Blood results - ?: Hi. I don't think my post of... - Thyroid UK

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Blood results - ?

Cup-cake7 profile image
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Hi. I don't think my post of last night sent ok possibly?

Only that I'm having a telephone Endo appointment today, first since last Aug

I want to get support if possible I don't know the guy so🤞🏻

My free thyroxine is nearly at top of range (so 20 and top is 22)

My ft3 STILL at same 4 (3 -6)

Tsh has reduced to 3.5

I've been taking levo 75 and 100 for three days only

Noticing my t4 result has shot up from14 to 20. since Feb!? (Same range at 22)

Is this to be expected please? Or is it relevant in some way pls

If these were your results with low t3 and high t4 with tsh 3.5 is it time to bring in t3

If I increase with levo it will go over range soon Can it be overage ? Is this not advisable (is this when it goes into Rt3)?

I should know, I've never been a researcher so really hard journey 🙈

Bed cortisol over range again, but had bucket loads of stress to contend with this year ongoing, I don't feel I want any more glandulars at the moment though, so looking at relax product and ashwandga product, meditation, walking and cream cakes

Any thoughts before I speak to endo much appreciated

I've sent him my results already via secretary and written my symptoms, as thought it may help 🤞🏻🤷‍♀️

Xx

If no one replies to this il be paranoid heightened 🙈🙃

🌞

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Cup-cake7
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Cup-cake7 profile image
Cup-cake7

....sorry

That read, "can it be over the range". Regarding the t4, dos it matter if goes over top of range?

SlowDragon profile image
SlowDragonAdministrator

What dose were you taking when test was done?

How long on that dose?

Bloods should be retested 6-8 weeks after constant dose. So if only just increased from 75mcg daily to 75mcg/100mcg alternate days, you will neeed FULL Thyroid and vitamin testing 6-8 weeks later

TSH is too high for someone on Levothyroxine

Aiming for TSH to be under 2

So will have to see if TSH drops after 6-8 weeks on new higher dose

Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine

(Many of us need TSH nearer 0.2 than 2.0 to feel well)

See box

Thyroxine replacement in primary hypothyroidism

pathology.leedsth.nhs.uk/pa...

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"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)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor

 please email Dionne at

tukadmin@thyroiduk.org

Cup-cake7 profile image
Cup-cake7 in reply toSlowDragon

Thankyou

But as t4 level is nearly at top of range, how can I increase levo? Can it over the top of the range?

SlowDragon profile image
SlowDragonAdministrator in reply toCup-cake7

What dose were you on when this test was done?

You say you just increased dose to 75/100

This implies you did test while on lower dose?

Was test as early as possible in morning and fasting and last Levothyroxine dose 24 hours before blood test?

Cup-cake7 profile image
Cup-cake7 in reply toSlowDragon

Yes it was over 24 hrs before done at noon no food eaten

I had been on 75 levo since Feb and had just increased to 100 for 2 doses which in hindsight was stupid

SlowDragon profile image
SlowDragonAdministrator in reply toCup-cake7

Then yes ...test result is not accurate

TSH is likely accurate....shows you needed dose increase

FT4 is high because you just increased dose

Only ever do test after minimum of 6-8 weeks on constant dose

Cup-cake7 profile image
Cup-cake7 in reply toCup-cake7

T4 is nearly at top of range!!? can I go over range to get tsh down to one do you know pls ?

in reply toCup-cake7

My T4 is 24.1 but my TSH is 0.02. Di

Cup-cake7 profile image
Cup-cake7 in reply to

Are you saying it's over range hylda

in reply toCup-cake7

Yes, top of range is 22!

Cup-cake7 profile image
Cup-cake7 in reply to

Thanks

I wasn't sure if it varied

Cup-cake7 profile image
Cup-cake7 in reply toCup-cake7

....worryingly he said t3 is fine anywhere in the range

SlowDragon profile image
SlowDragonAdministrator in reply toCup-cake7

Yes - FT4 can go above top of range ...see the extract above by Prof Toft

Many people need FT4 high in order to get high enough FT3

If this doesn't improve FT3 at next test, then would be looking at adding small dose of T3

But you won't know yet, until you try higher dose first

Most people eventually need somewhere between 100mcg and 200mcg Levothyroxine

Cup-cake7 profile image
Cup-cake7 in reply toSlowDragon

Thanking you as this has been my bugbear/ concern

It doesn't go reverse t3 does it?

SlowDragon profile image
SlowDragonAdministrator in reply toCup-cake7

Not necessarily

It might do....but until you test after 6-8 weeks....you won't know if FT4 is actually high....you just got a false high testing after recent dose. Increase

Most people manage on high FT4

About 20% need to try adding T3, which is much more complicated and almost impossible to get on NHS and then need private blood tests etc etc

So FIRST step is to always try higher dose of Levothyroxine

But adding T3 is not something to leap at, until tried much easier option of higher dose Levothyroxine first

For example the maximum dose of Levothyroxine I can tolerate is 125mcg, but I need higher dose, so, a year after getting all vitamins optimal and 2 years after going strictly gluten free, (Hashimoto's and Heterozygous DIO2 gene) then T3 was prescribed by my endo as my FT3 remained too low despite high FT4

Cup-cake7 profile image
Cup-cake7 in reply toSlowDragon

Ok. I may end up similar but so glad to chat.

