Endo appointment next week

[Craigd101]

Hi everyone,

I posted back in July to ask for advice on my blood test results. I've since been seeing a private endo, and have more blood test results. I'm seeing him again next Wednesday and want to get some advice on what to push for when I see him. A bit of background, I had RAI in September 2018, and commenced levothyroxine in January 2019.

Results from 3/7/19 (on 125mcg LT).

TSH 17.8 (0.3-4.2)

FT4 23.4 (12-22)

FT3 not tested

Was advised to change dosage to 100/125mcg on alternative days due to high FT4.

Results from 6/8/19 (on 100/125 mcg LT)

TSH 13.1 (0.3 - 4.2)

FT4 22 (12-22)

FT3 4.8 (4-6.8)

Advised to continue on 100/125mcg on the basis that TSH was coming down, and to be honest I had started to feel a little better, so didn't protest too much.

Results from 24/9/19 (on 100/125mcg)

TSH 16.9 (0.3-4.2)

FT4 22.4 (12-22)

FT3 4.6 (4-6.8)

I've been feeling worse recently and need to discuss this and my latest results next week. My TSH doesn't seem to want to come down to an acceptable level even though my FT4 is top end. My FT3 is low down in the range, could this explain my high TSH?

At my last appointment I tried to discuss the possibility of a T3 prescription, but he made it clear he wouldn't prescribe it. Do you think I should ask for more levothyroxine to boost up my FT3 and bring down my TSH? I'm conscious that my FT4 is already top end, does it matter if it goes over range in order to get my FT3 up the range?

Any help would be appreciated.

Thanks

Craig

[greygoose]

It might matter and it might not - could cause symptoms in some people. But, you're going to need an awful lot more levo to get your FT3 to a reasonable level. You're a poor converter, and having such a high FT4 is making conversion worse. These endos are such jackasses, they can't see that. Have you considered buying your own T3 and self-treating? This endo is never going to make you well, and will probably make you worse. I'd tell him to take a hike, if he were mine.

[SlowDragon Administrator]

Absolutely essential to test Vitamin D, folate, ferritin and B12

Has this been done?

Add results and ranges if you have them

Getting vitamins tested by GP or endocrinologist or privately

What vitamin supplements do you currently take?

Getting vitamins optimal is essential and can help improve conversion of FT4 to FT3

But your results seem to suggest you are going to need the addition of T3

[Craigd101 in reply to SlowDragon]

Thanks for the advice. I had other blood tests done in July, and was told all was 'ok' at the time. I went and picked up a copy of the results last week after reading on here about the importance of optimal levels. I can't see that vitamin D was tested, but here are the other results:

Ferritin: 243 ug/l (30-400)

B12: 591 ng/l (197-771)

Serum folate: 6.9 ug/l (3.89-26.8)

As of last Friday, I have started taking 400ug daily folic acid in light of the low folate. I don't take any other supplements. I take a maintenance dosage of mesalazine to control ulcerative colitis which I was diagnosed with about 5 years ago. It hasn't given me any trouble for a few years now though.

I wanted to exhaust the possibility of getting well on LT before going down the T3 route. Reading on here, the supply of T3 seems to be so hit and miss for some people.

[SlowDragon Administrator in reply to Craigd101]

You can test vitamin D here via NHS postal kit £29

vitamindtest.org.uk

GP's often reluctant to test as it's relatively expensive