Quick review of results please - doc appt 2.30 today, results just in! Should I increase dose?

[Hashi-hacker]

Hi,

Could someone take a quick look at my results please. I have the DI02 gene mutation on one side, which suggests T4 to T3 conversion. The question is - should I ask for 100mcg? My thinking is that I try 100mcg and see what happens then see an endo regarding possibility of T4/T3 combo. I'm on Teva as it's lactose free.

FYI, I changed my user name to something more private, you will see my history of diet, supplements etc is as good as I can get to manage the Hashi's.

Based on this set of results, I will be bumping up my Vit D.

One additional question - I am not supplementing iron but do eat reasonable amounts of liver and red meat. I am still menstruating. I am not sure why my iron level is still high. Any thoughts? I don't actively supplement iron.

Sorry if I've forgotten to add anything vital!

Thanks

[greygoose]

It's already pretty obvious that you are a poor converter. So, increasing your levo will probably take your FT4 up to a point where your will convert to more rT3 than T3, so your FT3 could possibly drop lower.

So, given that information, you have to decide, do you want to try and get your FT3 under-range in an attempt to convince the endo that you need T3, and in doing so, make yourself feel worse for a while? Or do you want to stay as you are and hope those results are enough to convince him/her? Depends, of course, on how much the endo knows about thyroid. They might just say, well, the FT3 is still in-range, so it has to be fine. Or, even if it's under-range, they're capable of saying, well, it's only slightly under-range, so it's probably ok! Just impossible to predict how a 'specialist' is going to react. But, the odds are that increasing your levo could make things worse.

[Hashi-hacker in reply to greygoose]

Thanks Greygoose, that's not something that I had considered and makes a lot of sense. My last set of results on 50mcg were free T4 18.2 (only 0.3 lower than most recent on 75mcg) and free T3 4.42 (which is 0.78 higher than my most recent results on 75mcg). So it seems I am already making more rT3 than previously.

The option to see an endo is mostly up to me in that I will go and see a private endo as the local NHS endo told me I had absolutely nothing wrong with my thyroid. I have to see a new GP today as my old one has gone on maternity, not sure what reaction I will get!

As an aside, I looked up why my ferritin has gone up and this is apparently quite common when you start taking thyroxine. Not sure if it is an issue though, happy to hear your thoughts.

[greygoose in reply to Hashi-hacker]

I'm afraid I know nothing about iron. As much as I try to understand it, it remains a mystery for me.

Endos seem to be very fond of telling you there's nothing wrong with your thyroid. I had one tell me that when my TSH was 11! So, make sure you pick your endo carefully.

[Hashi-hacker in reply to greygoose]

I've had the appointment now, and thankfully, the new doctor was extremely helpful - she acknowledged my results were within normal range but asked how I felt and agreed that this was just as important and that normal range doesn't necessarily mean normal for me.

We've decided to take the risk of trying out 100mcg and retesting at 6 weeks, with the knowledge that I could actually get worse. At this point she has the option to refer me to an NHS endo in Glasgow (avoiding the local endo) or I have the option to book a private appointment with the endo I saw in Edinburgh.

Here goes 100mcg!

Thanks greygoose for your input, super helpful as ever x

[greygoose in reply to Hashi-hacker]

Well, that's good news! I'm so glad you've found a GP that listens. Let us know how you get on.

[danym in reply to Hashi-hacker]

please let me know how it goes, I have the same issue and I have a high rt3.

[Hashi-hacker in reply to danym]

Will do x