Help with Thyroid Results and ? what next ?

[Sixties123]

Hi there , I have just recently had my bloods done : my results are as follows : they were taken exactly as should be before a blood draw .

TSH 0.02 range 0.30 - 4.50

Serum FT4 11.1 range 11.0 - 22.0

Serum FT3 5.6 range 3.1 - 6.8

Serum Ferritin 107 range 23 - 400

Se Thyroid Peroxidase 13 range <34

Serum Folate 7.3 range 2.5

I have been taking 100mcg Levothyroxine , 25 mcg Liothyronine (split in two doses) I take Vit B12 supplements , Magnesium , Vit D3 800,

I have noticed that I still dont have a great deal of energy . I am slow to get going in the morning . I have tried to walk more especially during pandemic. I find that I am out of breath if I walk and talk and also if there is a slight incline my legs just dont seem to have any muscle strength its like they are heavy as lead. I have found my weight difficult to shift which is disappointing given that I am now on liothyronine and thought id have more energy . My hair and nails have improved initially (poss due to Vit D 3) however my hair has started to come out again. Not massively but I am seeing it in the bottom of the shower and on my clothes again.

I have Non Alcoholic Fatty Liver Disease , I take Premarin for HRT .

I am wondering if there is anything stand out about my results that I should address. Can increasing my Levothyroxine give me a higher FT4 result and will that give me more energy ? Any advise would be gratefully received as I speak to my Consultant on Friday 10th July and could really do with some help explaining to him over the phone. ]

Thank you in advance

Lesley

[SlowDragon Administrator]

Looking through previous posts

Do you have Hashimoto’s

Couldn’t see if you have ever had TG antibodies tested

Are you on strictly gluten free diet

When was vitamin D last tested

Folate is on low side

You might be better off taking a vitamin B complex, rather than just B12

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

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...

[Sixties123 in reply to SlowDragon]

Hi SlowDragon , I have Graves Disease which I had rai for and am now hypo . I have had vit d checked but they will only do it 1 time a year. I am not on gluten free diet.

I cant find my last vit d and tg antibody results . Would I need to know them ?

I will look into getting a bit b complex supplement too . Thanks for your help . How do I know if I'm converting t4 to t3 please ?

Regards Lesley

[SlowDragon Administrator in reply to Sixties123]

Getting vitamin D tested via NHS postal kit at least annually. Preferably twice yearly

vitamindtest.org.uk

You can’t know how well your converting when on levothyroxine plus T3. But your Ft4 is on low side, you might benefit from small dose increase in levothyroxine

It’s all trial and error what works for each individual

I have to take my T3 as 3 split doses per day. Others can take as two doses, some find single dose works best

Same is true of gluten free diet. But it’s always worth trying. But get coeliac blood test first - buy online under £20 ...just to rule it out

Otherwise if you see dramatic improvements GF you might have to consider going back on gluten to get tested for coeliac

[Sixties123 in reply to SlowDragon]

Thanks so much x I've been tested for coeliac by blood test and skin biopsies too as you can have coeliac in your skin and that was negative too . I will get vit d test . What are likely to be good levels ? . Again thanks

[fuchsia-pink]

If it were me I think I'd be looking at upping the levo a bit. Your free T3 is 2/3 through range but the free T4 is crawling along the bottom x

[Sixties123 in reply to fuchsia-pink]

I was thinking this fuchsia-pink . Might be worth a try .

[SeasideSusie Remembering]

Poppyrocks369

I am on Levo plus T3 combination and if my FT4 was the same as yours I'd be virtually bedbound. I need my FT4 much higher in range, almost the same as my FT3, I'm best when both are around 60-70% through range. It's not the same for everyone, some people are fine with a very low FT4, but it's just a thought.

[Sixties123 in reply to SeasideSusie]

Hi thank you . What dose are you on please? A d when do you take the medication ? Appreciate your reply. Lesley x

[SeasideSusie Remembering in reply to Sixties123]

Poppyrocks369

I take my Levo plus half my dose of T3 around 4-6am when I need the bathroom, the second half of my T3 I take at 5pm.

To be honest, my doses are of no relevance, this is because we all have different needs. The amount of T3 we need depends on how much natural conversion of T4 to T3 we still have, whether we have optimal nutrient levels (your Folate and Ferritin aren't optimal). Also, my latest results show lower levels of FT4 and FT3 than normal so I have changed batch of T3 to see if the out of date T3 I was using has lost it's potency or whether there is another reason.

[Sixties123 in reply to SeasideSusie]

Ahh I see . I dont actually get up for bathroom . So have been taking my levo and half the t3 at around 1030 /11 am and then the next bit of t3 at around 6 pm maybe I'm doing it all wrong . Cheers

[SeasideSusie Remembering in reply to Sixties123]

Poppyrocks369

When taking thyroid meds, in order that nothing affects its absorption, we should

* Take it on an empty stomach, one hour before food or two hours after.

* Take it with a glass of water only, no tea, coffee, milk, etc. Water it for one hour either side.

* Take it 2 hours away from other medication and supplements, some need 4 hours (Vit D, iron, calcium, magnesium, oestrogen, maybe others).

[Sixties123 in reply to SeasideSusie]

Oh no ! I've been taking all wrong . I will rectify this . Thank you

[Hidden]

You may be one of these people that need their levo a bit higher or need their t3 a bit higher. When ft4 is very low sometimes some of us need high t3. It is very individual.

[Sixties123 in reply to Hidden]

Thank you for your advice. I will ask these questions.

Lesley