Help with thyroid results please

[TiredMummy]

Hi there,

I have my latest thyroid bloods and wondered what people thought. I haven’t gone all out and done the all singing and dancing tests offered by Blue Horizon. I might do this at some stage but I’m interested in what people think of these test results in the meantime.

TSH <0.01 (0.30 - 4.20)

Free T4 - 17 (9-19), Free T3 - 4.9 (2.60 - 5.70)

The blood test was taken 26 hours after taking 125mcg Levothyroxine, I’m not on T3.

Thanks hugely for your help, I’m having fatigue, brain fog etc but trying to work out if this is menopause symptoms or low T3 conversion.

[fuchsia-pink]

I think it shows pretty good conversion - and good levels through range. Because you left more than 24 hours from taking levo, you have a slight "false low" in your results, but as these stand, your free T4 is 80% through range and free T3 is 74% through range. So maybe check nutrients next??

[TiredMummy in reply to fuchsia-pink]

Thanks Fuchsia pink, glad to hear that as I think every other time I have posted on here the wise forum have advised me that I was converting to T3 poorly. It’s encouraging to see I’m moving in the right direction. It could be because I’ve reduced my oestrogen & also space it now as far away from my thyroid meds as possible. I’m suffering from insomnia at lot at the moment so I suppose I don’t look over medicated then??

[fuchsia-pink in reply to TiredMummy]

You're ONLY over-medicated when free T3 goes over-range - so not there yet!

Your GP will probably say you're over-medicated if your TSH is suppressed - but he's wrong - just goes to show you can't tell much if all you look at is TSH ...

But not getting enough sleep - whether small babies, menopause or whatever - is very tiring, so hope you get your mojo back soon x

[TiredMummy in reply to fuchsia-pink]

Ah i see, thanks for clarifying

[pennyannie]

Hello TiredMummy

Well your thyroid conversion is pretty good :

Your T4 is 80% through the range and your T3 a little lower at around 75% :

There is room for an icrease in T4 which might just take your T3 a little higher but seeing as your TSH is suppressed you'll probably have a conversation with your doctor wanting you to drop your dose, not increase it.

Since you still have symptoms of hypothyroidism it might help to ensure that your ferritin, folate, B12 and vitamin D are at good, optimal levels, as these could well improve conversion if a dose increase isn't forthcoming.

[TiredMummy in reply to pennyannie]

Thank you Pennyannie. Out of interest, if I were to get my Levothyroxine raised....I wonder what I would raise it to? I’m on 125mcg daily currently so to 150mcg or might that be too much? I also have some T3 which I could consider adding in but again, not sure how much I’d start with.....I have T3 because I was prescribed it when I wasn’t converting very well but never got on with it. I think in hindsight it might have been because I was taking it close to my oestrogen medication & I’m a bit more clued up now and taking my thyroid meds as far away from my Thyroid meds as possible!

X

[pennyannie in reply to TiredMummy]

Hey there,

Well it seems your conversion must have improved quite a lot - unless my maths is wrong ?

The next dose up will be 150 mcg but if you get the 50 as 2 x 25mcgs. rather than a 50, you could always split one 25mcg tablet in half thereby giving you 12.50 and 137 daily.

I don't know of the interaction of HRT and thyroid hormone replacement, but have read similar to what you find yourself now having to do.

As for the T3, again, not too sure what to say - when I took T3 my conversion was very poor with my T4 at around 110% and my T3 at around 60% - I dropped 25mcg T4 as I was at the top/over range and took 6.25 T3 and my brain became switched on again.

I felt a bit turbo charged on T3/T4 but then I'm without a thyroid having Graves Disease and RAI thyroid ablation back in 2005.

I'd been refused both T3 and NDT on the NHS in early 2018 and that's when I started DIY. I've now moved onto NDT as it seems softer on my body and was easier to source back then but currently I think that table has turned around.

