Late Update with my blood results - need help

[Anic]

I've been meaning to get back since last posts with my blood results but life catches up.

I had a few probs that came up earlier this year which gave me a bit of a jolt. I had eye problems and of course it was over the weekend so I had to go to the Emergency at the Eye Hospital. After extensive tests over 2 days etc and a visit to my Ophthalmologist the next day it was decided I had a classic case fo "dry eye" so eye compresses and eye drops now. I'm intolerant of the eye drops, even those without preservatives, I get a funny throat and my voice gets croaky/husky So I use them every other day.

then COVID-19 lockdown work etc and few more weird problems; foot pain (under third and fourth toes) on and off for about 8 weeks now. I wear very orthop friendly shoes, been in Birkenstock and Uggs since lockdown (its winter downunder)

Joints are feeling weak and the cold too

Also my hair is probably thinning and my eyelashes are too. Dry skin ...the list goes on.

I have now some lower back pain specially in the last few weeks - probably from lots of pushing and lifting of hubby who has Parkinson’s for over a year, Although he’s a bit better now(touch wood).

Anyways I’m needing some help with direction, thyroid meds etc - I’m on Thyroxine 100mg a day for 5 days and 50mg on day 6 my Endo wanted to reduce it by 50mg last Oct but agreed to leave as is. Also take 600mg Calcium a day

I had thyroid cancer in 2015, total thyroidectomy followed by Radioactive Iodine.

What is the formula for Thyroxine?

I’m only small 154cm and usually 58kg

I’m a bit scared to play around with my meds but would appreciate some advice please.

I’m going to Endo again in October with new blood tests and follow up ultrasound and I would like to be prepared.

My blood results from October 2019

Are:

TSH 0.25

T4 14.8

T3 4.1

Thyroglobulin <0.9

Thyroid antibodies <0.3

Thanking you in advance

[SeasideSusie Remembering]

Anic

What is the formula for Thyroxine?

I’m only small 154cm and usually 58kg

What do you mean by "what is the formula"? Are you asking how much Levo you should be taking based on your height/weight? If so then that has nothing to do with it. You need what you need.

If you've seen on the forum about XX amount of Levo per kg of body weight, then that is in the new UK guidelines to base the starter dose on for newly diagnosed Hypo patients. It then goes on to say that dose is adjusted as necessary.

What is important, and what should guide you is

(a) how you feel - are you still experiencing symptoms of hypothyroidism - if so you are undermedicated, are you experiencing symptoms of overmedication - if so dose is reduced.

and

(b) where your thyroid hormone levels are within their range. The thyroid hormones are FT4 and FT3. TSH is not a thyroid hormone, it's a signal from the pituitary and not particularly relevant for someone already taking Levo, it's useful for diagnosis but should not be a guide to thyroid status for a patient on treatment.

For us to be able to interpret your results, can you please add the reference ranges as these vary from lab to lab, country to country. What we can immediately see is that your TSH is in a good place but we have no idea about your FT4 and FT3. The aim of a treated Hypo patient on Levo, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges if that is where you feel well.

[Anic in reply to SeasideSusie]

Yes what i should be taking based on my height and weight

If i put on weight should it be adjusted ??

I cant say i feel great some of my symptoms make me think maybe im undermedicated?

The range

Are:

TSH 0.25. mlU/L Ref Range (0.40 to 4.00)

T4 14.8 pmol/L Ref Range (9.0 to 19.0)

T3 4.1 pmol/L Ref Range (2.6 to 6.0)

Thyroglobulin <0.9 ug/L <30

Thyroid antibodies <0.3 iuM/L <4.1

[SeasideSusie Remembering in reply to Anic]

Anic

If i put on weight should it be adjusted ??

As I said, weight doesn't come into it for deciding dose once established on Levo. As explained, you go by how you feel and your test results.

I cant say i feel great some of my symptoms make me think maybe im undermedicated?

That's very vague. What symptoms exactly are you experiencing?

TSH 0.25. mlU/L Ref Range (0.40 to 4.00)

T4 14.8 pmol/L Ref Range (9.0 to 19.0)

T3 4.1 pmol/L Ref Range (2.6 to 6.0)

Thyroglobulin <0.9 ug/L <30

Thyroid antibodies <0.3 iuM/L <4.1

Your FT4 is 58% through range, your FT3 is 44.12% through range

(calculator: chorobytarczycy.eu/kalkulator )

So you can see, taking into account what I said before about where most people need their FT4 and FT3, yours are quite low in range and you may feel better if they were around 70% + through range, eg FT4 at 16 and FT3 at 5, of course that's pure guesswork and you'd need to find exactly where you need the levels to feel optimally medicated.

I would say from your current results you may benefit from an increase in your Levo. An increase of just 12.5mcg may be enough. If you do increase then retest 6-8 weeks later.

Your antibodies are nice and low and don't suggest autoimmune thyroid disease (aka Hashimoto's).

[Anic in reply to SeasideSusie]

Hi SeasideSusie

Thank you for the fountain of info and clarifying optimums. I really appreciate it. I do love this site, very valuable link and support for us.

As i take 100mcg Monday-Friday and 50mcg on Saturday and no tablet on Sundays maybe its not tying over?

The calculator is not in English ...what do i need to enter ?

[SeasideSusie Remembering in reply to Anic]

Anic

As i take 100mcg Monday-Friday and 50mcg on Saturday and no tablet on Sundays maybe its not tying over?

Levo (T4) is a storage hormone so there is no immediate reaction to it, some people take their weekly dose all at once under medical supervision.

You are taking 550mcg a week so that equates to 78.57mcg daily. If you want to even it out then you could take 100 and 50 on alternate days and take 1 extra 50mcg tablet on one day and over 2 weeks it would average out at exactly the same dose.

The calculator is not in English ...what do i need to enter ?

It's quite straightforward.

First box is your result.

Second box is lower limit of range.

Third box is upper limit of range.

Click OBLICZ to calculate.

[Anic in reply to SeasideSusie]

Thank you again

[Batty1 in reply to Anic]

Your without a thyroid and your doctor told you to skip meds one day a week ... wow!

[Anic in reply to Batty1]

Yes and she wanted to drop 50mcg so i will be seeing her soon see what we can improve

[Batty1 in reply to Anic]

What issues are you having?

[Anic in reply to Batty1]

i have dry eyes, foot pain under third fourth toes right and sometimes left, joint pain, a bit tired in afternoons, not everyday but a few times a week, hair breaks and some loss, eyelash loss, dry skin, digestion heartburn, lower back pain but that could be from helping hubby who has PD get up and down chair, bed. Just generally not feeling good. Im 63 but i see 90 year olds with more oomph than i have at the moment. Im usually a positive person but Get anxious about my health.