Block and replace method and testing??

[Inafunk63]

Hi guys. Coming up to my 2 week test after starting the block and replace method. Currently at 50mg PTU(anti-thyroid medication) and 25mcg Levo. I wake at 5:30 to take the Levo with a little water and go back to bed until 6:30am. Eat breakfast around 7ish and then take PTU around 8:30ish. Not sure if to take both of my doses as normal on day of test. I’ll be there at 9am for blood drawing, which Is when they open.

I’m hoping bloods will show something up as to why I’m still having this awful off balance feeling...like I’m swaying or sinking...I’m not as fatigued as I was before starting Levo but, I still don’t feel right. I’m sure I am speaking for a lot of people when I say I just want to feel normal again...what ever normal is.

[Wwerty]

I had swaying feeling when I first got diagnosed with hypo, I read somewhere that it’s sometimes a symptom of having antibodies, it went away after about 6 weeks on levo

[greygoose in reply to Wwerty]

More likely to be a low thyroid hormone symptom. The thyroid is one of the organs responsible for balance.

[Inafunk63 in reply to greygoose]

Can you offer any advice on the blood drawing? I’ve seen where when on just Levo it’s recommended on here to take blood at least 24 hours after last dose. Would that apply to block and replace method and should I wait 24 hours after taking both ATM and Levo? Or should I take both doses as normal before blood drawing?

[greygoose in reply to Inafunk63]

If you take your levo before the blood draw - whether on block and replace or T4 monotherapy - you will get a false high because you will be testing the dose you just took. If you want to know the level of normal circulating T4, you need to leave a gap of 24 hours between your last dose and the blood draw. I have no idea how ATM affects the results, though, I'm afraid.

[Inafunk63 in reply to greygoose]

Thank you!

[greygoose in reply to Inafunk63]

You're welcome.

[Inafunk63 in reply to greygoose]

Had my blood results back today. The swaying is still ongoing and I’m flying in two days. This is actually a nightmare. I’m already a terrified flyer and I’m worried the dizziness is going to become unbearable while flying. Still on PTU 50mg per day (I split it into one half and two quarters so 1/4 in the morning, 1/4 in the afternoon, 1/2 at night) and Levo 25mcg. 24hours after last Levo dose my t4 is 16.8 (12-22) tsh 2.84 (0.27-4.2) gp says no dose change 😩 I feel so rubbish.

[greygoose in reply to Inafunk63]

I'm afraid I really can't help you with PTU because I've never had Grave's. But, your FT4 is now below mid-range, and that is too low. And that probably means that your FT3, the active hormone, is also too low. I don't think your doctor knows what he's doing. He's made you hypo and he's leaving you there.

But, have you had your B12 tested?

[Inafunk63 in reply to greygoose]

I have. I don’t have the numbers on hand but I got a print out of the results and it was just borderline high b12. I do take a b complex and didn’t realise they were testing b12 at the time. I’m on such a low dose of PTU (from my understanding maintenance is usually around 100-150mg ptu) which makes it so frustrating because I feel like how has such a low dose made me so hypo. They’ve refused to retest antibodies due to my initial slightly elevated t4 and suppressed tsh. I felt so much better before starting back on ptu

[greygoose in reply to Inafunk63]

You say in your profile that you've never actually seen a result for antibodies. So, that begs the question: which antibodies did they test? Which begs the question: do you actually have Grave's at all?

They’ve refused to retest antibodies due to my initial slightly elevated t4 and suppressed tsh.

Do you mean your FT4 was 'slightly' elevated when you were first diagnosed? Have you ever had your FT3 tested? The odds are you don't have Grave's at all, you have Hashi's, and that's why such a small dose of PTU has made you so hypo. Sorry if you've explained all this before, but I don't have time to read through all your posts, and it's a mistake that doctors often make because they don't do the right tests, and just go by the TSH.