Can someone look at my test results please

[foreversummer]

So now I'm confused. My doctor, based on TSH alone wanted to reduce my thyroxine as it was very low. I have had the following blood tests done by Medichecks:

TSH 0.032 (0.27 - 4.2)

FT4 25 (12 - 22)

FT3 4.32 (3.1 - 6.8)

I reduced for a week and half and started to become symptomatic so put myself back to 125 mcg (was trialling 100/125 mcg alternate days).

I feel better again now. He's never going to increase my dose going forward back to 125 mcg. I don't think I convert very well. Was hoping everything would be in range so I could just keep to my usual dosage which I've felt fine on.

[SeasideSusie Remembering]

foreversummer

Looking at Diogenes' reply to your previous post, you'll know that TSH is not the way to decide if a dose change is necessary.

However, your FT4 is over range but your FT3 is only 32.97% through the range.

When did you take your last dose of Levo? It should be 24 hours before testing.

If you followed the correct time gap then obviously your conversion is poor. If you took your Levo before the test then you have a false high FT4 result.

Did you have vitamins tested as well, as advised in reply to your previous post?

Hashi's complicates things anyway, but it can also cause low nutrient levels and deficiencies, and we need optimal levels for thyroid hormone to work properly and good conversion to take place.

If all your nutrient levels are optimal, i.e.

Vit D- 100-150nmol/L

B12 - top of range for Total B 12, at least over 70 (better 100+) for Active B12

Folate - at least half way through range

Ferritin - half way through range

then consideration could be given to a lower dose of Levo plus the addition of some T3.

[foreversummer in reply to SeasideSusie]

Hi SeasideSusie

Thank you for replying.

I left a 24 hour gap before my blood test. I haven't had the nutrients tested because I had already ordered the kit from Medichecks. This is the highest I've ever seen my FT3. It's always been near the bottom before so I know I am not a good converter. I've just felt perfectly normal for the last couple of years. Now I've got a hopeless GP's surgery to deal with.

I'm going somehow to plead with them to keep my 125mcg a day and look into getting the nutrients tested I guess.

[SlowDragon Administrator]

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]

Suggest you also ask Dionne for the list of recommended thyroid specialist endocrinologists who will prescribe T3

If GP refuses to allow you to remain on dose of levothyroxine that cures all your symptoms then they will instead have to agree to referral to an endocrinologist of your choice, for evaluation of wether it would be better to take higher dose levothyroxine (cheap and easy to manage) or lower dose levothyroxine plus Endocrinologist prescribed small dose of T3 alongside levothyroxine (costly and GP will be extremely reluctant)

First step is to get FULL thyroid and vitamin testing via Medichecks after MINIMUM of 6-8 weeks on constant unchanging dose of levothyroxine

Always make sure you get same brand of levothyroxine at each prescription too

Good vitamin levels improve conversion of Ft4 to Ft3

What vitamin supplements are you currently taking?

Looking for vitamin D at least around 80nmol and around 100nmol may be better

Folate at least 10

B12 at least 500

Ferritin at least half way through range

Refuse to reduce dose of levothyroxine and Ask GP to test vitamins

Come back with new post once you get results

Do you have Hashimoto’s?