Advise on Blood results please

[tutbury]

I am 69 years old. Have had an underactive thyroid for about 30 years. Well managed in the first 15 years by a consultant in the Midlands. when I was taking 200 thyroxine and 20mcg Tertroxin.

Since moving away Dr's in my medical practice have lowered and lowered my Thyroxine and stopped T3. Endo's I have seen have been uninterested in my problems.

I had bloods taken 30th January 2020. At that time I was taking 125/150 Thyroxine on alternate days and was requested by the Dr to reduce thyroxine. I had had some palpitations.

Free T4 14.1 (11-24)

TSH 0.15 (0.35-4.5)

Serum Ferritin 69 (13.0-150)

Sodium 142 (133-146)

Potassium 4.7 (3,5-5.3)

No other test were given although I requested T3

I reluctantly agreed as I was worried that the Dr had said over prescribing Thyroxine could cause the palpitations and encourage a stroke! I had been to A and E with the palpitations and they could find nothing untoward in mechanical or electrical impulses of my heart.

I had bloods taken this week, having reduced to 100/125 Thyroxine on alternate days.

18th June 2020

Free T4 18.1 (11-24)

TSH 0.14 (0.35-4.5)

I requested T3 and vitamins but was refused.

In the last month I have suffered from tingling/numb cold hands and creepy throbbing pains in my legs, some so painful, especially when lying or sitting. I wondered if I had lowered Thyroxine too much or low B12 so requested a blood test and explained symptoms requesting Vit check and T3.

I was amazed that the TSH came back almost the same , in fact 0,01 lower even though reduced Thyroxine intake.

I also take rotating antibiotics and 40 Esomeprazole daily. (Renal problems and reflux)

I would be grateful for some advice. I have a phone consultation on the 22nd June.

Thanking you in advance.

[Lalatoot]

Esomeprazole is for reflux caused by too much stomach acid. Hypos tend more to have reflux caused by too little stomach acid. The symptoms are similar. It could be that Esomeprazole is reducing your stomach acid further. To increase stomach acid diluted apple cider vinegar is often used.

TSH can remain stubbornly low and may never rise. It is one of those things.

You really need to know what FT3 and vitamin levels are to understand what is happening and how to improve your health.

[SlowDragon Administrator]

Reflux is common when under medicated and hypothyroid

Reflux due to LOW Stomach acid

Any PPI like omeprazole is to treat high acid

Thousands of posts on here about LOW stomach acid

healthunlocked.com/search/p...

Current obsession with TSH is completely wrong. Often on levothyroxine and especially if also taking T3, TSH will almost always be suppressed. It’s irrelevant. Most important results are Ft3 followed by Ft4

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you Hashimoto’s or as now, under medicated

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)

If/when also on T3, make sure to take last third or half of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

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...

Email Dionne at Thyroid UK for list of recommend thyroid specialist endocrinologists (NHS and private) who will prescribe T3

[e-mail]

First step is to get full testing see exactly where you are

[tutbury in reply to SlowDragon]

Thanks for the advice. I think I will have to get a private blood test as my Dr refuses to make the necessary tests. An ongoing battle!

[tutbury in reply to SlowDragon]

Thinking about your response. They removed T3 15 years ago and won't test. Palpitations have not appeared since reduction in January which leads me to believe that their suggestion of reducing might have been correct but when one symptom goes another seems to present itself.

I have emailed Dionne for the list.

Thanks

[SlowDragon Administrator in reply to tutbury]

High Ft4 can cause lots of symptoms

But reducing levothyroxine dose obviously then results in drop in Ft3, causing other symptoms

Testing should be done minimum of 6-8 weeks after any dose change or brand change in levothyroxine

Always test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Come back with new post once you get results

[tutbury in reply to SlowDragon]

Thanks so much. Hopefully I will get sorted