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)
Is this how you do your tests?
If you took levothyroxine before test then Ft4 is false high
When were vitamin D, folate, ferritin and B12 last tested?
What vitamin supplements are you currently taking?
Optimal vitamin levels frequently improves conversion of Ft4 to ft3
Ft3 is nowhere near top of range, so shows you are not over medicated
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
Hi, I took my levothyroxine after I did the test first thing in the morning. I'm supplementing with D3 as my levels are in the mid 80's but my endo wants it to be at 125. I supplement with iron as I have adenomyosis and cervical fibroids My ferritin is in the normal range, but needs to be higher. I have struggled getting my ferritin about 10 in the past, but it's now in the 40's.
It certainly looks as though you're not converting well enough. See if you can get a trial of T3 meds. Dionne at Thyroid UK can also give you the list of T3-friendly endos - or put up a separate post asking if anyone can recommend someone in your area. You don't have to see the nearest person to you, but obv must be reasonably convenient.
I've just recently started seeing an endo privately. My follow-up with him is in a few weeks. He does prescribe T3. He wanted me to try a couple of other things before prescribing it. I'm hoping, hell give me T3 at the next appointment.
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