Latest Blood Test High rT3 with T4 and T3 OK?

[GardenerSue]

Following earlier posts I have just received the results of my latest private blood tests. I have annotated these with my meds taken at the time etc. My vitaminD is now raised , or was when these were taken on completion of a loading dose of vitaminD. However I am feeling decidedly ‘hypo’ which makes me wonder if the vitamin D level has now dropped. With the raised rT3 I am thinking that I possibly need to reduce my Levothyroxine again. Attached photo of both sets of blood test results for comparison.

[greygoose]

Your high rT3 is more than likely due to your high FT4, yes. But, if you drop your levo, your FT3 will also drop. You are a very poor converter. And, with your FT3 only just over mid-range, you don't really want it any lower - especially not if you already have hypo symptoms. So, unless you are able to add some T3 to a reduced dose of levo, then you're better off leaving the levo dose where it is.

Don't worry about the high rT3, it's not doing you any harm.

[GardenerSue in reply to greygoose]

I’ve not yet approached anyone with a regard to taking T3. Next task is to find someone that will prescribe it, that ought to be easy!!!! Or try NDT?

[greygoose in reply to GardenerSue]

You could try NDT, yes. But, as you are such a poor converter, there might not be enough T3 in NDT.

[GardenerSue in reply to greygoose]

Oh whoopie! I shall look at the list of private dr’s that will or have prescribed both T3 and NDT.

[SeasideSusie Remembering]

GardenerSue

My vitaminD is now raised , or was when these were taken on completion of a loading dose of vitaminD. However I am feeling decidedly ‘hypo’ which makes me wonder if the vitamin D level has now dropped.

According to your previous post you didn't have Vit D deficiency, your lelvel was 56.5nmol/L so you wouldn't have had loading doses, it was suggested that you follow the Vit D Council's advice to take 3,700iu D3 daily (4,000iu would have been the nearest) to aim for their recommended level of 125nmol/L.

healthunlocked.com/thyroidu...

How much D3 have you been taking?

Have you stopped taking it?

Have you been taking D3's important cofactors as mentioned in reply to your previous post?

What is your current Vit D result - I can't read any of your results, they're too feint and blurry.

[GardenerSue in reply to SeasideSusie]

My original vitamin D levels in June were at the bottom of the range verging on being deficient. This was highlighted by the lab Dr’s comments . The advice I took was either from someone on this site or TPAUK based on the NHS guidelines for taking a loading dose of Vitamin D . I started taking a maintenance dose at the same time the second lot of bloods were take.

[SeasideSusie Remembering in reply to GardenerSue]

It looks like Medicheck's range says 50-175 nmol/L.

Deficiency is <25

Insufficieny is between 25 and 50

Sufficient is above 50 (but that's debatable when you look at the Vit D Council/Vit D Society's recommendation).

You said in the previous post that I linked to where your Vit D level was 56.5nmol/L "The results for vitamins showed my Vitamin D level to be low, verging on insufficient" so nowhere has anyone mentioned that you were verging on deficient.

No-one on TPA quoted NICE guidelines in response to your posts there, nor here, so I expect you've seen the NICE Clinical Knowledge Summary quoted in reply to another member's post which says:

NICE treatment summary for Vit D deficiency: cks.nice.org.uk/vitamin-d-d...

(click on Management > Scenario:Management)

"Treat for vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 25 nmol/L

For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU]) given either as weekly or daily split doses, followed by lifelong maintenance treatment of about 800 IU a day. Higher doses of up to 2000 IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders.

Several treatment regimens are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."

Your current Vit D level of 114nmol/L is much improved but you may wish to raise it to the upper part of the Vit D Council/Vit D Society range of 100-150nmol/L.

[GardenerSue in reply to SeasideSusie]

The link to NHS Specialist Pharmacy Service was sent to me by TPA, I have a copy in my hand. According to this <30 is deficient 30-50 inadequate in some people and >50 sufficient for almost the whole population. In June my Vitamin D level came back as 56.5 nmol/L (Range : 50-175) The latest test shows the result as 114 nmol/L ( Range 50-175) . The advice from the Dr at Medichecks after the initial test was to increase my vitamin D level. I appear to have done this and there appears to be no further concern. While taking the loading dose my aches and pains etc subsided as did my ‘fog’. I think it is easy to attribute these symptoms to the thyroid also which is what I think dr’s have been doing in my case. Lots of messing around with doses of Levothyroxine when my vitamin D level was never tested. As these symptoms have returned now on a maintenance dose of vitamin D I wonder if my level has dropped too low? My T4 is still pretty high but I’m not yet bouncing off the walls again.

[SeasideSusie Remembering in reply to GardenerSue]

NICE Clinical Knowledge Summary used to have a level of <30 for deficiency, this was revised last year to <25 as can be seen from the date in my link:

"Last revised in September 2018. Next planned review by December 2021"

The SPS is either behind the times (their article was updated March 2018) or doesn't liase with NICE. But with neither of them did you come into the deficiency category, you came into the sufficient category with both however inadequate that may be.

800iu isn't a universal maintenance dose. As suggested in my original reply about supplementing to raise your Vit D level, once you'd reached the recommended level of 100-150nmol then you need to find your maintenance dose by trial and error and that could be 1000iu, 2000iu or more or less and you need to test twice a year to check to ensure that you maintain the recommended level. I need 5000iu daily even in summer, it a very individual thing.

[GardenerSue in reply to SeasideSusie]

I’m trying 1200iu daily currently and will test again in a couple of months to see how my level is.