I am posting on behalf of my Mum, who like me has an under active thyroid. She has been on levothyroxine for 20 years + and is now 84 years of age. For several months she had been feeling unwell and I thought it might be because of a change in blood pressure med and/or being under dosed for her thyroid. She visited her GP, who changed her blood pressure meds and several weeks later she is now feeling a lot better but still has some symptoms. She says she is still experiencing problems with her balance, she is always cold (hands in particular) and she was suffering from fatigue, although I don't think the fatigue is now as bad as it was. I suggested that she asked GP for a T3 test. Her GP requested but the lab declined to test as I thought they would so I ordered a medicheck test for her.
I don't have any of her previous results or reference ranges in front of me but I do know that in October 2019 her TSH was 2.2 and her T4 was at the upper end of the range and in December 2019 her TSH was 2 and again her T4 was at the top of the reference range (I took her to the hospital for the December test and made sure it was as early as possible, that she didn't take her levo before the appointment and that she hadn't eaten).
Her medichecks from her test on Tuesday are (again early morning and before taking levo or eating):
TSH 1.65 mIU/L (Range: 0.27 - 4.2)
Free T3 3.68 pmol/L (Range: 3.1 - 6.8)
Free Thyroxine X 22.300 pmol/L (Range: 12 - 22)
So her T4 was slightly over range but her T3 is quite low which makes me wonder if she is not converting T4 to T3 very well?
She is also on quite a low prescription. She takes 75 of levo Monday-Friday and 50 of levo Saturday-Sunday.
Any comments on the above results would be appreciated.
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Lje05
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Sometimes poor conversion can be due to LOW B12 - Folate - Ferritin - VitD - as well as other causes. Has Mum been tested for these recently ? Often low when Hypo ...
Over a year ago I suggested that she get them tested. Her GP did test them and told her they were fine! Unfortunately I don't know what her numbers were because she always accepts the GP's word and never asks for a print out of her results. I only know what her last two thyroid test results done through the GP were because I persuaded her to ask for them. Several months ago I bought her a good B complex, Vit -K2 spray plus magnesium spray which she wouldn't take because she said they could interfere with her meds. I did tell her they wouldn't. She eventually checked with her GP, a week or so ago, and GP told her it was fine to take them. I don't know if she has started to take them since her last GP appointment but I will check with her. I have to try and tread carefully with her because although I'm only trying to help her she get's very annoyed with me when I try to talk to her about her thyroid. She told me last weekend that I was obsessed with thyroid function!
Have you considered signing up for on-line access at the surgery so you can see results ? VitD often low too .
Your Mum is so lucky to have you keeping an eye - think of all those poor people in Nursing Homes who probably never have thyroids checked but pumped with many drugs treating a myriad of symptoms ...
I have checked her surgery's website and they are not offering on-line access but I did go and ask for a print out for her last thyroid results in December because at my suggestion she had ask her surgery for them but they give them to her in a sealed envelope and she took them away without checking them. When I opened the envelope they had given her the wrong results. She rung them up and told them. I went into her surgery to get them and when I opened the envelope they had printed the wrong ones again! I asked them to print the right ones and they did it without contacting my Mum to verify with her. I could ask her to get a print of her B12 and Vit D result but it was over a year ago and I know if i ask her she'll get annoyed with me again. Probably easier to persuade her to let me order her a test through medichecks.
As she has balance issues I would check her B12, and do the Active B12 test which Medichecks offers, not the Total B12 that is done by GPs. Low B12 is very common in older people.
Her conversion is poor, but the first thing to look at is whether nutrient levels are optimal, so testing them all for current levels, as Marz has mentioned, would be a good idea.
It's important not to take B Complex before any blood tests because the Biotin it contains can cause false results if Biotin is used in the testing procedure, and most labs do use Biotin when testing.
I will try and persuade her to let me order a B12 test for her. I am aware of Biotin in B complex and if she will let me order a B12 test for her I'll make sure she stops taking her B complex beforehand. If in fact she has even started taking it. How long before testing should B complex supplementation be stopped?
I learnt touch typing at school, 60 years ago, and was a secretary until my mid-40s, still use a keyboard on a daily basis and it's something that never leaves you. I now have arthritis in some fingers which causes problems, I get random odd letters or missed capital letters, drives me nuts!
I did Pitmans shorthand, I wonder if that's still taught? I did audio typing as well, that was fine until you got a mumbler or someone whose speech was so unclear you wanted to throw your earphones out of the window!
I never had a golf ball, was on a manual typewriter for many years, then we had electric with limited memory to store a few phrases, then eventually a word processor. Never used a telex.
I left employment in 1994 when we bought a restaurant, but still used a word processor daily, then progressed to computer.
Yes I did shorthand but then we moved on to audio. I was trained by the NHS to use their computers and I then did sage because I became interested in accountancy. I am trying to teach myself coding at the moment which is not easy.
I do know elderly patients take less Levothyroxine because my Dad who is 78 takes 100mcg but I think your mother might need an increase of 25mcg. Why don't you ask her Doctor to increase by 25mcg and then test in 6 weeks afterwards to see if there is an improvement. Also you need to get her vitamins tested as other members have suggested B12, Iron and Ferritin, Vitamin D and Folate they all need to be optimal for levothyroxine to work properly.
I know from personal experience that doctors say test results for anything are fine if they are within the reference range. Some years ago I had a ferritin level of about 20 with a reference range of 13 - 150. I was told that this was "fine".
What I wasn't told was that I had had a below range serum iron result for several years. I developed a permanent heart problem that I've never managed to get rid of as a result of being incredibly low in iron for several years. Now I monitor and treat my own iron levels and keep them as close to optimal as I can.
If I ever allow my iron levels to become low in range then I sometimes get chest pain severe enough to make me think I'm having a heart attack. I also get tachycardia (very fast heart rate) quite often as well.
So the moral of this tale is... Always, always, always get copies of results and reference ranges for everything. You never know when you'll find out they've omitted to tell you something important that you may be able to fix, and it could make a huge difference to how well you feel.
Yes I was told my TSH was fine for over 2 years and it was 0.002 and suppressed I only found out that by posting my results on Elaine Moore's site in the US. My GP was absolutely clueless about thyroid disease and how to read results properly.
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