I hope you can indicate to my daughter what kind of blood test she needs to have done for the following problem. She has had an under active thyroid for 1 year now (known), perhaps longer. She was on Levothyrox (Thyroxine) for a year 75 mg most of the time. She has recently had diarrhea for a number of weeks and couldn't sleep. She's very active, 45 years of age and a busy family life with 3 adolescent kids.
The history of her TSH the only factor the doctor has considered is as follows:
march 2017 before treatment: 7.7
may 2017 (beginning of treatment) à 3.71
sept 2017 = 4.92
may 2018= 4.085
january 2019 = 6.01
I know it"s incredible but the doctor hasn't requested T4 and T3 results, nor anything else.
She just changed from Thyroxine (Sanofi: Levothyrox, new formula) to I-Thyroxine by Sanofi (new excipients?) 100 mg. She is now sleeping well and no more diarrhea but still tired and feeling not well, losing her hair etc.. all the symptoms that we know so well.
Please tell her what you believe she needs to test in order to find a better treatment.
Many thanks
Written by
vivbr
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I'm not familiar with those brands, but my endocrinologist always stressed I should stick to the same brand. The doc should definitely be testing both T3 and T4. I couldn't get on with thyroxine and take only liothyronine, it's been brilliant. Might be worth a mention to her doctor. Good luck.
Please add the reference ranges for the TSH test but if it is the one my lab uses, it is much too high and your daughter is very undermedicated. You need to get both free T4 and free T3 to see what is really going on. She may not be converting well or she may just need more hormone. She may also be deficient in certain nutrients that are often low in thyroid patients. Ask for iron, ferritin B12 , folate and Vit D and post results under a new thread. It is all a mystery to doctors, so do not expect much good advice from that quarter. Are you in France, by any chance?
Yes we live in France, I take medication for Hashimoto's Euthyral (T4 & T3) because Thyroxine was not working for me, I feel good now since I take both thyroid hormones as I expect the T4 wasn't converting properly. My TSH has dropped to .767 mUl/L. Thanks for all the input which I will hand over to her asap.
Did you get any lab ranges with those results?, lab ranges vary so if you did can your edit your post, (this can be done by clicking on the three small dots on your original post, right hand side) and add them on.
Example
TSH 6.01 (0.27-4.20)
I would guess your daughter's TSH is in fact too high(need to see lab ranges though) and she should be given another increase of levo (25 mcg). 75mcg is still a low dosage to be on, what normally happens is that every 6-8 weeks you increase your levo by 25mcg each time and have blood taken testing TSH, T3 & T4.
Keep repeating that same process until your TSH reaches to 1 or below and T3 & T4 are in the higher figures of the lab ranges but, most importantly you feel well.
It appears that her GP is only testing her TSH, which really is no good
I see her TSH results are up and down, this could mean she has hashimoto's which can cause the TSH to fluctuate, or the times in which she had her bloods taken were not consistent. What time did she has those blood test done?
Has she been tested for an auto immune disease, thyroid antibodies test?
You have a few options, Your daughter goes back and asks for a further increase of levo (25mcg) stating she still feels unwell and gives that increase 6- 8 weeks to see if there is an improvement, or pay for private blood test now testing her TSH, T3 and T4 and vitamin levels. Low vitamins levels affect the thyroid as well.
Once you have the blood results post them on here and the more experienced members can give you further advice and your next step.
Medichecks offer discount on Thursdays for blood tests and today they are offering Thyroid check ultravit for £75.00 was £95.00, click on special offers, this test also covers the thyroid antibodies. For other tests not reduced put in the code Thyroiduk for 10% discount.
The results are emailed directly to you and you can either pay extra for the blood to be taken at your home, or pay £25.00 extra to visit a local hospital that medi checks use. Most of them are BMI hospitals and they will be able to advise the nearest one to you, or if you live in London there are walk in clinics.
Some tests can be done via a finger prick, so many members do them at home, but, the test above suggests a venous.
Make sure that you book the test as early in the morning as possible before 9am, and do not take your levo, no food and only drink water.
Thanks for your lengthy reply, she has been increased to 100 mg on another molecule, she is feeling better already but needs to insist on thorough tests to make sure she is producing/transforming T4 to T3. Thanks for your help
You don't need to see the ranges for a TSH. A TSH is always a TSH, and your daughter's TSH has always been too high. When on thyroid hormone replacement, it should come down to 1 or under.
I'm afraid that doctors in France are just as ignorant about thyroid as in any other country. And, they don't know how to interpret FT4 and FT3 results. They have only learnt about TSH in med school. However, I've always found that if I insist hard enough, they will usually crack and do the FT4 and FT3 - If they say they don't know how to interpret them, I say never mind, I do!
Failing that, you could ask at the lab if they will do them, even if they're not on the lab form, if you pay for them. But, here in France we do not have the private lab testing that they have in the UK - medichecks and blue horizon, etc.
It might be a good idea if your daughter can get Euthyral prescribe instead of Levothyrox, because a lot of people have had problems with that, since it's been reformulated. I took Euthyral for a while, but there wasn't enough T3 in it for me. But, it has to be better than the new Levothyrox! Perhaps she could ask her doctor about that? If not, find a new doctor!
Great, you obviously went down the same road as I did, I am taking Euthyral and feel much better for it, what are you taking today? My TSH is now down to .767 mUI/L I suppose that is pretty good compared to before, T4free 7.99pmol/L and T3free is4.54 pmol/lL, on Levthyrox I was a catastrophe. Daughter's dont always listen or believe entirely what their mother says...!!! Thanks to all for the advise I'll pass it all over
I've been taking T3 only for several years, now. I cannot tolerate T4 in any shape or form.
I'm afraid you need to add the ranges for those results to make sense. There are no universal ranges, they vary from lab to lab. But, a TSH of 0.7 is fine. But meaningless. Once you're T3, the most important number is the FT3.
No, daughters don't listen to their mothers! Mine thinks I'm obsessed and want EVERYBODY to have thyroid disease! Just because she's showing a lot of symptoms but refuses to get a test.
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