Recent results - dr refusing to increase levo

[MissSusan]

So these are my results for the last year, I went to the drs at the start of November complaining that my symptoms are coming back and I've requested an increased from 87.5 mcg to 100 mcg. I was told I'd have to have a blood test first. My results have come back and even though my T4 has dropped, I'm being refused an increase as my results are "normal" well I don't ruddy well feel normal! I feel better when my T4 is in the higher part of the range.

Serum free T4 level 16.8 pmol/L [11.0 – 23.0]06/11/18

Serum free T4 level 15.2 pmol/L [11.0 - 23.0]27/03/19 Serum free T4 level 20.1 pmol/L [11.0 - 23.0]11/06/19 Serum free T4 level 18.4 pmol/L [11.0 - 23.0]13/11/19

Serum TSH level 1.6 mU/L [0.27 - 4.5]06/11/18 Serum TSH level 1.0 mU/L [0.27 - 4.5]27/03/19 Serum TSH level 0.48 mU/L [0.27 - 4.5]11/06/19 Serum TSH level 0.28 mU/L [0.27 - 4.5]13/11/19

I've got another blood test on 12/12 for the following

Urea and electrolytes Full blood count Liver function tests HbA1c level (DCCT aligned) (XaERp)t Thyroid hormone tests NOS

I take 3000 IU of vitamin D, B12 complex, vitamin C and Ferrous Fumerate daily.

[SlowDragon Administrator]

As you have Hashimoto's conversion of FT4 to FT3 is frequently poor

Important to test FT3 and FT4 plus TSH

Also EXTREMELY important to retest vitamin D, folate, ferritin and B12 at least Annually

Ask GP to test vitamin levels

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Is this how you do your tests?

Are you on strictly gluten free diet?

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins

Cheapest option for just TSH, FT4 and FT3 £29 (via NHS private service )

monitormyhealth.org.uk/thyr...

thyroiduk.org.uk/tuk/testin...

For thyroid including antibodies and 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

[sy28 in reply to SlowDragon]

Dear SlowDragon I didn't realise there's a possible link between having Hashimoto's and poor conversion of FT4 to FT3, can you point me to the evidence, please - such evidence would help me. Best wishes.

[SlowDragon Administrator in reply to sy28]

Use this calculator to work out % through range of FT4 and FT3

chorobytarczycy.eu/kalkulator

They should be roughly similar.....at least around 60% when adequately treated

Great film explaining Hashimoto's

drbradshook.com/understandi...

Poor conversion links

naturalendocrinesolutions.c...

drknews.com/conversion-t4-t...

Both gluten intolerance and lactose intolerance are very common with Hashimoto's

These would indicate poor gut function

Improving low vitamin levels can help improve conversion

[sy28 in reply to SlowDragon]

Thanks SlowDragon, I am reading through the links now. Have been gluten free for some time and also avoiding lactose - why is lactose widely added to Levothyroxine, it is very frustrating. I seem to be experiencing the link between Hashimoto's and low stomach acid and now I see why Hashi's is implicated in poor conversion. This is a double whammy if there's also a genetic reason behind poor conversion, which applies to me. These links are really helpful, thank you.

[MissSusan in reply to SlowDragon]

That is exactly how I take my tests - I also stop taking my supplements a week before my blood draw. I've tried going gluten free and just couldn't manage it, only lasted 3 weeks and felt so miserable.

Will look at private FT3 testing as I wouldn't be able to do the DIY test.

[SlowDragon Administrator in reply to MissSusan]

Medichecks or Blue Horizon offer private blood draw

Medichecks is cheaper at moment I think at £25 extra

Important to retest vitamin levels annually too (if GP won't)