Blood test results after switching from levo to ndt. Gp is telling me I’m taking to much and I need to reduce?

[dizzy1979]

Hi I did post yesterday and had no replies so thought I’d it may have got lost so i have posted again I. I have just had first bloods drawn after switching from levo to ndt, my gp called me to say that I need to reduce my ndt because it’s showing i have to much in my system? I note that my t3 wasn’t tested so I will be getting that done privately with medichecks next week. But can anyone please help with actually reading my results and giving me an accurate review? We all know the gps are not in line with optimal results just being in the normal ranges. Thank you so much in advance I appreciate any help I can get.

[SlowDragon Administrator]

On NDT it's common for TSH to be low because it contains T3

So TSH is low but this doesn't necessarily mean you are over treated

FT4 is low. Again common on NDT

No FT3 test

You will need to test TSH, FT3 and FT4 together by private testing

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

If/when also on T3, or NDT make sure to take last dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Vitamin D - good result

Ferritin, ok

Eating liver or liver pate once a week, plus other iron rich foods like black pudding, prawns, spinach, pumpkin seeds and dark chocolate, plus daily vitamin C can help improve iron absorption

FERRITIN and being hypothyroid

healthunlocked.com/thyroidu...

B12 and folate both on the low side. Supplementing a good quality daily vitamin B complex, one with folate in not folic acid may be beneficial.

chriskresser.com/folate-vs-...

B vitamins best taken in the morning after breakfast

Recommended brands on here are Igennus Super B complex. (Often only need one tablet per day, not two. Certainly only start with one tablet per day after breakfast. Retesting levels in 6-8 weeks ).

Or Jarrow B-right is popular choice, but is large capsule

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Cholesterol is near top of range. High cholesterol is often linked to being hypothyroid

nhs.uk/conditions/statins/c...

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

[dizzy1979 in reply to SlowDragon]

Thank you so much for the reply. I’m ordering the test from medichecks today so hopefully get that next week. I stopped my b12 for three weeks before testing so will reintroduce that again now. Should I stop with the vitamin d oral spray that I had been using ( using being a loose term as I would forget to take this during the day when at work, and haven’t used in over a month)?

And on the results shown you wouldn’t suggest to decrease/increase my ndt?

[SlowDragon Administrator in reply to dizzy1979]

You will need a vitamin B complex - most contain B12. So you may not need B12 as well

[m7-cola]

Keep in mind that only you know whether ‘there is too much in your system’. The blood tests only tell how much is in the blood, at any one time There is no test, currently, to indicate what is in the cells of the body.

Keep a careful check/records of your pulse rate, basal temperature and blood pressure, any weight changes... these can indicate whether you are over medicated.

[dizzy1979 in reply to m7-cola]

In general I feel “ok” I have been very stressed for the past 3/4 weeks and so been a bit of an emotional wreck, but I’m coming out the other side of that now and feeling much better. My hair and nails are frowning and with going gluten free I am feeling less bloated and like my clothes are feeling more comfortable ( I will not weigh myself for fear of what it tells me ). My appetite is more stable and I am not raiding the cupboards every five minutes. Sleep is still not optimal but I wonder if it ever will be? I def feel like I don’t need as much as when on levo.

[m7-cola in reply to dizzy1979]

Sounds as though you are on the mend. Trust your instinct.

[dizzy1979 in reply to m7-cola]

Thank you that’s reassuring to hear, I really hope so, it’s such a worry when self medicating isn’t it.

[m7-cola in reply to dizzy1979]

But think how much you are learning about yourself!

[dizzy1979 in reply to m7-cola]

Yes I am a neurotic mess quiet a lot of the time 🤣 but seriously yes after 18+ years stuck on levo with horrific symptoms being told this is all there is for me for the rest of my life I feel like I am starting again, and with the help of this wonderful support group, As I definitely couldn’t have done it in my own. I will be eternally grateful to everyone who has helped me x

[Aurealis]

Your GP is just looking at the tsh result which is no help as a guide to treatment on NDT. You really need ft3 measured. FT4 is ok. The correct dose is that which makes you feel well. I have some questions about Medichecks fT3 results - see my recent post. So don’t panic if the result comes back high. And make sure you follow advice on timing of tests given on this site.

[SilverAvocado]

I'd say looking at these results there is no evidence you need a reduction. Most people will need a suppressed TSH to feel well. In this case it even says so on the form! "0.05-0.35 can indicate adequate thyroid replacement"!!

But unfortunately because you're in NDT, these tests are completely inadequate. You really need to see freeT3, you. This is because freeT4 will always be low when on NDT, its only about half T4 (by potency), and as others have said, TSH will inevitably be low.

The only thing that gives us new information is the freeT3.