I’d appreciate some help with my latest blood results – I normally take 20 mcg of lio and 50 mcg of levo. This was a 7.30am blood draw, with 24 hours from the previous levo tablet and 12 hours from half a lio tablet [a whole tablet having been taken 24 hours before the test]. I hope that’s right! I take no supplements at all and feel well.
TSH <0.03 [0.35 – 4.94] below range
T4 9.4 [9.0 – 19.0] low in range
T3 6.2 [2.6 – 5.7] above range
Vit D 71.4 [41.0 – 200] so low, but it’s winter
Serum B12 469 [180 – 640]
Serum folate 6.1 [3.0 – 20.0]
Ferritin 85 [15 – 200]
I asked for antibodies to be tested, but this hasn’t happened. Full blood count instead – don’t know if that is relevant, but everything is in range or just a whisker outside.
I think this means I’m taking too much T3 and should probably take a bit more T4. The doctor has suggested re-tested in 2 months, so I’m considering EITHER going back to 125 mcg of levo x 5 days and 150 mcg x 2 days - which is what I was on before I started taking lio 3 years ago, on which I also felt well, and which a private endo I saw back in November suggested I try out, despite this showing I was slightly over-medicated [I don’t have those results] OR reducing lio to 10mcg and increasing levo by say 50 mcg and seeing what that does.
Many thanks
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I normally take 20 mcg of lio and 50 mcg of levo. This was a 7.30am blood draw, with 24 hours from the previous levo tablet and 12 hours from half a lio tablet [a whole tablet having been taken 24 hours before the test].
When having thyroid blood tests it's correct to take last dose of Levo 24 hours before the test. Last dose of T3 should be 8-12 hours before the test, even if this means splitting your dose if you normally take it in one daily dose.
You should have split your T3 tablet the day before the test, 10mcg 24 hours before and 10mcg 8-12 hours before the blood draw. From what you say it seems that you have actually taken an extra 10mcg during the 24 hours before the blood draw by taking 20mcg 24 hours before and 10mcg 12 hours before, so 30mcg instead of 20mcg in the 24 hours before the test. This may have had the effect of giving a false high FT3 result.
I think this means I’m taking too much T3 and should probably take a bit more T4.
I think it's the extra T3 you took within the previous 24 hours that has given that high FT3 so you may not need to reduce your T3 dose. But if you were well on just Levothyroxine it begs the question why was T3 added.
My suggestion would be to obtain previous test results, with ranges, and see what you were taking at each test and how you felt at that time. In the UK we are legally entitled to our results so you should have no problem getting them if you ask the receptionist at your surgery.
It also might be a good idea to do another test now (taking your normal dose and making sure the timing of both Levo and T3 doses before the test are correct) to get accurate results, then make a decision. If you want to include antibodies then you could do Medichecks Thyroid Check Plus or Blue Horizon Thyroid Plus Six.
Vit D 71.4 [41.0 – 200] so low, but it’s winter
Well, that's not a reason to not aim for the recommended level. In the winter it's usual to increase our dose to maintain the recommended level, and the NHS even advises everyone to take some Vit D during the winter months as we can't make it naturally when there's no summer sun.
Do you normally supplement? If so what dose of D3? The Vit D Council/Vit D Society recommend a level between 100-150nmol/L so with your current level the recommendation would be to supplement at around 2,500-3000iu D3 daily during the winter months, along with D3's important cofactors - magnesium and Vit K2-MK7.
Serum B12 469 [180 – 640]
What's the unit of measurement for B12 - pmol/L or ng/L or pg/ml (the latter two are the same).
If it's ng/L or pg/ml then according to an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
Serum folate 6.1 [3.0 – 20.0]
This is very low in range. Folate is recommended to be at least half way through it's range. You might want to consider taking a good bioavailable B Complex such as Thorne Basic B or Igennus Super B. This will help raise your folate level and also help improve your B12 level. Also, look up folate rich foods and eat plenty of those.
Ferritin 85 [15 – 200]
Ferritin is recommended to be half way through range, yours isn't too bad but could be a bit better, eating liver, liver pate, black pudding and other iron rich foods regularly will help.
Full blood count instead – don’t know if that is relevant, but everything is in range or just a whisker outside.
As always, it's where in range a result lies that is important. What is outside of range?
Many thanks, Susie. I feel very foolish re T3 dose - I thought I was doing it properly [but now know better for the future!}
I will try and get the full results, with ranges, from three and four years ago. These were done at the surgery so I should be lucky. I struggle to get anything from the NHS endo - the only route is to ask the GP surgery to get them and they then pass them on ...
I was put on T3 because the final months of levo-only showed I was over-medicated on 150 x 4 days / 125 x 3 days, and when I reduced to 150 x 2 days / 125 x 5 days, and I felt unwell on 125 mcg every day. I'd moved house and GP, and the young new GP is very nervous/ cautious. My experience with the NHS endo has not been great (although he prescribes T3). An initial appointment with a locum was followed up almost a YEAR later, when the consultant put me on a "starting" dose of 40 mcg of lio {2 tablets] at the end of 2017 and reduced the levo slightly. Six weeks later, the appointment lasted 30 seconds, when he realised I was on 2 tablets, and he halved things to 20 mcg of lio and 50 mcg of levo. I suffered initially on cutting down, but have felt fine since around April 2018 and kept on the same dose.
I have never taken any supplements, but eat a healthy fresh-cooked diet and get outside as much as I can and don't have any symptoms of deficiency for vitamin D or B12, I will try and eat more iron-rich food and get some vitamin D supplements. The B12 was measured in ug/L
On the full blood count, red cell distribution width was 11.5 [11.6-14.0]; lymphocyte count was 3.1 10*9/L [1.0 - 3.0]. Things that were close to the edge of the range were haematocrit 0.38 L/L [0.36 - 0.46] basophil count 0.1 10*9/L [0.0 - 0.1] and nucleated red blood cell count 0.0 10*9/L [0.0 - 0.09]. I don't know what any of these mean! Generally though, I'm very fit and healthy. No problems sleeping or with energy levels.
Looking through previous posts couldn't see the if you ever had thyroid antibodies tested
If not....get both TPO and TG thyroid antibodies tested privately via Medichecks including vitamins in 2 months time after 25mcg increase in Levothyroxine
Endocrinologist frequently reduce Levothyroxine far too much when T3 is added
I was on 125mcg Levothyroxine....completely physically immobile. 20mcg T3 added and Levothyroxine dropped to 100mcg ....almost instant transformation ......able to walk miles. After 4 months ...FT4 rock bottom and increase in symptoms ...despite good FT3. (Like your current results) so I Increased Levothyroxine back to 125mcg. Significant improvements. More on my profile.
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