What about these results?: My doc wants me to... - Thyroid UK

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What about these results?

lisan1 profile image
10 Replies

My doc wants me to have a tsh within ref range. Am taking 100 t4 and 10 t3. I have long covid so I don't have the energy to fight. What do you think about these results? I'm sure the doc will lower either lio or levo on my next appointment and frankly I'm so ill anyway.

TSH <0.01

Ft3 5.1 (3.6-6.3)

Ft4 19(12-22)

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lisan1 profile image
lisan1
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SlowDragon profile image
SlowDragonAdministrator

Essential to also test vitamin D, folate, ferritin and B12

What vitamin supplements are you currently taking

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)

If/when also on T3, 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?

Presumably you have T3 prescribed through endocrinologist?

GP should not be meddling with dose

Anyone who is on T3 will almost always have suppressed TSH, it’s irrelevant as long as Ft4 and Ft3 are within range

lisan1 profile image
lisan1 in reply to SlowDragon

all of those are tested and good. That's how I have my tests done. Shall I let her lower dose? It would be nice to take as little meds as possible...

SlowDragon profile image
SlowDragonAdministrator in reply to lisan1

Optimal vitamin levels

Vitamin D at least around 80nmol and around 100nmol maybe better

Serum B12 at least over 500

Active B12 over 70

Folate and ferritin at least half way through range

Are you on strictly gluten free diet?

Personally I would refuse to reduce dose

Ft4 and Ft3 are exactly where they should be when on levothyroxine plus T3...if anything Ft3 is slightly low

When on levothyroxine and T3 we need to be taking high enough dose to replace thyroid hormones as thyroid has completely stopped working if TSH is suppressed

Lotika profile image
Lotika

Personally, if they were mine, I would be very pleased with them - they look like a thing of great beauty, as fT3 and fT4 are towards the top of the range but don’t look like they’re about to shoot over it any time soon. But I take the view that TSH will likely drop through the floor with the merest sniff of T3 and therefore would not be worried by the low TSH for this reason. Others’ mileage may vary, though, so worth hanging around for more and probably better advice!

As for doctor, if s/he wants to change dose, but you don’t, argue that you will stay like this for now and retest in 8 weeks, because you don’t know what impact long COVID has on thyroid test results :P

You can then put off the fight until you are feeling a bit better!

SlowDragon profile image
SlowDragonAdministrator in reply to Lotika

Agree absolutely ☺️

shaws profile image
shawsAdministrator

Unfortunately the majority of doctors seem to have been told that a very low TSH means we have become hyper-thyroid but that isn't the case.

Before levothyroxine was introduced (T4 alone), we were prescribed NDT (natural dessicated thyroid hormones) that contains all of the hormones a healthy gland would have without blood tests and giving gradual increases until we felt welt. We then remained on that dose with maybe a few slight adjustments until patient felt well..

Doctors used to diagnosed us through our clinical symptoms alone but Big Pharma introduced blood tests which gives them more profits and doctors have lost the skill of diagnosing patients without blood tests.

SeasideSusie profile image
SeasideSusieRemembering

lisan1

Looking pretty good, if anything there's room for FT3 to go higher.

How do you feel - maybe a stupid question as you have Long Covid, but can you separate that from how you normally feel thyroid-wise?

Very unlikely to have TSH within range when on T3, taking T3 lowers and maybe even suppresses T3, it's just what it does. Don't let GP alter dose, or is the endo who wants to lower it?

lisan1 profile image
lisan1 in reply to SeasideSusie

That's the problem I don't know what's what any more. Was taking 100+20 for a long time but when I got covid me heart rate went highwire and the Dr blamed that on suppressed TSH. I don't know what to do anymore since I'm so ill. 😔

SeasideSusie profile image
SeasideSusieRemembering in reply to lisan1

lisan1

It's awful when everything is blamed on TSH, I've had it myself and when I would not agree to lower my dose the GP walked out of the room and left me there with the nurse.

As Lotika has said, use your Long Covid as your reason for not messing with your thyroid meds at the moment, your actual hormone levels are not over range, they are well within range so don't suggest overmedication, I wish doctors would learn that T3 brings TSH down and stop just looking at TSH and look at the actual thyroid hormone levels.

SlowDragon profile image
SlowDragonAdministrator in reply to lisan1

taking 100+20 for a long time

If you were previously taking 20mcg and now taking 10mcg this could be contributing to some of your symptoms

What were results when on 100mcg plus 20mcg

Do you normally split your T3 dose?

Perhaps consider adding 3rd 5mcg dose T3 back in

Have you taken any probiotics since you had Covid

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