My latest blood test results, Hashimotos

[Jalisi]

My previous results

29.10.19 TSH 0.62(0.55-4.78), T4 11.1(10-20), T3 5.1(3.5-6.5)

03.10.19 before T3 therapy TSH3.57(0.55-4.78) T4 14.5(10-20) T3 4.1(3.5-6.5)

13.07.19 TSH1.01, T4 13.3(10-20), T3 3.4(3.5-6.5)

12.07.19. Medichecks TSH 0.556(0.27-4.2) T4 12.6(12-22) T3 3.28(3.1-6.8) TPO 178(<34) Tgab 541(<115)

29.04.19 Medichecks CRP 0.51(<5) ferritin 64.6(13-150) folate 16.94(>3.89) B12 107(37.5-188) vitD 62.8(50-175) TSH1.84(0.27-4.2) T3 5.08(3.1-6.8) T4 17.8(12-22) TPO 100(<34) Tgab 532(<115)

I'm currently on 75mcg levo, 15mcg T3 and 4.5ml LDN. I also take 4000IU vitD3 withK, omega3, selenium and magnesium. I am dairy free and avoid gluten as much as I can.

I have been feeling tired - slept for 12 hours today, have muscle aches, dry eyes, swolen hands and low mood. I do have a good day here and there but I think it's due to my willpower.

Any advice would be greatly appreciated.

[SlowDragon Ambassador]

Well we are all different....but your Ft4 is very low

Many of us on levothyroxine plus T3 need GOOD Ft4 and Good Ft3

Ft4 at least 50-60% through range

Ft3 similar

chorobytarczycy.eu/kalkulator

Helpful calculator for working out percentage through range

Suggest you increase levothyroxine by 25mcg and retest in 6-8 weeks

This should also increase Ft3 a little

Results from before adding T3 show you were always under treated and Ft4 far too low ...

Gluten free diet does need to be absolutely strictly gluten free to be effective

[SlowDragon Ambassador]

Previous post

healthunlocked.com/thyroidu...

GP was wrong not to increase dose levothyroxine

Even if we don’t start on full dose, most people need dose increased slowly upwards until on full dose

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 also clear on dose required

bmj.com/content/368/bmj.m41

Post re how to push for dose increase in levothyroxine

healthunlocked.com/thyroidu....

[Jalisi in reply to SlowDragon]

Thank you Slow Dragon, I hope I can get my GP to increase my dose. I really appreciate all the information, you're amazing.

[shaws in reply to Jalisi]

Beware - because doctors only seem to take notice of the TSH result (thyroid stimulating hormone) whilst ignoring clinical symptoms. When TSH reaches 'normal' range many GPs think we're on a sufficient dose and do not increase dose of levothyroxine. The aim is small increases in levo every six weeks until TSH is 1 or lower. Many GPs seem to think that once TSH is somewhere in the range - even upper part - that we're on a sufficient dose, when we aren't

The aim is a TSH of 1 or lower with a Free T4 and Free T3 in the upper part of the ranges. The latter two are rarely tested. Ask for B12, Vit D, iron, ferritin and folate to be tested next time. Everything has to be optimal.

Many GPs seem to think that once the TSH is somewhere in the range - even at the top - don't increae dose. They do not seem to realise that we need a TSH of 1 or lower with both FT4 and FT3 in the upper part of the ranges (these two don't get tested very often).

Blood should always be drawn at the earliest, fasting (you can drink water) and allow a gap of 24 hours between last dose of levo and test and take it afterwards. Also requested B12, Vit D, iron, ferritin and folate to be tested too. Everything has to be optimal.

[Jalisi in reply to shaws]

Thank you Shaws, I have made an appointment with a GP who tests my T3 and T4. I went private to get my liothyronine so my GP has a letter from my private DR explaining my conversion issue. I will question my TSH stats as they don't reflect my low T4. I can always ask her to explain to me why my TSH isn't higher if my thyroid is not producing enough T4. If she refuses I will ask her to put it in my notes and I will increase my dose myself.

I really appreciate your reply, I feel so lucky to have found this forum.