Blood test results please advise 2.7: Total... - Thyroid UK

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Blood test results please advise 2.7

cbraffe profile image
29 Replies

Total thyrodecotomy in july 2019

Symptoms: shortness of breath, chest and joint pain especially lower back pain, my blood pressure has been high too for the past month so have been put on medication . Referred to cardiologist.

I am taking 125 Teva thyroxine

Blood test results:

Serum folate level: 10.0ug/L(2.7)

Serum vit B12 :692ng/L(160.0-800.0)

Serum free triodothyronine 3.7(2.5-5.7)

Serum TSH level:0.75mU/L(0.3-4.2)

Serum free T4 14.0pmol/L(9.0-23,0)

Can anyone please advise on if I am under medicated or what could be the cause of my symptoms. Thank you

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cbraffe
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29 Replies
SlowDragon profile image
SlowDragonAdministrator

Yes. After thyroidectomy you need full replacement dose

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 in top third of range and FT3 at least half way in range

Your results show both FT4 and FT3 are only 35% through range

chorobytarczycy.eu/kalkulator

So you are good converter of FT4 to FT3 as they are similar %

But you need dose increase in Levothyroxine

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

Teva brand upsets many, many people.

Have you always been on Teva?

Or recently changed brand?

You need iron and ferritin tested - low iron can cause breathlessness

Plus vitamin D test too

See GP for testing and increase in Levothyroxine

cbraffe profile image
cbraffe in reply toSlowDragon

Thank you so much. I am on vit D and ferritin supplements as I am low. I posted those in an earlier post. I will contact the GP tomorrow. What upsets me the most is, the doctors do not seem to look at the low levels as the cause of other symptoms. For instance rushing to put me on blood pressure meds before doing a full thyroid check and then referral to a cardiologist. I believe everything is connected to the low levels and they took the time to listen then one will not end up with a multitude of conditions

cbraffe profile image
cbraffe in reply toSlowDragon

I am on Teva thyroxine as I am lactose intolerant. I had a severe allergic reaction while on levothyroxine

cbraffe profile image
cbraffe in reply toSlowDragon

I am so grateful to this site . I been so worried. I am considering seeing a private endocrinologist as I am not happy the way things are

SlowDragon profile image
SlowDragonAdministrator in reply tocbraffe

Email Dionne at Thyroid Uk for list of recommended thyroid specialist endocrinologists

Roughly where in the UK are you?

thyroiduk.org.uk/tuk/About_...

Your dose is too low. With lactose intolerance it's common to need higher dose Levothyroxine than might be expected

read.qxmd.com/read/24796930...

These findings show that lactose intolerance significantly increased the need for oral T4 in hypothyroid patients.

Presumably you are on a lactose free diet too?

As you have lactose intolerance you may eventually need addition of small split doses of T3

But first step us to get Levothyroxine dose increased until FT4 is in top third of range

After thyroidectomy about 20% of patients need addition of T3

There's over 102,000 members on here......precisely because current treatment guidelines are so poor

Literally thousands of patients left on wholly inadequate dose of Levothyroxine or have genetic or gastric reasons for needing addition of small dose of T3

cbraffe profile image
cbraffe in reply toSlowDragon

Thank you. Can I have Dione's email address please

SlowDragon profile image
SlowDragonAdministrator in reply tocbraffe

It's in that first link

thyroiduk.org.uk/tuk/About_...

cbraffe profile image
cbraffe in reply toSlowDragon

Thank you. I live in west London . Ealing

SlowDragon profile image
SlowDragonAdministrator in reply tocbraffe

Will send you private message

cbraffe profile image
cbraffe in reply toSlowDragon

Thank you.

Nanaedake profile image
Nanaedake

Perhaps some of your symptoms are side effects of the meds for blood pressure? I realise you are lactose intolerant but TEVA levothyroxine gave me joint and muscle pain and beta blockers gave me lower back pain. Bisphosphonates gave me hip leg and foot pain and muscular pain so medication can come with side effects.

cbraffe profile image
cbraffe in reply toNanaedake

I have only taken the BP meds for 2 weeks and had these symptoms before .

Nanaedake profile image
Nanaedake in reply tocbraffe

It could be the TEVA. But if you haven't had vit D, ferritin and calcium levels tested then worth doing those to rule out alternative cause.

cbraffe profile image
cbraffe in reply toNanaedake

I have and I am low on them apart from calcium

Nanaedake profile image
Nanaedake in reply tocbraffe

That could be it then.

