New test results. Next step?: I hope everyone is... - Thyroid UK

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New test results. Next step?

Ralph1985 profile image
24 Replies

I hope everyone is doing alright and staying safe at home while this Corona virus outbreak is still at hand, thank god we still have this thyroid community to help eachother out and seek advice, this is something I do not take for granted and am very thanful to be part of. A million thanks to everyone who’s part of this.Alright that being said let’s get to the juicy part haha. I been on 175 mcg of synthroid for 3 months. Before this I was on 150 mcg of synthroid and was still feeling hypo. Tsh was high though I’m a very good t4 to t3 converter.

My endocrinologist raised my dose from 150mcg to 175mcg 3 months ago And for the last week and half I been having hyper symptoms, anxiety, agitation and loosing my breath with any physical activity. This are my bloodwork for 175 mcg synthroid last dose taken 24 hours before bloodwork.

Tsh. 0.09 0.40-4.50

Tt4. 11.4 4.9-10.5

Ft4. 1.8 0.8-1.8

Ft4 index. 3.6 1.4-3.8

T3 uptake. 32. 22-35

Tt3. 134 76-181

Ft3. 4.0 2.3-4.2

Rt3. Is pending....

I’m still waiting on my rt3 results which might be the cause for the way I feel if it’s too high.

Anyways I think my Endo will try to lower my dose back down to 150 mcg as my bloodwork has some over the range results for the t4 number and that’s after 24 hours of my last dose. It would be alright if he lowers it by 12.5 mcg but synthroid doesn’t make 162.5 pills and I’m lost at this moment sure I can buy 2 different dosage pills but I don’t even think he would let me do that. And what if the rt3 comes back high what would be the next step? Would I have to lower my t4 and add t3 so I would convert less? I need a solid plan for my next visit. I do feel hyper on this dose. And at 150 I felt hypo.

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Ralph1985
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SlowDragon profile image
SlowDragonAdministrator

It’s common to need to very fine tune dose

You could tweak downwards slightly by taking 150mcg Just ONE Day a week and 175mcg the rest of week

Levothyroxine is a storage hormone....so you are looking for overall dose ...it’s not necessary to take exactly same dose every day

Are vitamin D, folate, B12 and ferritin levels optimal

What vitamin supplements are you currently taking

Ralph1985 profile image
Ralph1985 in reply to SlowDragon

I do have some 150mcg pills at hand from last prescription. That would be one option idk of just on day of 150mcg would make much difference. Would eod 175 and eod 150 dial down to what 162.5 would be like?

helvella profile image
helvellaAdministratorThyroid UK in reply to Ralph1985

Some people are perfectly happy on alternate day dosing to achieve an intermediate dose.

I can tolerate it, but prefer the same every day.

Ralph1985 profile image
Ralph1985 in reply to SlowDragon

Also what do you think maybe rt3 could be high with those numbers. And if it is what would be my next step. Or how do you even control rt3?

SlowDragon profile image
SlowDragonAdministrator in reply to Ralph1985

Little point testing Reverse T3

More important to test vitamin levels regularly

What vitamin supplements are you currently taking?

Low ferritin can cause reverse T3 issues

Ralph1985 profile image
Ralph1985 in reply to SlowDragon

I was taking Vit d but stoped last month because levels were getting too high I do take it on and off. When my leves start dropping I start again. All my other vitamins are great other then that I take a magnesium supplement and that’s it.

Ralph1985 profile image
Ralph1985 in reply to Ralph1985

Usually my iron is too high and I donate blood twice a year for that reason

SlowDragon profile image
SlowDragonAdministrator in reply to Ralph1985

Do you have hemochromotosis?

verywellhealth.com/hypothyr...

Rarely, certain diseases, like hemochromatosis, can deposit abnormal substances (iron, in the case of hemochromatosis) in your pituitary gland, causing central hypothyroidism, or less commonly, your thyroid gland, causing primary hypothyroidism.

redriverhealthandwellness.c...

ncbi.nlm.nih.gov/pubmed/182...

Ralph1985 profile image
Ralph1985 in reply to SlowDragon

Nope I just eat a lot iron fortified foods

vocalEK profile image
vocalEK in reply to Ralph1985

Exactly what was your blood level of Vitamin D? It is very difficult to overdose on Vitamin D. The mainstream medical folks don't know this, and they prescribe inadequate dosages of Vitamin D.

The Vitamin D Society recommends: "Please make sure your test score is in the range between 100-150 nmol/L (40-60 ng/ml USA)."

vitamindsociety.org/press_r...

Currently there is evidence that high enough blood levels of Vitamin D may be protective against corona virus and other flu bugs. preprints.org/manuscript/20...

I am trying to get my blood level up to 60 ng/mL (UK ~150 nmol/L) as research has found this level to be protective against several types of cancer.

grassrootshealth.net/blog/8...

Here is a handy calculator for you to figure out how much D to take to achieve your goal blood level. grassrootshealth.net/projec...

When taking larger doses of Vitamin D, don't forget the important co-factors:

Vitamin K2 MK-7 helps the Vitamin D route your dietary sources of calcium where it is needed -- bones and teeth -- instead of being deposited into soft tissues such as breasts and blood vessels. Also, magnesium helps D to work better.

