Please help with recent results

Hello everyone,I tried it before, couldn’t get you replies.

Test was done with the gap of 24hours .

Im on vitamin d3 daily doze for the last 6 years.this is in good range.

Hypothyroidism for the last 13 years,

On sertraline 150mcg for last 3 years.

Help me to understand what to do next?

I have always struggled with my daily life and never ever felt quite well.

Please advise if i need to take T3?

Also if there’s any Gp or Endocrinologist in Bristol Area?

I understand the privacy policy ,If needed please message me privately.Thanks.

[SeasideSusie Remembering]

lb1211

There were no furter replies to your previous post because you didn't respond to either myself or SlowDragon that you had added your reference ranges or posted a picture of your results.

As SlowDragon mentioned in reply to your other thread, your TSH is too high for someone on Levo. When on Levo only, the aim of a treated hypo patient generally is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their ranges if that is where you feel well. There is plenty of room for a dose increase as your FT4 is only 46% through range and your FT3 isn't bad at 62% through range currently. The longer you stay undermedicated, the lower your FT3 is likely to go.

Please advise if i need to take T3?

Impossible to say until TSH is down to around 1. So you need the increase in Levo to bring your TSH down, raise your FT4 and then see where your FT3 lies. That will then tell you how well you convert T4 to T3.

SlowDragon did ask if you'd had vitamin D, folate, ferritin and B12 tested recently? What is your current Vit D level and how much D3 do you take. Do you take D3's important cofactors, particularly magnesium and Vit K2-MK7? You should get the other tests done.

Setraline has been associated with a decrease in the effect of levothyroxine.

Help me to understand what to do next?

Test B12, folate, ferritin.

Increase dose of Levo, 25mcg now and retest in 6 weeks, continue increasing/testing every 6-8 weeks until your levels are where they need to be to feel well or TSH is down to around 1 or below.

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the magazine for doctors):

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l. In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l. This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).*"

*He recently confirmed, during a public meeting, that this applies to Free T3 as well as Total T3. You can obtain a copy of the article by emailing Dionne at

[e-mail]

Print it and show it to your doctor in support of an increase in Levo.

You can send for the list of thyroid friendly endos from Dionne (email same as above) then ask on the forum for feedback by private message on any that you can travel to.

[Hidden in reply to SeasideSusie]

Great help ,thank you seaside,I wish GPs could explain this in such details.i will be seeing my doctor very soon,

Thank you for your help. Appreciate a lot.