Not got the gene I tested that

Was endo helpful? I don't want to appear know all ( I had an arrogant g p experience)

I haven't taken levo today

I'm on sticky wicket if results are wrong - I could redo at docs hopefully

SlowDragon profile image
SlowDragonAdministrator in reply toCup-cake7

You should say test was done just after dose increase so FT4 result is not accurate

Cup-cake7 profile image
Cup-cake7 in reply toSlowDragon

Yes ok then

Relieved I can up the levo

Il,write down my points now

I have t3 at the ready for rainy day haha. Will check date but hope it's not needed

May I ask what you take for candida? , I don't feel I've covered it enough (athlete foot)

Are b complex adequate to cover b12 needs generally as I've taken all separately?

I'd like to condense if possible

Cup-cake7 profile image
Cup-cake7 in reply toCup-cake7

And before you go please may you tell me what you do to keep tabs on the candida/vitamins ? (What do you take for candida)

SlowDragon profile image
SlowDragonAdministrator in reply toCup-cake7

I haven't had Candida (as far as I know)

Though thrush and Candida can be linked

Good probiotic seems to help if you suffer Thrush

thyroidpharmacist.com/artic...

verywellhealth.com/candidia...

naturalendocrinesolutions.c...

Vitamins- I always get full private Thyroid and vitamin testing 2-3 times a year via Medichecks. NHS refuses to test FT3 even though I am prescribed T3.

Cup-cake7 profile image
Cup-cake7 in reply toSlowDragon

(That's crazy by anyone's standard surely)? So you are given something without assessing it along the way? Can't be right , il need to work on Acceptance as everything hits me in the forehead at the moment !!!

Where do they get the T3 from?

I've only had athlete foot , thanks for links , I'd have thought any fungal, bacterial thing is under the candida umbrella or maybe it can be external separately

Il have a read , I assumed fungal nails too

Quite nervously waiting for phone appointment as so want a positive outcome

If you don't mind. Il link in later if anything presents itself?

🙏🏻

Cup-cake7 profile image
Cup-cake7 in reply toSlowDragon

....I did feel uplifted after 100 doses. May sound mad so soon

Well I've loads of space with tsh still high, haven't I?

SlowDragon profile image
SlowDragonAdministrator in reply toCup-cake7

Yes, plenty of room to increase, probably in several more steps

Retesting after each increase obviously

Cup-cake7 profile image
Cup-cake7 in reply toSlowDragon

Ok. Il pray endo fits in with us 😁🤷‍♀️ Haha

Also

Thanks for antibody link!

No over range antibodies Again but then, it seems it doesn't show much

I'm sure I get hashi swings, I feel well for a while and been this way donkies years

Shall I push for antibodies test with endo? Any thoughts would you

....

SlowDragon profile image
SlowDragonAdministrator in reply toCup-cake7

Not much point....they have been tested

You can say TPO antibodies appear negative

TG antibodies have been above range, suggests you have Hashimoto's

Request an ultrasound scan of thyroid if not had one. This can help diagnose Hashimoto's

healthunlocked.com/thyroidu...

Emphasise that you have had enormous benefit going strictly gluten free

Plus Candida issue

Both suggest it's Hashimoto's

Endocrinologist will call it autoimmune thyroid disease and they often have little appreciation of gluten issue or the importance of vitamins being OPTIMAL

Noted in your profile you found improving vitamins very helpful

Cup-cake7 profile image
Cup-cake7 in reply toSlowDragon

....very much so, lifted out of the gutter, stopped getting heavy eyelids and falling asleep in lay- boys literally for a year

Yes I'd like a scan

Il tell him Iv had over range tg, can send him test if wants to see

What do you recommend for candida pls

I feel I'm moving on now

T h a n k y o u

Cup-cake7 profile image
Cup-cake7 in reply toSlowDragon

This is great article Thankyou as il use it if needs must x

Cup-cake7 profile image
Cup-cake7 in reply toCup-cake7

Ps. He worried about cardiac side of things

I know nothing of it except all this can affect heart

SlowDragon profile image
SlowDragonAdministrator

Guidelines suggest somewhere around 1.6mcg Levothyroxine per kilo of weight

So if around 9st 8lb for example = 60.78kg x 1.6= 97mcg Levothyroxine

But it's only a guideline, some need more

Cup-cake7 profile image
Cup-cake7

O good I've loads of leeway lol

So, when finally getting well and weight finally comes off, you reduce your dose according to this? So helpful

Cup-cake7 profile image
Cup-cake7

I've had telephone apptmt

Well he is up for me taking 100 andmpossibly up to 125

Why are they so cautious I do t know, we are all different and as said, weight wise.

