Don't worry about reducing your dose. As you are taking NDT your results cannot equate to the blood tests the NHS use as they are for levothyroxine alone - T4 only. With NDT you are taking T4, T3, T2, T1 and calcitonin. It is how 'we feel' when we take NDT that resolve or slowly resolves our clinical symptoms. That's the aim of replacing thyroid hormones, i.e. we feel well and symptom-free.
Do you get blood drawn at the very earliest, fasting (you can drink water) and allow a gap of 24 hours between last dose and test and take it afterwards. One of TUK's Advisers only took one blood test for the initial diagnosis and thereafter no more blood tests but all emphasis was on relieving clinical symptoms. I shall give you a link which one of his links that you might find helpful:-
I too am with Graves and had RAI in 2005, becoming very unwell some 6 years ago.
I am now self medicating with NDT and on 1 and a half grains daily.
My TSH is 0.01, and has been suck down there for many years, and isn't a reliable indicator of anything, especially if with Graves Disease.
I feel well on this relatively low dose and am much better than I was on monotherapy with Levothyroxine and listening to the dogma associated with a low, suppressed TSH.
How do you feel on this dose ? Your T3 seems a little low. Do you split your dose of NDT and how long did you leave between the dose and the blood draw ?
Good lord no! You're already under-medicated. Your FT3 is about to fall off the bottom of the range. And your FT4 is very low. You must feel terrible.
Did your endo tell you to reduce? If so, he's just looking at the TSH - did that ever go high after your sub-total thyroidectomy? It doesn't always, when you've had Graves.
How long a gap did you leave before your last dose of NDT and the blood draw?
Do you always take your NDT well away from food and other medication/supplements?
Thanks guys, am not at all sure what to do, not well TSH is always very low. Hair loss, sweating and muscle joint pains make me wonder if I should cut down the meds. I've given up on undo's as they don't have a clue.
How much is plenty of time, between meds and blood draw ?
Depending on the above, I think a dose increase might be more appropriate.
The symptoms you describe sound more like under medication than over.
The TSH is of no value and in itself without symptoms. but used as a marker to increase or decrease medication, but we have Graves antibodies in our blood distorting our TSH readings ;
I'm not too concerned about blood tests and ranges anymore, as I now self medicate.
I have no " hyper " symptoms and am still a work in progress, but much improved.
It's worth checking that your core strength, your ferritin, folate, B12 and vitamin D are all optimal to assist in your conversion of T4 into T3.
Left 24 hours between meds ad blood draw. Vits were checked by Midi-Check and were fine. I take a multi vet and a high dose vitamin D. It doesn't seem to make much difference what level of meds I take, the annoying symptoms remain, I've been up and down the spectrum with no real improvement.
I think a dose increase is certainly worth a trial considering you still have annoying symptoms. This might mean splitting the dose, depending on which NDT you are on.
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