I'm new here...advice on blood results please.

[DoodleMoo]

I was diagnosed with Hashimotos about a year ago and am currently on 100mg Levothyroxine. Whilst I am feeling a lot better (I have addressed my diet as well) I know I am still not 100%. My latest blood test results (I had a full bloods in April and iron levels in May if helpful) are:

FT3: 3.27 pmol/L (3.1-6.8)

FT4: 21.4 pmol/L (11.0-23.0)

TSH: 0.12 mU/L (0.27-4.5)

My FT3 levels have gradually crept up from 2.26 (same range as above) when first measured in January and 2.94 in April as my dose of Levothyroxine has increased. GP has said to maintain my dose at 100mg. I agreed to stay on 100mg and be retested in 2 months time. There is no chance of being referred to an endocrinologist on NHS.

Having read posts on this website I should probably add that I have been taking my Levothyroxine as normal before the bloods were taken.

My question is whether I would feel better having higher FT3 levels (I know the optimal range is between 5.0 and 6.0) but I am nervous to start dabbling with medication myself!

Thank you.

[SlowDragon Administrator]

First step is to get vitamins tested and to do thyroid test correctly

If getting GP to test is too much of a battle...like thousands on here you may need to test privately

Have you had coeliac blood test

Are you now on strictly gluten free diet

What vitamin supplements are you currently taking

EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common with Hashimoto’s

Ask GP to test vitamin levels

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)

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus ultra vitamin

medichecks.com/products/thy...

Medichecks often have special offers, if order on Thursdays

Thriva Thyroid plus vitamins

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes vitamins

bluehorizonbloodtests.co.uk...

Add any vitamin results you have or come back with new post once you get results

[DoodleMoo in reply to SlowDragon]

Thank you very much for your reply. The following were my levels in May '20:

B12: 440 ng/L (197.0-771.0)

Folate: 14.6 ug/L (2.0-18.7)

Ferritin: 205.6 ug/L (20.0-260.0)

Vit D: 75 nmol/L

My white blood cell count (total, neutrophil and basophil) has been consistently low over a number of years too. I have assumed recently this is due to Hashimoto's?

I take zinc, magnesium, omega 3, probiotic, Vit C, NAC as supplements.

I have been following the AIP diet and strictly gluten free for 5 months. Now starting to reintroduce excluded foods. I haven't had a coeliac test but do not experience any bowel issues/reflux etc. other than constipation fairly regularly.

I have managed to convince my GP to test FT3 so far but he is really not interested any further other than the "numbers". I take on board the testing before taking Levothyroxine and will do this going forwards.

Thank you for your help.

[shaws Administrator]

Your results will be skewed as it is recommended on this forum to allow a gap of 24 hours between last dose of levo and test and take it afterwards - if taking a dose at a.m..

Doctors only seem to look at the TSH results and adjust/reduce according to it alone - which is from the pituitary gland - and many patients don't feel much better.

Your FT3 is low - the aim is towards the upper part of the range. T4 is an inactive hormone and the aim is to convert to sufficient T3 - but many of us do not. T3 (liothyronine) is the active thyroid hormone and is needed in our millions of T3 receptor cells and brain and heart contain the most. Many improve when given a T4/T3 combination but due to the cost of T3 in the UK, most GPs will not prescribe.

Many researchers have proven that a T4/T3 combination can impove one's health. The pity is that in the UK they've withdrawn T3 due to the exorbitant cost the providers charge and an endocrinologist may prescribe but unlikely. It may be worth a consultation I think.

SlowDragon has given her excellent advice.

[DoodleMoo in reply to shaws]

Thank you for your reply.

I have asked for the list of "Private Doctors and Practitioners" from Thyroid UK (although I really cannot afford to go privately). As my results are all now "within range" my GP will not refer me on to an NHS endocrinologist.

[Aslangal in reply to DoodleMoo]

Ditto to all the advice above. If I hadn’t taken the Medichecks full thyroid panel privately - I would not know today that I had Hashimoto’s. I cannot afford to see a Dr privately either. It’s a disgrace that everyone on here has to battle for treatment in the NHS but it’s the sad state we are in in the UK. Good luck. 😉

[shaws Administrator in reply to DoodleMoo]

Maybe you should try a 'trial' by going-it-alone with advice from many on the forum.

You'd need to source your own T3 or NDT (by requesting private messages to be sent to you of where to source). NDT is the very original replcement (contains all of the hormones a healthy thyroid gland would do) and has been prescribed since 1892 (we didn't have blood tests then but we were given NDT with small increases until symptoms relieved).

You'd have to request private messages to be sent to you and put up a new post for information to be sent to you privately of where to source.

Or you could still get levo from the GP and add some T3. Researchers have shown that a T4/T3 combination works for many.

I must also state I'm not medically qualified but had to diagnose myself as no medical person could and my TSH was 100 by then.

[DoodleMoo in reply to shaws]

Thank you for that information. I have a couple of questions :

Is NDT less expensive than T3 or vice versa?

What would be the simplist route if I was to do a "trial" myself?

Help is greatly appreciated.

[shaws Administrator in reply to DoodleMoo]

I think NDT is cheaper than T3 but others will respond too if I'm wrong. NDT might be easier to source and it is the original thyroid hormone replacement from 1892 onwards. It also contains all the hormones a healthy thyroid gland would do.

[DoodleMoo in reply to shaws]

Thank you so much. I will repost for advice re. sourcing T3/NDT.