I'd be grateful for some advice. Recently I have felt some discomfort in the area of my thyroid. Not pain as such but a tight, aching discomfort. I'm wondering if I've just suffered an autoimmune attack on my thyroid and if that explains the less favourable results.
In December 18 my Medichecks results were as follows:
TSH 0.393 (0.27 - 4.2)
FT3 4.81 (3.1 -6.8)
FT4 20 (12 - 22)
I was on 67.85 mcg levothyroxine and feeling pretty good.
Latest results (March 19th):
TSH 2.09
FT3 3.99
FT4 18.3
still on 67.85 mcg levothyroxine, but not feeling as good as before - tiring easily with aching joints and anxiety.
Medichecks of course say everything is completely fine.
What would you advise? I have thought about increasing levothyroxine to 75 mcg daily which is, I know, a very small increase but I do normally respond quite quickly to small doses of supplements/medicines. Any advice or suggestions would be very much appreciated.
Best wishes
Caroline
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Caroline888
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Thanks Peanut. I agree that these latest results look as if I’m undermedicated though I am still on the same dose as December when my results were much better and my TSH was well below 1.
You are of course right. I did get FT3 and FT4 the wrong way round (have edited them now). And yes the range was the same in each case.
I did both Medichecks blood tests at 9.10 a.m. and had my last dose of levo 24 hours prior to doing the test and after fasting.
I have done three separate tests over the last year with doses ranging from 50/75 mcg alternate days to 75 mcg x 5 plus 50 mcg x 2 weekly. Each test resulted in a TSH of below 0.5 so am surprised by the latest result. I know that an increase of 25 mcg is often recommended when undermedicated but wonder if that might be too much for me bearing in mind that my current dose is only 67.85 mcg.
I am really grateful to you for taking the trouble to reply. I don’t know quite what I’m going to do but you’ve certainly given me something to think about.
My vitamin D was 108 nmol last time it was tested, my ferritin had improved greatly at 70.3 and my folate and b12 were both a little above range (hence me stopping the multivitamin containing b vitamins until July to establish a baseline - I was only taking a multivitamin containing the wrong kinds of vitamin b12 and folate!).
Do you think I should test b12 before July? I stopped taking the multivitamin a month ago. I am a vegetarian so find it difficult to understand why my b12 was high when only taking a Holland and Barrett multi. I eat yoghurt and cheese daily and an occasional egg but that's about it for b12-containing foods.
I will do as you suggest and take 75 mcg levo daily and retest in 6-8 weeks. Small increases have worked well for me in the past!
Thanks again for your advice and support. I am really grateful.
It's a balancing act this thyroid business and a slow one as well. I'm learning not one medication suits us all.
Your T3 is low and this maybe causing your symptoms, T3 is VERY important despite the doctors and some endos thinking otherwise.
Once you increase your levo by 25mcg you should hopefully see an improvement in your T3 results.
Try and keep your blood tests the same time as you have in the morning so there is consistency. If you feel on your next increase after this one, your over medicated then you can always spilt your 25mcg tablets with a craft knife. Like I say its a balancing act.
Keep testing your bloods for every increase though, so when you feel good you will know where your results need to be.
75mcg is still a low dosage anyway.
Many people on levo feel better when there T3 &T4 are in the higher figures of the range, so you have room to increase.
Don't get worried about a suppressed TSH either. Once you have increased stick at this for 6 - 8 weeks and then take the test. You only need to do TSH, T3 & T4 via a finger prick test and medi checks and blue horizon do this. Medi checks is £39.00 was £29.00 yesterday, but if not on offer enter the code THYROIDUK for 10 % off.
We say 6-8 weeks blood test, as it takes T4 a while to kick in.
Keep a record of your symptoms, i'm still old school and have a diary in my handbag.
I write very briefly how I am feeling that day, and, also put by the side of it the dosage I am on, this way I can look back and spot the issues.
I was on levo via the NHS, but, just didn't feel great at all, despite giving it a go.
I'm now self medicating on NDT, I'm better on this than levo, but, not perfect so I'm still tweaking my dosage.
Thanks, Peanut, for your very comprehensive reply.
I have previously had very good results on my small dose of levo, with both FT3 and FT4 being towards the top of the range so the latest results have certainly thrown me! I was however feeling a return of some hypo symptoms which is why I did the Medichecks blood test despite not having increased my levothyroxine since the last test.
I have been experiencing some thyroid discomfort which I take it means my thyroid has been under attack so maybe that has caused the drop in my hormone levels.
I like your idea of recording symptoms on a day to day basis! I’ll certainly give that a go😊.
Glad you are feeling better on NDT and hope you manage to determine your optimal dose soon. Of course things change all the time with hypothyroidism don’t they? It seems to be a never-ending story!
Another question on blood test technique that could impact things - had you been stable on that dose for 6 weeks before the test? It takes the body a while to stabilise.
Hashimoto's causes your thyroid function to slowly reduce over time, but it can also cause short term spikes (increases in hormone). Both those things could explain these results, you may have had a spike in December and have returned to your stable level in March, or your thyroid function could be reducing. Sometimes people will be very aware and feel ill during a flare, but it might be that while undermedicated you feel better.
The other thing that could cause these differences is getting accustomed to the medication. Being on a new dose that's one step closer to optimal can feel great, and the whole body overreacts thinking it's going to be much better. But after longer on the dose your body relaxes into it and it becomes clear you don't have enough hormone.
The explanation doesn't matter too much, though, because you have room for an increse in both sets of results. Ideally you want to push that freeT3 up near the top. On T4 monotherapy it's common to need freeT4 at the very top or just over to get a high enough freeT3.
I had been on the same dose of levothyroxine (67.85 mcg) for 23 weeks prior to the last test. I only did the Medichecks blood test because, for a couple of weeks, I have felt a few hypo symptoms were returning and so wanted to check my levels.
Prior to that I was feeling well on 62.5 mcg of levo. My dose increases have always been very small but nonetheless have proved effective.
Perhaps, as you say, my thyroid is just failing as is expected with Hashimoto's and more medication is required. All my vitamins are good except ferritin which at 70.3 probably needs a bit more work.
My December results were not quite as good as the ones before so perhaps that was the start of a downward trend, though I did feel well at that time.
I am thinking of increasing my levothyroxine just a little to 75 mcg daily and see if it makes a difference. If not, as you say, there is probably room for a further increase.
Thanks again for your help and advice; I am grateful.
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