[TiredMummy in reply to pennyannie]

Yes, my conversion has improved mostly I think from diet improvements & dosing it as far away from oestrogen as possible. The thing is, I crash and feel hot & nauseas after taking my Levo. Since my T4 is looking pretty healthy & T3 could do with a slight lift, I’m wondering if I should try dropping the T4 slightly to 112.5 (one 100 & half a 25mcg) & adding in 5mcg T3 (quarter of a 20mcg). I know my thyroid results look the best they ever have but it feels too much overload for my body to deal with at once. I took this blood test 26 hours after taking 125mcg T4 so I can imagine they look a bit more how I feel if I had the bloods done say even 4 hours after taking Levo. I get better as the day goes on so can’t help feeling I might be overloading & overwhelming my body first thing. I’ve tried taking Levo at night on at least 4 separate trials but never seemed to work for me. I’m tempted to try reducing the T4 & adding T3 tomorrow to see if it eases the pressure I feel building up after taking 125mcg T4. My whole body feels under strain if you know what I mean!

[pennyannie in reply to TiredMummy]

OK then, I get the feeling you are gonna' go for it anyway ???

If you work on the ratio 1/4 - drop 25 mcg T4 and add about 6.25 T3 and just see how you go :

The relief I found from the very first time I tried this was measurable - it was like a light switch going on and my brain fog totally lifted :

[TiredMummy in reply to pennyannie]

Ok, that makes sense. I will probably try dropping to 100 T4 with 5 T3 and any crumbs that fall to get as close to 6.25 as possible. Will see how it goes tomorrow morning! The other option I guess is to try this alternate dosing ive seen mentioned before when you alternate say between 100mcg T4 & 125mcg which might also be the answer to this ‘build up’ feeling I get.

Thanks for your help, it’s hugely appreciated that you’ve taken the time to respond. I’m extremely grateful 😊

[pennyannie in reply to TiredMummy]

No worries - the other alternative would be to split the T4 x 25 mcg in half giving you 12.50 and then take this everyday with the 100 T4 and have continuity of dose at 112.50 T4 daily ?

It's all trial and error - and you'll probably have to learn from your own mistakes - as I have, and as I'm sure many of us have.

[TiredMummy in reply to pennyannie]

Hi Pennyannie, yes another good idea but funnily enough I’ve tried that one before and sadly it didn’t suit me. I think, because I get all my T3 off the back of my T4 intake, I start to feel the drop in T3 fairly quickly and this has a negative impact on my well being. I think either dropping T4 and adding in T3 or T4 alternate 100 & 125 T4 dosing are definitely worth a go....Will drop it to 100 initially tomorrow & see how brave I feel about adding in T3 straight away!

[pennyannie in reply to TiredMummy]

OK then, fingers crossed for you:

[TiredMummy in reply to pennyannie]

Hi Pennyannie, well yesterday I tried dropping to 100mcg T4 as planned. I know this forum is full with extremely wise members that will advise me it’s not feasible to feel any significant impact for quite a while (days/weeks) but I obviously don’t fit the mould as I always notice the difference by late afternoon/evening. Anyway, dropping to 100mcg was a no go (without adding in T3 at any rate). Symptoms were worse and by the evening my cognitive ability (Brain barely functional) most noticeably and insomnia. Since my conversion looks to be ok, this makes me inclined to reconsider that my symptoms aren’t too much T4 in one go but actually symptoms of hypothyroidism and I might feel better on slightly more T4 to get my T3 optimised. I think I might try this next in the first instance by just upping by half a 25mcg (like you suggested) so I’m on 137.5mcg as opposed to 125mcg. If that doesn’t work, & this would take more time to work out for me than a T4 drop....then I could try dropping T4 & adding T3. If this doesn’t work then I’ll have to consider the symptoms I’m experiencing aren’t thyroid related but menopause related or something else. I’ve been a detective on my health for 10 years now.....I’m hoping one day I will totally crack it. It’s all very complicated though isn’t it!?

[pennyannie in reply to TiredMummy]

Hey there,

Maybe drop to 112.50 + 5 T3 ? and see how that feels :

With a view to adding a little extra T3 in the pm after a week or two if you still run out of stream ?

[TiredMummy in reply to pennyannie]

Oh yes! Very good idea, hadn’t thought of that.....definitely worthy of a try. I hope I find some alleviation soon as I’ve got a stupid big responsible job whilst feeling awful most of the time. It’s been easier to hide thank goodness during lockdown and think I would probably had to resign with the school commute and full working day in the office otherwise. I’m extremely lucky and grateful to have a job and it’s no picnic either if you feel unwell and don’t have a job as it’s stressful finding one and dealing with income loss too so there’s no escape when you feel dreadful most the time which ever way you swing it. I just hope the majority of people find a solution which works for them, it can be a long and lonely road!