The BUT is he isnt keen on over range and only wants tsh under a 2. !

He doesn't think I'm Hashi as peroxidase ok .........

( difficult to understand sadly as I do have accent problem )

The results of the bloods go to,E clinic (think that is what he said )

Meaning the doc sends them there and he can then vet the results so this is a step in right direction for the g ps

Just hoping I feel ok when I get to 125 🙈 But now have a plan for,the next weeks

He was keen to say how to take them with water etc early on

And said eat iodine foods

SlowDragon profile image
SlowDragonAdministrator in reply toCup-cake7

So good that he's happy for slow steady increase in dose

Levothyroxine contains iodine...and if you have Hashimoto's (obviously not 100% sure but likely with such good reaction to gluten free diet) it's best to avoid extra iodine. Though I suppose foods are ok.

Are you taking selenium supplements?

With Hashimoto's frequently adrenals are affected, so we simply can't start on full dose....common to need to increase very slowly

Cup-cake7 profile image
Cup-cake7 in reply toSlowDragon

Slowdragon and big thanks for yesterday,

Do you know if and when you are euthroyd with the levo, do you still need as many vits supplemented? As I would imagine your body will absorb better naturally again (hoping)🙏🏻

I'm maybe OCD on it but I take many at the moment to get by - I read stuff and fall for it basically

Here goes....

C &. D B complex. B12 (How much b12 should you take daily to keep levels up, probably varies?)

Folate, Selenium (or thyroid converter) zinc, magnesium, q10 (I may replace with a good multi mineral but read on here its not as good)

I take collegan , fish oil. Holy basil, thinking of ashwandga (for adrenals)

Rhodeola

Nightmare really and hate it and sooo expensive 😘

This why I'm asking 🤷‍♀️🙈

Cup-cake7 profile image
Cup-cake7 in reply toSlowDragon

.....oh and forgot to mention A &E vitamins! Have Got progesterone cream with 1%ostregen but unsure about it

Have A probiotic /gut tablet too

(Skin still very very dry so gather this is the lack of sex hormone side)

Any advice welcome , I can't imagine keeping this lot up I definitely - my last Vit test is just about right

And I was amused when the lady in the health shop said she took 22 vits a day!!!!!

🙏🏻🦋

SlowDragon profile image
SlowDragonAdministrator in reply toCup-cake7

I found, only since getting T3 added to my Levothyroxine has gut improved more so that I have been able to reduce some vitamins

I am confirmed by endoscopy as severely gluten intolerant (despite no obvious symptoms) and Heterozygous DIO2

Vitamin List daily

Vitamin D - 2000-3000iu (use to be 6000iu)

Re-Mag magnesium- 1/2 teaspoon daily in water

Vitamin K2 Mk7- 1 per day

Doctors Best vitamin C - 1 per day

Igennus Super B complex 1 per day

2 per week (used to be more frequent)

Zinc piccolante

Selenium with vitamin E

Stopped Sublingual B12

Cup-cake7 profile image
Cup-cake7 in reply toSlowDragon

I'm sorry you have severe gut prob

How do you know I'd not too personal

Cup-cake7 profile image
Cup-cake7 in reply toCup-cake7

'if'

SlowDragon profile image
SlowDragonAdministrator in reply toCup-cake7

I had no idea....but realised low vitamin levels suggested it was likely...more info on my profile

Cup-cake7 profile image
Cup-cake7 in reply toSlowDragon

Ok thanks

Any thoughts pls why I go so hot (like now ).

Not the usual hypo comment!?

Temp about 36.5 these days

Sorry to hog

So grateful as moving forwards at last it feels like

Cup-cake7 profile image
Cup-cake7 in reply toCup-cake7

BUT 37.3 at the moment!!!

Can it be as I took 100 levo

(I'm not with a bug pretty sure. Hope not to do with adrenal

Cup-cake7 profile image
Cup-cake7 in reply toSlowDragon

May I ask make of selenium with E

Like sound of it

SlowDragon profile image
SlowDragonAdministrator in reply toCup-cake7

This one

amazon.co.uk/gp/product/B00...

Cup-cake7 profile image
Cup-cake7

Yes. Well expect is also the case for most to be kind to the body

He thinks il be fine on 100 and said it would come under a two which is all he is looking to do

How can they vary so much!? He said 0.5 was too low

I really don't know,if I am hashi as he doesn't think so,

I need to explain my gut was not a problem to me as such but have felt better since gf (I used keniesiologist help at one point and he tested me for leaky gut which I've healed). But I'd imagine many older people have some leaky going on, But may be wrong

Cup-cake7 profile image
Cup-cake7

I have some villigi

Do you know if this is autoimmune?

Interestingly I have had dark rings under eyes for a lot of my life, since a child and read it's to do with adrenals

Also my face goes rounder it's obvious on photos and this too is to do with cortisol

My saliva bedtime one is over range and the report is to,see the doctor as may be cushings

However I was so stressed so il redo sometime

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