Thyroid Monitoring Results

[hippowarrior]

Hi guys

Any thoughts on these recent "In range" results? I don't feel any better.

Was on 175mcg T4, now on 150mcg T4 and 5mcg T3

TSH - 0.28. mIU/L 0.27 - 4.2

Free T3 - 3.55. pmoI/L 3.1 - 6.8

Free Thyroxine - 15.8. pmol/L 12-22

Thank you

[SeasideSusie Remembering]

hippowarrior

What was your FT4 on 175mcg only?

How long since you have been taking 5mcg T3? It's very obvious that your T3 dose needs increasing.

What are your endo's plans for increasing T3? When are you seeing him again?

[hippowarrior in reply to SeasideSusie]

Hi SeasideSusie

I haven’t got my last blood test results. It was a real fiasco to be honest and I was just happy to get the T3 prescription.

I’ve been on the T3 since the end of May and there are no plans for a review hence getting my own test done via medichecks so that I can make a GP appt to ask what they’re going to do to follow up.

They haven’t even added the T3 to my repeat prescription. They gave me 20mcg tablets and left me to deal with quartering them myself so I bought a pill cutter, I lose approx 1/4 of a pill every time I cut them. Fortunately I bought a pack of 25mcg last time I was in Greece but didn’t have the guts to start self medicating, so I’ve been quartering those, still lose a lot of each pill! So although strictly speaking, having been using the 25’s I’m taking up to 7.5mcg a day I think with the amount of wastage I’m probably still “evening out” to about 5mcg

Thank you for taking time to reply

[SeasideSusie Remembering in reply to hippowarrior]

I successfully cut the Greek T3 into quarters and don't lose any. I use a pill cutter and find they cut easily, any powder I knock out of the pill cutter into the little jar I keep the cut piece in and use that also.

You definitely need an increase in T3, your FT3 should be aiming for the upper part of the range when on combination Levo and T3. Your FT4 - well that's very individual. Some people do fine with it at the level yours is, I find I need both FT3 and FT4 at around 75% through range.

I wouldn't have thought your T3 would be added to your GP prescription yet, I would have thought your endo would do a follow up appointment no later than 3 months, then if satisfied you need the T3 then pass the cost of prescribing onto your GP. Can you ring the endo's secretary and ask what the plan is.

[hippowarrior in reply to SeasideSusie]

Thank you again

I find that I can halve them in the cutter but not quarter them, they just don’t sit straight so I do it by hand, sometimes it’s near perfect sometimes not.

I do have the endo’s Secretary’s contact but it’s up to 6 months wait for an appt.

The endo told me that he was going to tell my GP to prescribe it.

I’ll try the endo secretary tomorrow

[SeasideSusie Remembering in reply to hippowarrior]

The endo told me that he was going to tell my GP to prescribe it.

OK, so ask the secretary if the endo has contacted your GP about prescribing the T3 because it appears that it's not on your repeat prescription. Also ask if the endo will sanction an increase due to your extremely low in range FT3 and the fact that you feel you're not yet on a big enough dose to feel enough improvement. Be careful how you word that, it's possible that the endo may say that if you don't feel any better then your "trial" has failed as it hasn't done you any good. The only problem you have is that you haven't had an increase to a reasonable dose yet and that you have no follow up. I think it's quite negligent that all this hasn't been put into place, there doesn't seem to be any kind of plan to monitor you.

[hippowarrior in reply to SeasideSusie]

SeasideSusie

Thanks, I’m planning on telling the truth, that a couple of hours after taking T3 I do feel a bit perkier but it wears off by afternoon and in general the fatigue, weight problems and all the other “good stuff” haven’t changed at all

[SlowDragon Administrator in reply to hippowarrior]

First I find cutting into 1/4's is easy using a sharp craft scalpel

Something like this

scalemodelshop.co.uk/produc...

Second

NHS guidelines say Endocrinologist should prescribe T3 for first 3-6 months trial. Then assuming all going well, endo should write to GP to continue prescribing. With annual review back with endocrinologist

sps.nhs.uk/wp-content/uploa...

Note that it says test should be in morning BEFORE taking Levo thyroxine

Also to test vitamin D, folate, B12 and ferritin

[greygoose in reply to hippowarrior]

Don't waste the crumbs, tip them into your mouth and swallow them with your 1/4 tablet - lick them up, if necessary.

[Hidden in reply to greygoose]

I second this! These crumbs are gold!

[SlowDragon Administrator]

Most patients on T3 need 2 or 3 small split doses per day

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)

Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).

If/when also on T3, 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

Is this how you do your tests?

If not done this way you may need to consider retest. Testing vitamin levels at same time if not been done

If test was done with correct timing gap

Suggest you consider adding a second 5mcg dose of T3 8-12 hours after first dose

Retesting bloods 6-8 weeks later

[hippowarrior in reply to SlowDragon]

Hi SlowDragon

Yes did all that re blood test except the time I’d taken my T3 which was also 24 hours before.

No way on this earth could I split the tablets into 1/8 in order to split the dose, splitting it had been my plan until I got these pills and my prescribed dose.

Have done but levels previously but think I’ll do them again next time

[SlowDragon Administrator in reply to hippowarrior]

I didn't mean split into 1/8ths ......but to consider adding a second 5mcg dose in the afternoon

However as you left 24 hours, not 8-12 hours between last dose of T3 and blood test....your result will show false low FT3

FT3 doesn't last long in blood

So you may not need an increase.....ideally you would retest at correct 8-12 hour gap before blood test

With sharp scalpel it is actually possible to cut into 1/8th - When I originally started T3 I took on 2 x 1/8th tablet....though that was Uni Pharma brand from Greece and slightly easier to cut than UK brands.

I now take 20mcg daily- 10mcg at 7am, and 5mcg at 3pm and 5mcg at 11pm

Can you add your latest vitamin test results and ranges