. My dr will give me a tough time and probably reduce my levo. I'm wondering how best to ask for either NDT or possible T3?
TSH should ideally be between 0.4-1.5 on just Levothyroxine
New NHS England Liothyronine guidelines November 2018 clearly state on pages 8 & 12 that TSH should be between 0.4-1.5 when treated with just Levothyroxine
Note that it says test should be in morning BEFORE taking Levothyroxine
sps.nhs.uk/wp-content/uploa...
If GP tries to reduce dose, instead request referral to endocrinologist of your choice
Email Dionne at Thyroid Uk for list of recommended thyroid specialists
Essential to test vitamin levels and thyroid antibodies,ask GP, but do privately if necessary
Vitamin D should be over 80nmol, many find over 100nmol is better
B12 and folate near top of range
Ferritin at least half way in range
Frequently they are too low, but may still be just within range
Getting vitamins optimal is first step
TSH may then rise
If antibodies are high trying strictly gluten free diet
If after this TSH remains low and FT3 low look at seeing T3 friendly endo
verywellhealth.com/the-thyr...
Ask for cholesterol test
If result is high this suggests you are still under medicated for thyroid
High cholesterol is linked to being hypothyroid
nhs.uk/conditions/statins/c...
Thank you again, SlowDragon... I will ask for those tests and also cholesterol, which was high before taking levo. Hoping for cooperation as, like so many others, just really running on empty.
There have been so many warnings that the TSH level once you begin treating with hormone is NO LONGER valid. For one, it is a test of the pituitary NOT your thyroid gland. FT4 measures the production from your thyroid gland and FT3 tell you if your body is correctly converting the T4 into T3. They are both so low it's difficult to tell how well your are converting but for certain your active hormone which is T3 is no where near enough to relieve symptoms in my opinion. You need to upgrade your dose or add T3. An average dose for Levo is about 125 mcgs. per day.
Or many do better on 100mcg Levo plus small dose of T3 (typically 3 x 5mcg)
Thanks, Heloise and Slow Dragon. I'm going to ask for a trial of Levo with some T3 added, or at least Armour
I hope your doctor will comply. There is nothing worse than being on a dose that is insufficient. Again, it's my opinion that your body will need to compensate since every cell needs T3. If you run into a wall, there are other options so you won't need to ruin your health.
Thanks Heloise, when I saw my results this morning That's exactly how I felt...like I had run full speed into a brick wall. I guess that will be the time when I ask for a pm to follow my own path, with the guidance of this unbelievably wonderful community. I know I need to research much more ,but today my brain is too shaky from running into that wall!!
I know and it's terrible. Most of us here have had the same challenge. I see a deterioration in the medical profession and I no longer waste time fighting the system. We just work our way around it and you will feel better for it.
Until vitamins are optimal you won't know if you need T3
Only an NHS endocrinologist can diagnose clinical need for T3 prescribed on NHS
Many many people well and stable on NHS T3 are having it stopped against their wishes
You may need to get private consultation
Dossier presented to Lord O'Shaughnessy November 26th
drive.google.com/file/d/1c2...
Liothyronine gender inequality
england.nhs.uk/wp-content/u...
medscape.com/viewarticle/90...
There's nor reason why she should reduce your levo, your TSH is in-range. Before it was much too high.
Dr's office finally called to say lab results are fine and to stay on 50mcg levo and retest in 6 months! I asked to be increased to 75 mcg because FT3 is 2.5 (2.2-4.5 )and was told no for fear of toxicity. I'm not sure what next steps should be as I'm not responding much anymore to 50mcg. This is a new endo that I waited 6 months to see.
Are you in the UK?
Email Dionne at Thyroid Uk for list of recommended thyroid specialists
You MUST get vitamins and thyroid antibodies tested before starting on any T3 or NDT
Post from 9 months ago.... ShootingStars advised on private testing options in USA
Thank you for responding, SlowDragon and reallyfedup. As far as private testing, stopthethyroidmadness.com has information for private testing in the US. I will ask my GP for the tests first and go private if necessary. Hope you are both well.
Hi I have just got a very similar blood result back - having some over function symptoms- did you reduce your dose at the time ? Kind Regards Michelle
Hi, I did not reduce my dose. In fact, after reading the responses here and after a lot of research, I decided to switch to NDT. I did it very slowly and have recently started to feel that I'm approaching an optimal dose for me. I never went back to that endo, but my new gp is following me and actually listens to my symptoms and orders FT3 with my labs! That's my experience...we are all unique and need to listen to our bodies. Best of luck to you!
Are you in the UK - sounds good your GP is listening - I’m in UK going privately to see an Endo. GP happy for me to go but says he can’t get me T3 on NHS if prescribed because of the cost. I may not need it though 😊
Hi, no I'm in the US... I'm very fortunate that I finally have a gp who listens to me, however, she is not treating me. I'm self-sourcing from Thailand and she is aware of that. Getting a prescription for T3 is just as unlikely here as it is in the UK. My free T3 was at the very lowest end of the range and is now 3/4 of the way through because of the NDT. Best to you!
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Updated results TSH, fT3 & fT4, ferritin and folate
