New test results, a little advice please?

[DonnyJam]

Currently taking:

3 x metavive 2

50mcg T3.

Test results today:

TSH 2.29 mIU/L (Range: 0.27 - 4.2)

Free T3 5.92 pmol/L (Range: 3.1 - 6.8)

Free Thyroxine X 5.770 pmol/L (Range: 12 - 22)

I know tsh could do with being a little bit lower and T3 a little higher probably wouldn't hurt but I'm not sure if the low T4 really matters with T3 where it is?

I upped from 2 metavive to 3 a few days before I decided to get a test so I'm guessing those levels will rise over the next few weeks also.

Should I add in some more T3 or should I be looking at raising T4 instead? Or the other option would be test again in another 3 weeks to see where the 3rd cap of metavive takes me?

Thanks, Jamie

[Lalatoot]

You are wasting your money testing so often. The body needs time to settle and balance after each change be it changes in t4 or t3 dosing. To give it time to stabilise 8 weeks is a general rule. If you test more often you risk not getting a true reflection of your levels. And consequently risk altering doses in the wrong way.

I would do nothing at the moment.

[DonnyJam in reply to Lalatoot]

Thanks,

Ahh my mistake, it's been a while since I had to test and retest. I thought it was 4 to 6 weeks and thought the 8 week approach was more the lazy inadequate NHS way of doing things.

[SlowDragon Administrator]

When were vitamin D, folate, ferritin and B12 last tested

What vitamin supplements are you currently taking

Are you on strictly gluten free diet

Bloods should be retested 6-8 weeks after each dose change

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)

If/when also on T3, or NDT or Metavive make sure to take last third or quarter of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you do your tests?

[DonnyJam in reply to SlowDragon]

When were vitamin D, folate, ferritin and B12 last tested,

Unfortunately I haven't had these tested for a while but I try to keep on top of taking those apart from iron supplements as they give me stomach problems.

Are you on strictly gluten free diet,

I've been on and off with this as its really difficult to resist eating Gluten foods indefinitely, I have however returned to a gluten free diet over the last couple of months,

If/when also on T3, or NDT or Metavive make sure to take last third or quarter of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test,

I take me metavive and t3 first thing in the morning so tests are done before meds but not 8 to 12 hours after last.

[SlowDragon Administrator in reply to DonnyJam]

I upped from 2 metavive to 3 a few days before I decided to get a test so I'm guessing those levels will rise over the next few weeks also.

Only ever test after 6-8 weeks on constant unchanging dose

results show falsely low Ft3 results if last dose was 24 hours before test

On day before testing you need to split the dose

You might find it better to split dose every day

Some people find they need GOOD levels of Ft4 and Ft3. Other people find low Ft4 isn’t a problem

Suggest you get full thyroid and vitamin testing in 6 weeks, making sure to split dose day before

Remember to stop taking any supplements that contain biotin a week before ALL BLOOD TESTS as biotin can falsely affect test results

[Jodypody in reply to SlowDragon]

So if for instance you had a blood test booked for 9am and you usually take say 3 grains all in the morning how would you dose on blood test day?

[SlowDragon Administrator in reply to Jodypody]

Don’t you normally split dose anyway?

Day before blood test

You would split into 3

One grain waking. One grain mid afternoon

Last grain 9-11pm

[DonnyJam in reply to SlowDragon]

I used to a long time ago then I read that for homeostasis reasons it's better to take it all in the morning as that mimics how the body releases thyroid hormones in a person that has no thyroid issues

[Jodypody in reply to SlowDragon]

Never have done, don’t have the time or the inclination it’s too complicated when I have supplements to take etc