Latest Medichecks Results, any clues?

[axism]

I am now on 50mg Thyroxine + ERFA 30mg (1/2gr) and these are my latest results from Medichecks. I'm feeling better(ish) but not great. Exhaustion is the one thing that is causing real problems. I keep having to nap just to get through the day. Fortunately I am working from home at the moment.

My TSH is the only thing now out of range on the Medicheck results.

Is there anything else I should be looking into, adrenals etc..

Many thanks in advance!

CRP HS: 1.11 mg/L

FERRITIN : 174 ug/L 30 - 400 R

FOLATE - SERUM: 9.02 ug/L > 3.89 R

VITAMIN B12 - ACTIVE: 150 pmol/L > 37.5 R

VITAMIN D: 76.5 nmol/L 50 - 175 R

TSH: 6.77 mIU/L 0.27 - 4.2 R

FREE T3: 4.97 pmol/L 3.1 - 6.8

FREE THYROXINE: 15.5 pmol/L

THYROGLOBULIN ANTIBODIES: 13.4 kIU/L < 115 R

THYROID PEROXIDASE ANTIBODIES: 20.7 kIU/L < 34 R

[jrbarnes]

How long have you been on this combo? I've contemplated mixing NDT and Levo but currently trying a synthetic T4/T3 combo. Since you're on a combo you have an option to increase the Erfa by 15mg, which would slightly increase the T4 and T3 or you can increase the Levo by 12.5 to 25mcg increments.

[axism in reply to jrbarnes]

Thanks for the info. I've been on this regime for about 10 weeks at the request of the endo. I was hoping to be feeling a bit better than I am. I am probably just being inpatient. My results are allot better than when I was just on thyroxine but how I feel doesn't reflect that yet.

[SlowDragon Administrator in reply to axism]

So you either need to increase levothyroxine or NDT

[jrbarnes in reply to axism]

I read one of your post from 3 months ago and yeah I suspect I also had hypo from my teens and it wasn't discovered until I was 27, now 40. It started with low motivation, sleeping in classes and family gatherings. You're not being impatient because you should be systematically increasing every 6 weeks. You don't feel well because you're not getting enough thyroid hormone. You can't always dose according to the TSH but in your case it's saying that you're way undermedicated. 30mg of Erfa gives you 4mcg of T3 and 18mcg of T4. It's not a huge amount of T3 but you may not need that much added. NDT + Levo can be a little tricky to work out but you'll only find out by increasing one or the other. I'm not a health professional but if I had your results I would start with an increase in Levo of 12.5 mcg or increase by 15mg of Erfa(half of a 30mg.) When you increase the Erfa due to the added T3 you may feel better for a short time however it will take the T4 longer to build up. It's a slow game and can't be rushed. I just started a Levo/T3 combo this week. Previously I was on 88mcg of Levo for 10 years with my T4 levels at the very top and T3 levels sadly around 50%. My TSH was 1.5 to 1.88 because I was undermedicated. Before medication it was 5. Currently, I'm taking 75 mcg and 7.5 mcg of T3 . At this point I'm sitting on this dose of T3. T4 can stick around for awhile so in a week I may have to increase my T3. I hope this example helps.

[axism in reply to jrbarnes]

Thanks for the detailed information. Yes your situation is very similar to mine, I feel I've been hypo pretty much since I contracted glandular fever when was a teenager. I was only diagnosed hypothyroid when I was about 30. Up until that point I had just made up for my lack of energy by exercising like crazy to wake myself up, but that option only worked when I was younger. I've ended up in hospital a couple of time recently when trying to push through the symptoms.

It's a crazy balancing act getting the medication right. I have now spoken to my endo and shown him the latest results, and he has decided to increase the ERFA to 60mg a day so we will see how it goes. Thanks again for your reply, very interesting.