For full Thyroid evaluation you need TSH, FT4 and FT3 tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
Have you had vitamin levels tested?
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).
Is this how you do your tests?
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins
Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random
Your FT3 is nowhere near top of range
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
Professor Toft recent article saying, T3 may be necessary for many. Note especially his comments on current inadequate treatment following thyroidectomy or RAI
In summary, patients on long-term T4 with either an increased serum TSH (>4 mU/liter) or a suppressed TSH (<0.03 mU/liter) have an increased risk of cardiovascular disease, dysrhythmias, and fractures when compared with patients with a TSH within the laboratory reference range. Patients with a low, but not suppressed, TSH (0.04–0.4 mU/liter) had no increased risk of these outcomes in this study.
What was the dose of levo you call 'high'? 125 mcg levo? And, are those results on 125 mcg levo? Sorry, for the questions, but it's not clear in your post.
So, assuming those results were on 125 mcg levo, your FT4 is high over-range, but as you are a poor converter, your FT3 is only about mid-range.
T3 is the active hormone, not T4 (levo), so that is the one that would 'hurt' your heart if it were over-range. It isn't. High T4 will not have any effect on your heart. So, it is not the 'high' dose of levo that has caused your heart pain either directly or indirectly.
Therefore, if you have a problem with your heart, it is due to something else other than the levo. (What is THC?) So, it is doubtful that reducing your levo will stop your heart hurting.
On the other hand, reducing your levo to such an extent will probably make you ill in other ways, because your FT3 will also reduce. So, it's probably not a good idea.
How do you know your ecg is abnormal? It's extremely difficult to read ecg's properly and those done on a watch are known to be inaccurate due to interference.
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