No noticeable improvement

[QandA]

Not feeling any improvement and weight has gone up since taking levothyroxine which is so frustrating. At my last (second) endo appointment he said my bloods were exactly where they should be so would keep me on 50mg. Do I go back and beg for an increase or try and source T3 myself, and if so, how do I get recommendations of a reliable and reasonably priced place to get it?

[bantam12]

50mcg is a starter dose so you no doubt need an increase but you need a copy of your results to see what your levels are.

[QandA in reply to bantam12]

Thanks Bantam12, these were my last results taken in March.

TSH: 1.28 (0.27-4.2)

Free thyroxine: 17,4 (12-22)

free T3: 5.29 (3.1-6.8)

[SeasideSusie Remembering]

QandA

What are your current test results?

In March they were

TSH: 1.28 (0.27-4.2)

FT4: 17.4 (12-22) = 54% through range

FT3: 5.29 (3.1-6.8) = 60% through range

Those don't show the need for T3, your T4 to T3 conversion is excellent.

There is room for an increase in Levo. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their reference ranges, if that is where you feel well.

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.

If you would like a copy of the article, email Dionne at ThyroidUK

[e-mail]

Are your nutrient levels optimal?

Vit D - 100-150nmol/L

B12 - minimum 550 for serum B12, for Active B12 minimum 70

Folate - at least half way through range

Ferritin - half way through range although I've seen it said that 100-130 is good for females and 150 is good for males.

[QandA in reply to SeasideSusie]

Thanks Susie, those were my last results. I will get a copy of that article and go back to the endo as a first course of action. I don't know what my vit levels are at the moment, I have been supplementing D3 with K2 and magnesium for a few months now as well as having black pudding every week. It's all so expensive to have to do these blood tests and see someone privately. B12 was over range in March, so I have not been supplementing.