Latest test results and they actually did all of them this time, much to my amazement.
TSH 0.02 mU/L (0.20-4.5mU/L)
Free T4 24.3 pmol/L (11.00-22.00 pmol/L)
Free T3 5.1 pmol/L 3. (10-6.80 pmol/L)
TSH suppression is about where it has been for some years and the surgeon is reasonably happy with that because I am only taking 1.25 mg Levothyroxine (no thyroid) but has referred me for a bone density scan because I have been suppressed for 11 years. Calcium levels have always been ok though. Should I consider a reduction?
Feel well apart from the continual struggle against weight gain despite diet and exercise and high Testosterone problems but that is more likely to be because of PCOS.
Would a Levothyroxine reduction help at all?
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annnsandell
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For full Thyroid evaluation you need TSH, FT4 and FT3 tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
What vitamin supplements are you currently taking?
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?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
Your results are virtually identical to mine, my doctor is also happy to leave well alone, if you feel fine then best not to try rocking the boat but reducing dose, I have never had weight gain and could actually do with some extra weight so I can't answer that bit for you 🙂
"the reduction in bone mineral density due to thyroxine is small. It is unlikely to be of clinical significance and should not on its own be an indication for reduction of thyroxine dose in patients who are clinically euthyroid."
No, the bone density scan is irrelevant to medication. I think my bone density is fine but worth having the xray particularly because of my other symptoms and my Mother had brittle bones. Thank you
Feel well apart from the continual struggle against weight gain despite diet and exercise
Could very well be the diet and exercise that stop you losing weight, because it will affect conversion. And, your conversion isn't good.
So, don't consider reducing your levo unless your endo suggests replacing it with T3. Because if you reduce the levo, the FT3 will also reduce, and you'll probably put on even more weight.
Since you haven't a fully functioning working thyroid you're feedback loop is broken and the reliance on a TSH measurement for dose and or management of thyroid hormone replacement totally inadequate.
I don't think the TSH being suppressed is an issue - yes we are told about the risks of a low suppressed TSH but we then learn on here that, again, the more recent research and people's experiences likely to contradict the dogma, and the longer your TSH has been suppressed the less likely it is to recover.
If you dropped your Levothyroxine by 25 mcg daily you would probably just fall into the range and with a bit of luck your TSH might move to " please " those concerned but there's no guarantee.
What will be guaranteed is that your T3 will drop down a little and that might risk you becoming more hypothyroid than you are currently.
No thyroid hormone works well if ferritin, folate, B12 and vitamin D are not maintained at optimal levels so you might like to get these checked out.
Your conversion ratio of T3 / T4 is coming in at 4.76 -just divide one into the other - and most people feel well when the ratio is around 3.5 - 4.50 most preferring to be down at around 4 or under, so conversion might improve with optimal vitamins and minerals.
Whilst it's perfectly acceptable to run T4 slightly over range to get a good level of T3 conversion - I don't think this is working well for you : as your T4 is running at 121% through the range but your T3 lagging behind at just 54 % through the range.
The logical option is to drop your T4 a little and introduce a small proportion of T3 - the active hormone your own thyroid once gave you, that now isn't there.
A fully functioning working thyroid would be supporting you on a daily basis with approximately 100 T4 + 10 T3. T4 is a storage hormone which your body needs to be able to convert into T3 - the active hormone that the body runs on. I read T3 - Liothyronine is about 4 times more powerful than T4 and the average person uses about 50 T3 just to function.
Your thyroid is a major gland responsible for full body synchronisation, your mental, physical, psychological, emotional and spiritual well being, your inner central heating system and your metabolism, and living without a thyroid comes with it's own set of issues.
Some people can get by on T4 alone, some people at some point in time simply stop converting the T4 into T3 and some people simply need both these vital hormones dosed and monitored independently to bring them both into balance and to a level of wellness acceptable to the patient.
Thank you for your thoughts. Probably unlikely that anyone is going to recommend T3 at the present time with those results but certainly worth a try when T3 if more readily available. I will have this conversation when I get the opportunity. My surgeon is only interested in supression to prevent regrowth and cancer. I have an Endo for PCSO and she thinks the thyroid function is ok, not sure I want this fight, I would rather she helped with the excessive Testosterone, although that is proving difficult. Vitamins have always been good and I top up Vit D.
Your FT4 is over range this is usually considered hyperthyroidism and as far as bone scan is concerned If you show any sort of low density the endo most likely will reduce your dose.
Thyroidectomy for thyroid cancer can mean losing parathyroid glands that regulate calcium levels. I presume you haven't lost yours. But we also lose c cells that produce calcitonin and nobody seems to know what the long term result is, so I think keeping an eye on bone density is a good idea.
Yes my parathyroid glands are fully intacted, the surgeon worried first of all that they may have been damaged by all ok. Very good surgeon considering he did two operations. Good point on c cells. Thank you and good information for others.
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