I have recently realised that I am symptomatic the usual with gp etc telling me my thyroid is in range. Having been requesting telephone consultations 4 blood tests later i explain that the t3 level is only just in range.
It suddenly occurred to me that it seems to be a pattern. I have depression or anxiety am immediately prescribed an antidepressant then gradually I develop more and more hypothyroid symptoms. I was horrified when I read an article this evening.
This is not the first time whilst receiving gp care that again my thyroid is dismissed and not even considered. I am so upset.
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Pawsedagain
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oh yeah, this happened to me for three years as the symptoms piled up and I was left severely debilitated. He ran every test to blame it on something else and ignored the obvious low T3 levels. It got so bad I'm on a medical leave at this time. It wasn't until I got out all my blood tests and compared results over the past fours that I discovered a pattern as well. I'm also very upset at my Dr.
Definitely. I too was put on anti depressants. My tiredness became so bad they then had to increase my thyroid meds, now I’ve come off the antidepressants I feel over medicated. They 100 percent interfere with the absorption if Levothyroxine.
What i don't understand is that i have to do the research and asks for tests .and keep exaining what t3 is. When I am unwell . The damage caused to my body from my liver to kidneys and heart then I'm put on.more meds with side effects to counteract the effects of being under treated.
Presumably you have Hashimoto’s as you have type one diabetes
Have you had coeliac blood test
Are you on strictly gluten free diet
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Ask GP to test vitamin levels
Common for conversion of Ft4 to Ft3 to get worse as we get older
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)
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
Thank you for your advice and apologies for the late reply. I have struggled to but now found the results. My latest results 8th October. Unfortunately no vitamin or iron level tests for over 18months. Will have to call back and ask for further tests.
Clearly Ft3 is rock bottom and TSH higher than typical
You need thyroid antibodies tested too
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Ask GP to test vitamin levels
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 .
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
Tomorrow I plan to go for vitamin and iron blood tests as you advised.
However I am just wondering how if the issues I now have with my liver will get better. My cholesterol has risen to 8.8!! I was absolutely horrified when I received the results. Is this what is referred to as Non Alcoholic liver disease?
If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.
The aim of levothyroxine is to increase the dose slowly upwards in 25mcg steps until TSH is under 2, Ft4 is in top third of range and Ft3 at least 60% through range
See GP for 25mcg dose increase in levothyroxine
Bloods should be retested 6-8 weeks later
Most people on levothyroxine have TSH well under one when adequately treated
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.
Most patients will feel well in that circumstance.
But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
(That’s Ft3 at 58% minimum through range)
You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor please email Dionne at
I am prescribed levothyroxine 175mg 3 days a week and 150 for 4. However since last Thursday I met my new endocrinologist he agreed that I could increase to 175mg every day of the week. I've been asked to return for blood tests 6 weeks from then.
So your results are extraordinary considering such high dose levothyroxine
Essential to always take levothyroxine on empty stomach and then nothing apart from water for at least an hour after
No other medications within 2 hours
What vitamin supplements are you currently taking
Are you on strictly gluten free diet or lactose free?
Lactose intolerance is very common with autoimmune thyroid disease and lactose intolerance frequently results in needing higher dose levothyroxine than typical
Which brand of levothyroxine are you prescribed
Do you always get same brand
Recommend getting vitamin levels tested at next test, if not earlier
I have been gluten ftre for about 8 or 9 years however about 2ce a year I will have bite of birthday cake. I had never been completely dairy free I wi eat eggs, and have a small amount of yoghurt or cheese. I did want to go completely dairy free and. But was admonished sorry advised not to. The same as eith gliten
I wait an hour before any drink and 2 before coffee.
I take hrt 2 hrs after.
My levo 50 and 100 micrograms are both almost.
The 25microgram is Mercury Pharma.
I've always been on a high dose for levo. Prior to 2012 I was on 225 or 275.
Apologies I hope my reply is clear.
Will ask gp if possible.ifnot I will get vitamins tested privately.
So it’s looking like you may be gluten and lactose intolerant
If lactose intolerant then you should be prescribed lactose free levothyroxine
Likely to have low vitamin levels
Getting levothyroxine dose fine tuned and all four vitamins optimal is first steps
But likely to need addition of small doses of T3 prescribed alongside levothyroxine too
Email Dionne at Thyroid UK for list of recommend thyroid specialist endocrinologists who will look in depth at malabsorption issues and may prescribe T3 if necessary
Email Dionne at Thyroid UK for list of recommend thyroid specialist endocrinologists...NHS and Private
tukadmin@thyroiduk.org
The aim of levothyroxine is to increase dose upwards until Ft4 is in top third of range and Ft3 at least half way through range (regardless of where TSH is) ...important to have optimal vitamin levels too as this helps reduce symptoms and improve how levothyroxine works
Too little of what you do need, usually the cheapest, least absorbable ingredients, plus most contain iodine too (not recommended for anyone with Hashimoto’s)
This seven seas supplement also contains biotin so you ALWAYS need to stop any supplements that contain biotin a week before ALL BLOOD TESTS as biotin can falsely affect test results
Vitamin D - dose likely too small
B12 possibly too little
Far better to test vitamin D, folate, ferritin and B12 then only supplement what we need using good quality vitamin supplements
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