IMPORTANT: If you are prescribed the usual stuff to prevent or treat osteoporosis, it contains calcium. Insist that the doctor test your blood levels of calcium. Most people get plenty from their diets. I, for example, never drink milk, yet my calcium level is in the lab's mid-range. If adequate, tell the doctor you don't want to take extra calcium and risk kidney stones and other ailments associated with too much calcium.

vocalEK profile image
vocalEK in reply to Ralph1985

Exactly what was your blood level of Vitamin D? It is very difficult to overdose on Vitamin D. The mainstream medical folks don't know this, and they prescribe inadequate dosages of Vitamin D.

The Vitamin D Society recommends: "Please make sure your test score is in the range between 100-150 nmol/L (40-60 ng/ml USA)."

vitamindsociety.org/press_r...

Currently there is evidence that high enough blood levels of Vitamin D may be protective against corona virus and other flu bugs. preprints.org/manuscript/20...

I am trying to get my blood level up to 60 ng/mL (UK ~150 nmol/L) as research has found this level to be protective against several types of cancer.

grassrootshealth.net/blog/8...

Here is a handy calculator for you to figure out how much D to take to achieve your goal blood level. grassrootshealth.net/projec...

When taking larger doses of Vitamin D, don't forget the important co-factors:

Vitamin K2 MK-7 helps the Vitamin D route your dietary sources of calcium where it is needed -- bones and teeth -- instead of being deposited into soft tissues such as breasts and blood vessels. Also, magnesium helps D to work better.

IMPORTANT: If you are prescribed the usual stuff to prevent or treat osteoporosis, it contains calcium. Insist that the doctor test your blood levels of calcium. Most people get plenty from their diets. I, for example, never drink milk, yet my calcium level is in the lab's mid-range. If adequate, tell the doctor you don't want to take extra calcium and risk kidney stones and other ailments associated with too much calcium.

Ralph1985 profile image
Ralph1985 in reply to vocalEK

It’s usually in the 90’s

vocalEK profile image
vocalEK in reply to Ralph1985

Exactly what was your blood level of Vitamin D? It is very difficult to overdose on Vitamin D. The mainstream medical folks don't know this, and they prescribe inadequate dosages of Vitamin D.

The Vitamin D Society recommends: "Please make sure your test score is in the range between 100-150 nmol/L (40-60 ng/ml USA)."

vitamindsociety.org/press_r...

Currently there is evidence that high enough blood levels of Vitamin D may be protective against corona virus and other flu bugs. preprints.org/manuscript/20...

I am trying to get my blood level up to 60 ng/mL (UK ~150 nmol/L) as research has found this level to be protective against several types of cancer.

grassrootshealth.net/blog/8...

Here is a handy calculator for you to figure out how much D to take to achieve your goal blood level. grassrootshealth.net/projec...

When taking larger doses of Vitamin D, don't forget the important co-factors:

Vitamin K2 MK-7 helps the Vitamin D route your dietary sources of calcium where it is needed -- bones and teeth -- instead of being deposited into soft tissues such as breasts and blood vessels. Also, magnesium helps D to work better.

IMPORTANT: If you are prescribed the usual stuff to prevent or treat osteoporosis, it contains calcium. Insist that the doctor test your blood levels of calcium. Most people get plenty from their diets. I, for example, never drink milk, yet my calcium level is in the lab's mid-range. If adequate, tell the doctor you don't want to take extra calcium and risk kidney stones and other ailments associated with too much calcium.

Lalatoot profile image
Lalatoot in reply to Ralph1985

Rt3 is a red herring. Many factors can cause high Rt3 and not all are thyroid related. Rt3 has its own functions and its own receptors.

Ralph1985 profile image
Ralph1985 in reply to Lalatoot

Ok nice to get that cleared out i had the misconception of too high t4 would obviously convert to t3 and rt3 at the same time

Lalatoot profile image
Lalatoot in reply to Ralph1985

Yes it does but Rt3 has its own functions. It used to be thought that it blocked the T3 receptor cells but this has been de-bunked by later studies.

Ralph1985 profile image
Ralph1985 in reply to SlowDragon

Finally got the rt3 results they are 15 8-25

Happy to know it wasn’t that

Ralph1985 profile image
Ralph1985 in reply to SlowDragon

Let me ask you a question in which I would like your opinion. If I wouldn’t have hyper symptoms with these lab numbers, would those numbers indicate being hyper or some form of being over medicated? Or would they be acceptable even tho very low tsh and over range t4 ?

SlowDragon profile image
SlowDragonAdministrator in reply to Ralph1985

If you don’t feel over medicated levels look fine

Many people need high Ft4 and high Ft3

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

tukadmin@thyroiduk.org

pennyannie profile image
pennyannie

Hey there Ralph

Without reading any further of what anybody else has to say, or knowing more about your issues - I just think why not cut the 25 mcg tablet in half and see how that goes

Ralph1985 profile image
Ralph1985 in reply to pennyannie

Yeah the only thing is I don’t have 25mcg tabs and I can’t see my Endo untill he gets back to work he has self quarantine and not seeing anyone at the moment. Good plan tho 😄

pennyannie profile image
pennyannie in reply to Ralph1985

Ah, ok, I couldn't understand how I was the only thinking this !!!

Guess you might be able to buy a packet over the internet ??

Ralph1985 profile image
Ralph1985 in reply to pennyannie

Yeah, I will do that for now atleast untill see my Endo hopefully he won’t give me a hard time and try to back me up to 150 mcg altogether. Will give him the idea of 138 plus 25 to get my desire dose hopefully he will accept this

pennyannie profile image
pennyannie in reply to Ralph1985

I don't see why not, it's your health, not his, and worth a try, good luck.

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