bloood test results

[Sweetpea1157]

hi everyone , sorry not been here in some time but the last quarter of last year was a nightmare for me , with 2 family losses and my general health being totally ***t . my gp wanted to drop my levothyroxine down to 25mcg , but i didn't take any notice and continued taking the 50mcg , going by my latest blood results , glad i didn't listen to her . So , in a nutshell , am presently taking 50mcg levothyroxine and 10mcg liothyronine [ t3 ] daily and these are my latest results ;

Date taken ; 29th Jan 2020 .

CRP HS 2.4mg/L range ; < 5

FERRITIN 106ug/L range ; 13 - 150

FOLATE 17.03ug/L range ; > 3.89

VITAMIN B12 > 150pmol/L range ; >37.5

VITAMIN D 93.3nmol/L range ; 50 - 175

TSH 0.044mlu/L range ; 0.27 - 4.2

FREE T3 4.61pmol/L range ; 3.1 - 6.8

FREE T4 13.5pmol/L range ; 12 - 22

TGA 27 klu/L range ; < 115

TPA < 9 klu/L range ; < 34

though these results seem pretty good to me , some advice would be very much appreciated as i am still feeling so unwell , constantly feeling like i've been hit by a bulldozer , and over last few months only generally been getting 1 - 2 hrs sleep a night with very short cat nap through the day { which i don't want to be doing } .

[SeasideSusie Remembering]

Sweetpea1157

FERRITIN 106ug/L range ; 13 - 150

FOLATE 17.03ug/L range ; > 3.89

VITAMIN B12 > 150pmol/L range ; >37.5

These all seem to be good. Do you supplement for any of them?

VITAMIN D 93.3nmol/L range ; 50 - 175

This is OK, almost reached the level recommended by the Vit D Council/Vit D Society which is 100-150nmol/L. I like mine as close to 150nmol as I can get it.

TSH 0.044mlu/L range ; 0.27 - 4.2

FREE T3 4.61pmol/L range ; 3.1 - 6.8

FREE T4 13.5pmol/L range ; 12 - 22

TSH is where one would expect to see it when taking a combination of Levo plus T3.

However, there is some room to improve FT3 as it's only 40.81% through it's range.

FT4 may be OK for you, some patients on combination therapy are fine with it that low, for me I would be very unwell and I need both FT4 and FT3 at 70-75% through range (I am on Levo plus T3).

If those were my results, I would first of all be increasing Levo, retesting in 6-8 weeks to see how I feel and where my FT4 and FT3 then lie, then reassess.

[Sweetpea1157 in reply to SeasideSusie]

Hi SeasideSusie , thanks for getting back to me . i do take supplements but only Vit D 2000 lu extra stregnth , selenium 200ug and on occasion Vit K2 , i was thinking the same about FT4 , like yourself and SlowDragon i think it is a little on the low side , but , as i have said to SlowDragon i am a little apprehensive of taking full 75mcg levo daily , as when was on that dose before my FT4 was a little high , so am thinking of taking 50mcg / 75mcg alternate days

[SeasideSusie Remembering in reply to Sweetpea1157]

See how you go with that you can always increase again if you need to.

[SlowDragon Administrator]

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)

If/when also on T3, make sure to take last dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you did this test?

Assuming yes.....

Ft4 very low and Ft3 low

I would agree with SeasideSusie ...trying a 25mcg dose increase in levothyroxine as next step. Retest in 6-8 weeks. You should see increase in both Ft4 and ft3

[Sweetpea1157 in reply to SlowDragon]

Hi SlowDragon , thankyou for getting back to me , i agree that my FT4 could do with a little improvement , but am a little apprehensive of taking the full 75mcg daily as the last time i was on that dose my FT4 was said to be a little high , so am thinking maybe do 50mcg / 75mcg alternate days . Do you think this is a good idea to start with then re-test in 6-8 weeks ??

[SlowDragon Administrator in reply to Sweetpea1157]

Yes ....I did that when I first increased Levo back up...I still ended up increasing by 25mcg in total, but did it as two smaller steps

suspect you will need to as well. Your Ft4 is right at bottom of range

[Sweetpea1157 in reply to SlowDragon]

thanks for that SlowDragon , will give that a go .