IM IN A STATE OF CONFUSION! I desperately need help to understand and actions to take following recent blood results.

[Golli]

My GP reduced my levo thyroxine from 100mcg to 75mcg, at beginning of March, as my

TSH was 0.13 (0.27-4.2).....

T4 was21.1 (12-22)

T3 was 4.9 (3.1-6.8)

Of course he thinks that TSH is the most important reading , 😡 and I hadn’t the energy to dispute it . Was supposed to be retested in 6 weeks but due to COVID restrictions haven’t yet been retested . So did a Medichecks test last week and had a Thyroid and vitamin profile done.

These most recent results are

TSH 0.047 (0.27-4.2)

Ft34.11 (3.1-6.8)

Ft4 18.4 (12-22)

T.G.A <10 (<115)

T.P.A. <9 (<34)

CRP 1.56 (<5)

Ferritin 70.4 (13-150)

Folate-serum 4.4 (3.89-19.45)

VitB12- active 52.1 37.5-187.5)

Vitamin D 86.5 (50-175) .

I can’t understand why my TSH is so low, , - the only vitamin I take is Vitamin D spray, , I wanted to get my levels checked before I took any supplements.

Am I right in thinking my vitamin levels aren’t optimal even though they are within range, I know my folate is very low.

I would be so grateful for advice on what to take , - I’m terrified that if my Gp knew the recent TSH result he would want to reduce my levo thyroxine even further !

Would my levels improve if I were to optimise my vitamins, without any change being made to my levo ?

I’m feeling ok ‘ish. Energy low at times , aching painful joints, hands/ fingers.

As stated in previous posts I had RAI treatment in 2008. And for past few years frequent gut problems , low stomach acid, haven’t managed to go gluten free ...yet but reall must try. ( coeliac test negative). Bowel investigations were all normal and I only know from this wonderful forum that my gut problems are related to thyroid issues, no one in medical profession could tell me that!

Apologies for long post but would be so grateful for advice.

Thank you so much in advance.

Best wishes to all on forum.

[SlowDragon Administrator]

Ft4 is 64% through range

Ft3 only 27% through range

Helpful calculator for working out percentage through range

chorobytarczycy.eu/kalkulator

B12 and folate are very low

But GP unlikely to agree

Do you have any Low B12 symptoms, if yes see GP for further testing before starting on any B vitamins

b12deficiency.info/signs-an...

Supplementing a good quality daily vitamin B complex, one with folate in not folic acid may be beneficial.

chriskresser.com/folate-vs-...

B vitamins best taken after breakfast

Igennus Super B is good quality and cheap vitamin B complex. Contains folate. Full dose is two tablets per day. Many/most people may only need one tablet per day. Certainly only start on one per day (or even half tablet per day for first couple of weeks)

Or Thorne Basic B or jarrow B-right are other options that contain folate, but both are large capsules

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Low vitamin D and low B vitamins may be linked as explained here.

drgominak.com/sleep/vitamin...

In YouTube video when Dr Gominak talks about vitamin D levels ...vitamin D at 40ng/ml (USA units) is equal to 100nmol (UK units)

youtu.be/74F22bjBmqE(Not working as expected?)

Trying strictly gluten free diet likely next step.....before looking at adding small dose of T3 alongside levothyroxine

[Golli in reply to SlowDragon]

Thank you so much for your response and excellent information.

I can identify with at least 12 symptoms of possible B12 deficiency.

But trying to convince Gp when results are within range ,will be a different matter.

I honestly don’t think my GP knows of the existence of T3. ,as usual is fixated on TSH.

But determined to give my point of view on next meeting., in the past he has said my symptoms were due to stress! I know they are most definitely not .

Once again thank you .

[SlowDragon Administrator in reply to Golli]

If your wasting your breath trying to get GP to test low B12 just start supplementing

Supplementing a good quality daily vitamin B complex, one with folate in not folic acid may be beneficial.

chriskresser.com/folate-vs-...

B vitamins best taken after breakfast

Igennus Super B is good quality and cheap vitamin B complex. Contains folate. Full dose is two tablets per day. Many/most people may only need one tablet per day. Certainly only start on one per day (or even half tablet per day for first couple of weeks)

Or Thorne Basic B or jarrow B-right are other options that contain folate, but both are large capsules

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Email Dionne at Thyroid uk for lists of NHS and private recommend thyroid specialist endocrinologists who will prescribe T3

[e-mail]

[Golli in reply to SlowDragon]

Thank you so much again SlowDragon , I think I will indeed start supplementing with B12, With folate , the sooner the better, I think , now I know they are in the lower range , rather than waiting on the GP to agree or disagree.

I really appreciate your advice and time taken to respond.

( not sure if list of nhs + private thyroid specialist endos include ones in Northern Ireland , where I live)

[SlowDragon Administrator in reply to Golli]

Yes there’s a couple of private and one or two NHS options

[Golli in reply to SlowDragon]

Oh that’s great, I hope to follow that up. This site gives me so much hope in this world of thyroid maltreatment . Thank you , - your advice is much appreciated.

[DippyDame]

I see in a previous response you have been told your T4 to T3 conversion rate is poor ...in the intervening 3 months have you managed to increase/optimise your nutrients as explained. It doesn't look like it....it can take time.

This will support conversion and should raise FT3.

For good healthT3 is required in every cell in the body in a constant and adequate supply.

"Within range" is not good enough numbers need to be optimal for these nutrients

SlowDragon has explained what to do.....follow her advice

TSH is not the significant result....those are FT4 and FT3

This is why...

bmcendocrdisord.biomedcentr...

Until this stage is achieved and more tests are carried it is difficult to advise further.

If conversion does not improve with optimal nutrients then you may need to add a little T3 but you're not at that point yet.

You have to progress step by, very often slow, step!

With improved conversion hopefully you will feel better....if not come back and members will discuss further options

Don't be terrified of your medics....they are there to advise not to dictate. Many of us resort to self medicating if they fail to understand our medical condition and how to diagnose and medicate us....and they often do!

You can do it....nutrients first!

Best...

DD

[Golli in reply to DippyDame]

Thank you DippyDame for your response, and sound advice , I will indeed follow what you and SlowDragon have advised, ...the reason I haven’t optimised my nutrients/ vitamins over the past couple of months, is, my surgery is virtually on lockdown and I haven’t been able to get my bloods done., So I managed to get them done by Medichecks last week. I did not want to start vitamins until I knew what my deficiencies were.

I’m hoping things will start to improve when I can things going with nutrients/ vitamins.

Have to convince my GP of my needs, 🤷‍♀️ ( as I have said before, he is only concerned about TSH, which is totally mis informed)

Thanks for taking time to respect. Much appreciated.

[SlowDragon Administrator in reply to Golli]

If GP won’t refer you to NHS endocrinologist you may need to go private initially.

GP can’t refuse a private consultation

NHS can be many months wait, even up under normal circumstances.