Nanaedake profile image
Nanaedake in reply tocbraffe

Personally, I don't think you need a levothyroxine dose increase. If your vitamin levels improve your thyroid hormone will function more effectively. I don't think your symptoms are caused by your dose. You are well within range and any symptoms would be very minor. My non medical opinion is that symptoms are coming from elsewhere. I would stick to your currant dose and work on vit levels. If possible avoid TEVA.

Ensure a calcium rich diet and add in magnesium and K2-MK7 if taking vit D3 supplements.

cbraffe profile image
cbraffe in reply toNanaedake

Thank you. As I lactose intolerant what else can I take. I can not take Levothyroxine

Nanaedake profile image
Nanaedake in reply tocbraffe

Is there a society or charity for lactose intolerance? They must have experience of this.

cbraffe profile image
cbraffe in reply toNanaedake

Thank you. I will check

SlowDragon profile image
SlowDragonAdministrator in reply tocbraffe

You can be prescribed lactose free, liquid Levothyroxine

But it's expensive, so they rarely offer if

See list here

thyroiduk.org.uk/tuk/treatm...

cbraffe profile image
cbraffe in reply toSlowDragon

Thank you. The way I am feeling I do not mind paying

SlowDragon profile image
SlowDragonAdministrator in reply tocbraffe

Did you get dose increased to 100mcg?

Are you now on liquid levothyroxine?

All four vitamins need to be optimal

Vitamin D at least over 80nmol and around 100nmol maybe better

Folate at least over ten

B12 at least over 500

Ferritin at least half way through range

cbraffe profile image
cbraffe in reply toSlowDragon

I did not. The doctor suggested a dose reduction. My throat feels as if I am chocking and most days I can not get out of bed. I am at a point where I wish I had remained hyper. I am on 2 grains of NDT. I have palpitations, loose stools, chest pain, joint pain , dry throat and cough . Fatigue . I am fed up . I am on vit D and was on Iron but the doctor suggested I stop taking it as my b12 was getting too high

SlowDragon profile image
SlowDragonAdministrator in reply tocbraffe

Iron is not related to B12

irondisorders.org/Websites/...

Your GP seems clueless

Recommend getting thyroid and vitamin testing privately and come back with new post

cbraffe profile image
cbraffe in reply toSlowDragon

I will. Thank you

pennyannie profile image
pennyannie

Hey there again,

Just to say glad we've now have some blood test results.

It's good in that your T3 and T4 are balanced at roughly 35% through the range, and that you are converting the T4 well.

As detailed by SlowDragon you need to increase your T4 slowly in 25 mcg increments until your T4 is up in the upper quadrant of its range at around 20.

This will also have the effect of increasing your T3 which is the active hormone your body runs on.

Once with an increase you'll need to wait 6 weeks for it have taken effect and then repeat the blood tests and see where you then, and maybe repeat the whole exercise once again, during which time I'm sure you will start to experience some relief of symptoms.

Yes, I was very breathless, and my ferritin came in at 22 - the bottom of the range was 15, but with a top of the range at 250 - not acceptable for a patient with a thyroid condition, as I read that ferritin has to be at least at 70 for thyroid hormone replacement to work.

So far so good, let's hope your doctor covers the ferritin, iron, vitamin D blood tests, and the increase in Levothyroxine.

cbraffe profile image
cbraffe in reply topennyannie

I have posted my ferritin results in an earlier test. How about my B12 do I need to take supplements for it too.

pennyannie profile image
pennyannie

I can't see a ferritin result only that you were prescribed 2x 210 ferrous fumarate -

Vitamin D needs to at around 100 - I think -

B12 - don't know my results are " active B12 " and the numbers look very different to this :

The thing is we need someone who knows, rather than me guessing - could you start a new post asking for vitamin and mineral help and there are people on here, who know, the answers, but they probably won't find our little conversation down here.

The Admins come in and initially answer, as best they can, what they can.

If you have the results of ferritin, folate, b12 and Vitamin D pop them in again as a separate question. You now have the answer for the Levothyroxine to be increased and just need confirmation of the vitamins and minerals. If you want, reply to SlowDragon and you'll get the answers you are looking for, if you have the results that she has asked for.

cbraffe profile image
cbraffe in reply topennyannie

Thank you. I will post them

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