Help needed with these blood test results! Im new here!

[Neesie45]

I have recentley had my dosage reduced from 100 to 75, had terrible symptoms constant palpitations and exhausion, dry skin, restless legs, insomnia, had to send away for a private test as tsh was in normal range, gp agreed to trst t3 and 4 this is the result, i think i may have a conversion problem and need t3, but dont know how to go about this, im in Bristol

[SlowDragon Administrator]

TSH is far too high at 4.88

Ft3 BELOW range

Ft4 is high .....did you take levothyroxine dose before blood test

The aim of levothyroxine is to increase the Dose in 25mcg steps until TSH is under 2. Many people will have TSH well under one

Most important result is Ft3. This should be roughly 60% through range.

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

Have you had thyroid antibodies tested

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 .

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

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/thyr...

Why was dose reduced from 100mcg?

Do you have results from then?

Do you always get same brand of levothyroxine

Which brand of levothyroxine are you currently taking

Many people find Levothyroxine brands are not interchangeable.

Many patients do NOT get on well with Teva brand of Levothyroxine. Teva contains mannitol as a filler, which seems to be possible cause of problems. Teva is the only brand that makes 75mcg tablet. So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half

Are you currently taking Teva?

Teva, Aristo and Glenmark are the only lactose free tablets

dropbox.com/s/6h3h0qi4eqwi6...

Teva poll

healthunlocked.com/thyroidu...

Once you find a brand that suits you, best to make sure to only get that one at each prescription.

Watch out for brand change when dose is increased or at repeat prescription.

academic.oup.com/jcem/artic...

Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).

Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after

Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime, or middle of night

verywellhealth.com/best-tim...

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.

Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

What vitamin supplements are you currently taking

[Neesie45 in reply to SlowDragon]

I did the test first thing before any food or drink, i am on teva, switched over from Actavis (I think) 4 months ago, i have always taken my levo dfirst thing in the morning before my tests and have never had results like this, i had a test done Blue Horizons thyroid panel 5 weeks ago, results hs-CRP 0.68 <5.0 mg/L

Ferritin 69.8 13 - 150 ug/L

Magnesium H 1.03 0.7 - 1.0 mmol/L

Hormones

Cortisol (Random) 448.0 6am - 10am 113 - 456 nmol/L

4pm - 8pm 58 - 278

Midnight <64

Thyroid Function

TSH 0.56 0.27 - 4.20 mIU/L

T4 Total 130.0 66 - 181 nmol/L

Free T4 H 29.0 12.0 - 22.0 pmol/L

Free T3 3.78 3.1 - 6.8 pmol/L

Immunology

Anti-Thyroidperoxidase abs <9.0 <34 kIU/L

Anti-Thyroglobulin Abs 15 <115 kIU/L

Vitamins

Vitamin D (25 OH) 87 50 - 175 nmol/L

Vitamin B12 524 Deficient <145 pmol/L

Insufficient 145 - 300

Consider reducing dose >569

Serum Folate 26.80 8.83 - 60.8 nmol/L

Was considering taking dosage at night, taking B complex, mag 365 bone complex, rhodiola and selenium thanks for your input

😀

[elwins in reply to Neesie45]

Can I ask you why you switched to Teva, was it the chemist because you had your dose reduced as Teva are the only one who make a 75. I have just come off teva as I found the fillers did not agree with me. I take a 50 and 25 to make a dose of 75. See comments from other members on here. I have gone back on to my previous brand. Some people get on with teva well but others do not. Hope you soon get sorted with all the excellent help on this site.

[Neesie45 in reply to elwins]

I was getting a lot of palpitations so they changed me over to see if it made an difference, but as you can see from the blood tests i have too much t4 and not converting im guessing, i have a 50 and a 25 of teva, seems like a very good sourse of information thank you 👍

[SlowDragon Administrator in reply to Neesie45]

was getting a lot of palpitations so they changed me over to see if it made an difference,

Suspect palpitations were due to low Ft3.....on reduced dose likely worse

Vitamins are good

Your clearly poor converter of Ft4 to ft3

[SlowDragon Administrator in reply to Neesie45]

i have always taken my levo dfirst thing in the morning before my tests and have never had results like this

Last dose of levothyroxine should be 24 hours before test

That’s a FALSE high Ft4 result as you took levothyroxine before blood test

Ft4 result is false high

But Ft3 is only 24% through range

your results show TERRIBLE conversion

Helpful calculator for working out percentage through range

chorobytarczycy.eu/kalkulator

Low Ft3 will be causing symptoms

As you REDUCED dose after this previous test, Ft3 has now dropped even further below range

Email Dionne at Thyroid UK for list of recommend thyroid specialist endocrinologists who will prescribe T3.......NHS and Private

[e-mail]

Like many, many patients, You are likely to need addition of T3 alongside levothyroxine

Endocrinologist may trial liquid levothyroxine first

[Neesie45 in reply to SlowDragon]

Thank you for your response, and all the great nformation and links, i know feel i am armed with my amunition when i speak to my gp im going to try and get a referral fingers crossed

[SlowDragon Administrator in reply to Neesie45]

Roughly where in the U.K. are you

See if there’s a recommended endocrinologist near you on the list from Thyroid U.K.

If not, many are currently doing consultations via zoom. So might be useful option