latest bloods

[malohant]

Hi folks

Just had my latest blood tests through (medichecks) and wondered if I could bother anyone for an opinion...

TSH: 0.23 (0.27-4.2)

Free T4: 20.1 (12-22)

Free T3: 4 (3.1-6.8)

Vit D: 71.5 (50-175)

Active B12: 116 (>37.5)

Folate: 10.3 (>3.89)

Ferritin: 74.8 (30-400)

(for history see here: healthunlocked.com/thyroidu... )

B12 has improved a little, Vit D and Ferritin have actually dropped a bit (if you look at the test range for D... but I guess the drop in D is to be expected in winter?) and more worryingly my T3 has also dropped (T4 roughly the same). Folate has never been a problem.

I am taking 2 Igennus B-Complex daily (no extra B12), Vit D 1000 IU daily (with K2 and magnesium), L-Glutamine daily and have just started Betaine HCL with Pepsin daily (since tests). I am in the third (gut support) stage of the Wentz Hashi's protocol, basically AIP diet, and have felt that it has shown some small improvements (which are not to be scoffed at!). I'm eating chicken liver pate and cooked leafy greens to try to keep my iron intake up. I'm having meat at breakfast and dinner to make sure I'm getting enough protein (with pea protein in lunchtime smoothie) - mostly turkey, some pork/uncured bacon, beef at least once a week.

I'm still exhausted pretty much all the time (although I'm sure I'm better than I was in the summer). I find it difficult to concentrate, and the brain fog gets worse when I get more tired. I rarely sleep through the night, often lying awake for long periods. I get restless, unable to sit still for too long yet also unable to get up and do much.

I have a phone call with the doctor tomorrow morning (the GP also did blood tests, roughly in line with the above - TSH 0.24, FT4 a little lower at 18.8) and would like to be prepared. It's been 10 months and I still don't feel even as good as before I started taking levo so I feel I should be able to ask for an appointment with an endocrinologist, right? Is there anything else I should be doing, or that I should bring up with the GP?

Thanks in advance, as always any thoughts/tips/advice will be very much appreciated

Happy holidays x

M

[jrbarnes]

Was this test done before 9am? Your T4 levels are higher in range but your T3 levels are lower in range which is why you don't feel well. Pushing my T4 higher only kept my head above water still with lingering symptoms. The only way I could solve this issue was to start adding small increments of T3(liothyronine) to my Levothyroxine. Happy Holidays

[malohant in reply to jrbarnes]

Thanks jrbarnes !

The GPs test was done at 8.30am, the medichecks at about 9.15am I guess. I'm going to push for an endo appointment to get T3, but I understand T4>T3 conversion depends on good gut health (which is why I've been following the Wentz protocol) to see if I can improve it in the meantime. What I don't get is why my T3 is dropping... but yes I get the 'keeping head above water' feeling! Some days its definitely easier than others...

[jrbarnes in reply to malohant]

T3 levels can fluctuate but here is an article below that might explain why that could be happening.

thyroidpatients.ca/2018/12/...

[SlowDragon Administrator]

Are you still on 100mcg levothyroxine

Always same brand levothyroxine?

TSH slowly increasing ......you may be ready for small dose increase in levothyroxine soon ....but GP very unlikely to agree. They will look at low TSH and may even want to reduce dose....but refuse to do so

Suggest you increase your vitamin D dose

[malohant in reply to SlowDragon]

Yes still 100mcg levo. Always Northstar 100s (Accord/Actavis).

Happily GP agreed with you, suggested at next blood test I might increase dose on alternate days or something. Also suggested increase in Vit D.

I asked about a referral to an endocrinologist and they said they hadn't suggested it because my TSH/T4 are both within range so I would be unlikely to get anywhere, and they 'wanted to save me from an unsatisfactory experience'. I argued that this whole year has been an unsatisfactory experience so could they please try anyway, lets see what happens.

Thanks as always SlowDragon , very much appreciated

M

[SlowDragon Administrator in reply to malohant]

Many of us been forced to see private thyroid specialist endocrinologist to make progress

See if increase in levothyroxine improves low Ft3 ....unlikely to make significant improvements

If not..... it’s time to consider addition of T3 alongside levothyroxine

Roughly where in the U.K. are you

[malohant in reply to SlowDragon]

I'm in the southwest, I've already done a little research (mainly around NHS endocrinologists). Fully anticipating needing to go private eventually but figure it makes sense to at least give NHS route a chance.

[SlowDragon Administrator in reply to malohant]

Well Devon 2nd highest and Kernow CCG is 3rd highest prescribing area....

openprescribing.net/analyse...