Blood results : Thanks for the help with regard... - Thyroid UK

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Blood results

goofball profile image
11 Replies

Thanks for the help with regard to my last results.

One last question, if the doctor wants to increase my Levothyroxine to 100 from 75 this still will not help with my conversion of T4 to T3 as I have Hashimotos.

My results are T4 -22.6 (12-22)

TSH -4.4 (0.27-4.2)

T3 -3.3 (3.1-6.8)

Thank you Slow dragon and SeasideSusie for your help with my previous post

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goofball
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SlowDragon profile image
SlowDragonAdministrator

Yes it probably will. Most people convert Ft4 to Ft3 pretty well

TSH is still far too high so this confirms you need dose increase in levothyroxine

Important to regularly retest vitamin levels and keep levels optimal by supplementing. This helps improve conversion of Ft4 to Ft3

Many people find Levothyroxine brands are not interchangeable.

Once you find a brand that suits you, best to make sure to only get that one at each prescription.

Watch out for brand change when dose is increased or at repeat prescription.

Many patients do NOT get on well with Teva brand of Levothyroxine. Teva contains mannitol as a filler, which seems to be possible cause of problems. Teva is the only brand that makes 75mcg tablet. So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half

Teva and Aristo are the only lactose free tablets

healthunlocked.com/thyroidu...

Teva poll

healthunlocked.com/thyroidu...

academic.oup.com/jcem/artic...

Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).

Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after

Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime

verywellhealth.com/best-tim...

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap. Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

greygoose profile image
greygoose

My personal opinion is that no, it won't help much. You're conversion is very poor. And at the point you're at, with your FT4 over-range, most of your T4 will be converting to rT3 rather than T3, you'd have to take an awful lot of levo just to get your FT3 up to range. Which will mean that you have very high rT3. And, whilst rT3 doesn't have any immediate effect on anything, we don't really know what effect it could possibly have long-term. And, remember, this is for life.

Your TSH is high because your FT3 is so low. It doesn't mean you need more levo. So, if I were you, I would be looking into the possibility of procuring T3, rather than increasing levo.

SlowDragon profile image
SlowDragonAdministrator in reply to greygoose

goofball took levothyroxine 10-12 hours before test, so Ft4 was false high

greygoose profile image
greygoose in reply to SlowDragon

In which case, we cannot possibly know her true FT4 level, nor how well she converts.

goofball profile image
goofball in reply to greygoose

Thank you for your replies.

My TSH is at one of the lowest that it has been, having been, starting on diagnosis (Oct 2017)with 11.4, then 7.2, 7.3,6.8,4.5,6.9,6.5,4.0,6.5, never having gone down below 4. I also did have a gluten free diet for around 6 months, with little affect on my results. I did buy Isabella Wentz's book.

I believe that I did on one of my tests leave 24 hours between doses of Levo and without remembering exactly which test it was, it did not make much difference to my TSH as you can see or FT4 level.

I'm thinking along the lines of greygoose, in that I do need T3, but as I have said in a previous post, the Endo that I visited was not interested.

I did e mail the lady who has a list of endos who prescribe, but all are miles away from me.

I'm still despite all your advice at a loss what is the best thing to do. I do not think increasing Levo to 100 will affect much as greygoose suggests, it made my T4 go too high when this was prescribed before, and I was put back onto 75.

I am taking vitamin D, and B12, and maybe as suggested a B complex and iron tablets may help.

I could get a private test, but am still not sure how this will help me, if it is T3 that I need and T3 is not available to me on the NHS without seeing an Endo that will prescribe this.

As you say this is for life so the cost of the tests would be negligible.

Thank you once again for your time.

goofball profile image
goofball in reply to goofball

Oh and is this why I have piled on the pounds?

greygoose profile image
greygoose in reply to goofball

My TSH is at one of the lowest that it has been, having been, starting on diagnosis

Yes, but it's not the TSH the most important result. The most important result is the FT3.

I also did have a gluten free diet for around 6 months, with little affect on my results.

I wouldn't expect a gluten-free diet to have much effect on your results. What is important is if the gluten-free diet made you feel better. It does for a lot of people.

I believe that I did on one of my tests leave 24 hours between doses of Levo and without remembering exactly which test it was, it did not make much difference to my TSH as you can see or FT4 level.

The gap between your last dose of levo and the blood draw won't have any effect on the TSH, because it doesn't move that fast. But, it will give you a false high FT4. So, if, as far as you know, you've never left 24 hours, then you've always had a false high FT4, and we have no means of knowing what your normal circulating levels is, nor how well you convert. It many not make much difference, but we cannot know that with any certainty. You cannot compare results unless they are done under the exact same conditions.

I'm thinking along the lines of greygoose, in that I do need T3, but as I have said in a previous post, the Endo that I visited was not interested.

But we cannot know for certain that you do. You could just be under-medicated. 75 mcg is just a small dose.

I do not think increasing Levo to 100 will affect much as greygoose suggests, it made my T4 go too high when this was prescribed before, and I was put back onto 75.

I didn't say it wouldn't affect much, I said it wouldn't make your FT3 go high enough to make you well. But, I said that before I knew that you hadn't left 24 hours between your last dose and the blood draw. That changes everything.

If going up to 100 mcg made your FT4 go too high, it was probably because you didn't leave 24 hours between the last dose of levo and the blood draw. This is so important, I can't say it often enough.

I am taking vitamin D, and B12, and maybe as suggested a B complex

If you're taking B12 you need to take a B complex because the Bs all work together and need to be kept balanced. The individual B vitamins do not work well on their own.

I could get a private test, but am still not sure how this will help me

At least you would know what's going on if you did full testing. It would help you decide what to do next. But, no point in doing it if you don't leave the full 24 hours between your last dose of levo and the blood draw.

if it is T3 that I need and T3 is not available to me on the NHS without seeing an Endo that will prescribe this.

You could source and buy your own T3. Like so many of us do. And, we're all here to help you take it correctly and safely.

is this why I have piled on the pounds?

You've put on weight because your FT3 is so very low, and you are still hypo. A TSH over 4, with very bottom of the range FT3 is the very definition of hypo, no matter what your FT4 is. But, that could actually be low, too...

goofball profile image
goofball in reply to greygoose

Thank you so much, very very helpful :)

greygoose profile image
greygoose in reply to goofball

You're very welcome. :)

SlowDragon profile image
SlowDragonAdministrator

A year ago ...all vitamins low and bloating

healthunlocked.com/thyroidu...

When were vitamins last retested ?

Vitamins need to be optimal

Bloating is common gluten intolerance symptom

Improving low stomach acid very commercial problem

goofball profile image
goofball

Thanks, vitamins tested in February this year, apart from vitamin D, last tested in april 2019. The bloating was a massive ovarian cyst, which negligently my doctors faffed around with before it was diagnosed. Just serves as a warning to others, as I was told to go on a fodmap diet first, then I was told it was constipation, then when I went back for the third time they decided to listen and actually look at my stomach. In my head it was all to do with thyroid and diet. Had a full hysterectomy. Anyone experiencing symptoms like myself the gynecologist said you must request a scan.

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