Am I getting there?

[Nonameavailable]

Is this a fair balance?

This is the latest results including the T3 following a very erratic year. I am looking for confirmation and feedback on the balance as the results themselves all appear within normal limits.

[SeasideSusie Remembering]

Nonameavailable

Yes, they're within range but your FT4 and FT3 aren't in balance.

The aim of a treated hypo patient on Levo, generally, is for TSH to be around 1 or below with FT4 and FT3 in the upper part of their ranges. Your FT4 is 69% through range but your FT3 is only 15.14% through range.

Are your nutrient levels optimal - Vit D, B12, Folate and Ferritin?

[Nonameavailable in reply to SeasideSusie]

Hi there I didn’t pay for a vitamin check this time just gets too expensive but I do supplement my vitamin d . was thinking I might add selenium into that? My general health has not been particularly good and I get recurrent shingles. Do you think I need to be adjusting my thyroxine just now?

[SeasideSusie Remembering in reply to Nonameavailable]

When taking Vit D we need to test twice a year to ensure levels stay within the recommended range of 100-150nmol, adjusting dose if necessary.

We need optimal nutrient levels for thyroid hormone to work properly and good conversion of T4 to T3.

Selenium may help, some people prefer to test before supplementing.

[Nonameavailable in reply to SeasideSusie]

Sorry and I get B12 injections every 10 weeks . I was supplementing in between but decided to see what would happen if followed GP

[SeasideSusie Remembering in reply to Nonameavailable]

When we take B12 in any form - injections or oral supplements - we should take a B Complex to balance all the B vitamins.

[waveylines in reply to Nonameavailable]

And when you were supplementing inbetween injections were your thyroid hormones levels more balanced? Ive found regular b12 injections to be a key issue for me & has helped my uptake of thyroid hormones immensely to the degree Ive been able to reduce my daily dose of ndt.

[Nonameavailable in reply to waveylines]

Hi my thyroid has been Particularly erratic for a year. But became more unstable 10 years ago. HRT completely messed it up. But I can’t say it was any more stable when I started to use and supplement my B12. 😕

[waveylines in reply to Nonameavailable]

B12 wont stabilise thyroid hormones but it helps with the conversion of t4 to t3. Therefor it may help to increase the conversion of your thyroid hormones into more t3.

Am guessing if your thyroid hormone have been very "erratic" that you have been checked for Hashi?

[Nonameavailable in reply to waveylines]

Hi there.

NHS did not check anything ever. Private tests would indicate hashis.

I took tests into GP and they showed little interest...and in fact laughed at me!!! I work in the NHS and deal with all the local surgeries and don't think a change of GP or surgery would be any different.

I may go private endo and get opinion from someone clued up on thyroid.

I have 2 consultant appts (neuro and rehab...I get botox for Trigeminal neuralgia) this month, so may see if they will at least be honest about what they understand.

I could budget for vit testing or could just supplement. I may supplement mt B12 and do every 5 weeks. Vit D and B complex recommended. Anything else? Already as gluten free as i can be without checking stock cubes and sauces!!

Thanks for taking time to respond.. You guys are a life line and make me feel sane.

[SlowDragon Administrator]

How much levothyroxine are you currently taking?

Your ft3 is far too low

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 is in top third of range and FT3 at least half way through range

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

[Nonameavailable in reply to SlowDragon]

Hi there

They now have me on 50mg but 75 every third day. Having had GP reduce it about 8 weeks ago. Will look at rest of info. Many thanks. I have been re referred to neuro because of migraines however I think the migraines are a secondary problem but no one will listen to me. That’s why I thought if I got my private results I might be able to take in the information to the neurologist and see if some of the symptoms are not primarily migraine related.

[SlowDragon Administrator in reply to Nonameavailable]

You needed dose increase, not dose decrease

Getting all four vitamins optimal should help improve very poor conversion of Ft4 to Ft3

[penny in reply to Nonameavailable]

Did they up your dose to 50mg or reduce it to 50mg? IMHO your T3 is much too low in relation to your T4, which will looks like a conversion problem. Does your doctor go by your tsh results? If so, then you will probably me under medicated as usually we are well with a tsh of 1 or less but this is not accepted by GPs or Endos. My tsh is unmeasurably low but I’m well at that level and take T3, which keeps tsh very low. You may need T3 medication.

[Nonameavailable in reply to penny]

This time my dose was reduced!!! For the last year every test every three months it has been changed!! And the tweak it ever so slightly so I used to take 50 and 75 the next. For most of my thyroid life I was on 150 and function quite well.

[penny in reply to Nonameavailable]

Then why was it changed? Do I assume that they were using the tsh for dosing? If you were well on 150mcg then you should have stayed at that level not reduced your dose. It sounds as if you need a new GP, one who understands thyroid issues (difficult).

[Nonameavailable in reply to penny]

NHS ...lol need I say more

[shaws Administrator in reply to Nonameavailable]

I'd change your doctor as he/she is only taking notice of the blood test and not your clinical symptoms so adjusting willy/nilly it would seem to me. I will also state that I'm not medically qualified but like the majority on this forum, doctors know very little about how to treat us to an optimum. Most are always adjusting our dose to 'fit into some sort of scale' when we need a FT3 and FT4 to be in the upper part of the ranges.

You state:-

"For most of my thyroid life I was on 150 and function quite well. "

I'd have a talk with your GP and insist on your previous dose'. Tell him you are now very symptomatic indeed and functioned well on 150mcg.

He/she should bee more interested in relieving your symptoms, rather than trying to 'fit' into a range which varies throughout the day.

[SlowDragon Administrator in reply to Nonameavailable]

NICE guidelines

nice.org.uk/guidance/ng145/...

1.3.6

Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.

BMJ clear on dose required

bmj.com/content/368/bmj.m41

Post re getting dose increased

healthunlocked.com/thyroidu....

Ft4 is 69% through range

Ft3 only 15% through range

Helpful calculator for working out percentage through range

chorobytarczycy.eu/kalkulator

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 is in top third of range and FT3 at least half way through range

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

Email Dionne at Thyroid UK for list of recommend thyroid specialist endocrinologists who will prescribe T3

Meanwhile getting all four vitamins optimal and push to get dose levothyroxine increased

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor



please email Dionne at

[e-mail]

[Nonameavailable in reply to SlowDragon]

Should have added. Been on thyroxine over 30 years