Help explaining new blood results

[Louife49]

Hi All,

I'm hoping to get some help re my latest blood tests which have confused me!

After getting some good advice from people on here in March last year, I finally managed to persuade my GP in September (🙄), to give me a trial of Levo, after my TSH increased again:

Sept 18

TSH 9.11 (0.35 - 5.00)

Free T4 11 (9.00-22.00)

She gave me 25mcg and even on such a small dose I felt better, all symptoms improving. Had a re-test in December and results were:

TSH 0.02 (0.35-5.00)

Free T4 17.8 (9.00-22.00)

She then put me up to 50mcg, saying this was the normal dose, would hopefully be all I needed and to keep a eye out for any symptoms of being over medicated. I felt great on this, retest booked for Feb 19.

In the last couple of weeks, I had felt the creeping up of a couple of previous symptoms, but I had the cold virus, so I initially put it down to that. However, I got my new results back yesterday and they are:

TSH 9.98 (0.35-5.00)

Free T4 12 (9.00-22.00)

My ferritin has also dropped from 48 in Sept 18, to 26 (10.00-200.00).

Is this kind of fluctuation normal and is it a sign that I need to increase my dose again, or should I stick on 50mcg and retest? I do have Hashimotos and know that this can make results swing a bit?

I'm back to the GPs on Thursday to review tests, but just wanted to get a bit of advice first.

Thanks in advance. 😊

[greygoose]

50 mcg is the normal starter dose. It would be very unusual if that were all you needed.

Yes, you need to be increased to 75 mcg, now, retest in six weeks, then more than likely a further increase. I think the fluctuation was shown in the December results. Now you're back to your normal circulating hormone level, and it's too low.

It's perfectly normal to feel symptoms creeping back in as your TSH rose. And, if that ever happens again, you'll know you need another increase in dose.

[Louife49 in reply to greygoose]

Aha, yes that makes sense now. Thanks for clearing that up and I'll know what to do next time. 😊

[greygoose in reply to Louife49]

You're welcome.

[SeasideSusie Remembering]

Louife49

Fluctuations like that are normal with Hashi's, it's the nature of the beast. Dose adjustments can be made when these happen, readjust when things settle down again.

Some Hashi's information:

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

thyroiduk.org.uk/tuk/about_...

Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies. Your nutrient levels were discussed in your previous thread here

healthunlocked.com/thyroidu...

Did you start eating liver and other iron rich foods as suggested? Eating liver regularly should raise your level.

What happened about your B12?

Did you get folate tested?

Did you start taking D3 and it's important cofactors.

When you have a cold, or any kind of infection, it's always best to delay thyroid tests until well and truly over the infection, (a month from when you are over the infection should be OK) as it can affect results.

[Louife49 in reply to SeasideSusie]

I did start eating liver regularly and that was helping to raise my iron I think, but haven't had it in the last 3/4 weeks.

In Sept 18 my B12 was 672, so the vit B complex seemed to be working. My folate in April was 4.66. (2.91-50.00) medichecks test.

That's good advice re testing after being ill, I'll remember that, thank you. 😊

[junecox92]

I had similar problems with my levels fluctuating as well... mine ended up being that my t3 wasn't converting the t4 properly! My doctor added in Liothyronine 5 mcg to see if that helped and sure enough it did! After one year, my levels started to creep up a bit and he increased it to 10 mcg and I am back to normal now!

[SeasideSusie Remembering in reply to junecox92]

mine ended up being that my t3 wasn't converting the t4 properly!

Just to avoid any confusion for anyone reading this that doesn't already know, it's T4 that converts to T3 (T4 is a storage hormone, T3 is the active hormone)

[Brownsugar7]

Lot of doctors don't check free T3 ..they really should as well it gives a complete picture...my T3 was low as well they had to add cytomel in there for me to feel better..but yes they will need to increase your dosage at least couple of times 50 is only starting point. Mine was started at 50 ended up at 100

[Louife49 in reply to Brownsugar7]

Thanks for answering my post, I’ll slowly get the hang of this with everyone’s help. 😊

[GKeith]

You need your FT3, not just FT4, checked. As your FT4 was normal at least once, at 17.8, if your FT3 is (was) too low you're probably having conversion problems. I took 88mcg of T4 for 26 years before I could no longer take it at all. I'm now on 50 mcg of T4 (the only amount I feel good on) along with 30 mcg of T3. Everyone is different; ask your endo if he thinks you may be having conversion problems and if, so, to try a small dose (2.5. or 5mcg of T3)?

[Louife49 in reply to GKeith]

Sorry for the late response and thank you for yours. You are right, they never test T3, so I will ask that they do on the next retest to assess properly. 😊

[Dadondadda]

50 mcg is a decent dose. You could try a bit more but I would work on raising ferrin first.

I aim for 100 - 150 ferritin. I don't have the exact number handy but there should be something like 1.5 grams of iron in liver with ferritin at 100.

So, if you're lacking 1 g and absorption is about 1/4, that's 4 grams to supplement or 1 and a 1/3 months of 100 mg/day.

Iron inadequacy is very common globally and can take a while to increase body stoores. I would supplement for a month and retest.

[Louife49 in reply to Dadondadda]

Sorry for the late response and thank you for yours. I will definitely work on increasing my iron and see what effect that has. 😊