Big Increase in T4/T3 levels after small increase in Thyroxine

[Thyroidconfusion]

I hope you can help with these latest results. My wife increased her Thyroxine from 75-100 mrg in November following some low results and we just received the following test as the T4/T3 has increased a lot. At least these results show that she is converting T4-T3. We have focused on increasing Vitamin D for Thyroid and Covid Reason which may explain the increase. Are the current levels too high, I know you recommend that levels should be at the higher end of the ranges. I am also concerned about the GGT and other liver function test and the Ferritin levels but these may not be Thyroid related. Any comments on the results below. Do we need reduce the Thyroxine back down assuming the better levels of Vitamin D have increase conversion. Thank you for any feedback

THYROID FUNCTION TESTS

Thyroid Stim. Hormone L 0.01 0.270 - 4.2 mIU/L (previous 0.45)

Free T3 6.4 3.1 - 6.8 pmol/L (previous 3.3)

Free Thyroxine (FT4) H 23.4 12 - 22 pmol/L (previous 17.1)

Thyroid Peroxidase Antibodies <5 0 - 34 kIU/L Method: Roche Cobas

Total Thyroxine (T4) 151.00 59 - 154 n (previous 87)

C Reactive Protein (high sensitivity) 1.83 <3.0 mg/L

25 OH Vitamin D 96 75 - 175 nmol/L

Hb A1c (mmol/mol) 35 20 - 42 mMol/Mol

LIVER FUNCTION TESTS

Total Protein 70 63 - 87 g/L

Albumin 42 34 - 52 g/L

Globulin 28 19 - 35 g/L

Alkaline Phosphatase H 181 <130 U/L

Alanine Transferase H 68 10 - 35 U/L

Gamma GT H 176 <42 U/L (previous 91)

Bilirubin 9 <15 umol/L

LIPIDS

Cholesterol H 6.3 <5.2 mmol/L

Triglycerides 0.83 <2.0 mmol/L

Non-Fasting: <2.3 mmol/L

HDL Cholesterol 2.08 1.0 - 3.88 mmol/L

HDL % of Total 33 >20 %

Non HDL Cholesterol H 4.22 <4 mmol/L

LDL Cholesterol H 3.8 <3.4 mmol/L

Triglyceride/HDL Ratio 0.40 <1.74 Ratio

HAEMATINICS

Ferritin H 164 13 - 150 ug/L

Active B12 71.0 37.5 - 188 pmol/

[Lalatoot]

If you do decide to reduce levo I would only reduce it by 12.5mcg initially to see what effect it has.

[SlowDragon Administrator]

High cholesterol suggests not over medicated

No folate result

What other vitamin supplements is she currently taking

How much vitamin D?

If she feels slightly over medicated I would suggest even smaller reduction...perhaps reducing levothyroxine by 25mcg per week and retest in 6-8 weeks

So 100mcg 5 days a week and 87.5mcg twice week

Or preferably.......leave dose as is and retest in further 6-8 weeks

[Thyroidconfusion in reply to SlowDragon]

Thank you for your response. She feels well and some symptoms such as cramps have gone. If the levels are not a concern then staying where she is is probably a good option. Thanks

[greygoose]

There's something not quite right, here. An increase of 25 mcg levo and increased intake of vit D doesn't seem likely to be the cause of such a huge increase in both FT4 and FT3. Looks more like a Hashi's 'hyper' swing, to me. I know her TPO antibodies are low, but has she had her Tg antibodies tested? Also, 20% of Hashi's people never have over-range antibodies, so Hashi's is still a possibility even if both antibodies are negative. It would take an ultrasound to diagnose it.

If I were you, I'd be more concerned about the B12 level than the ferritin. I wouldn't want my B12 that low.

[Thyroidconfusion in reply to greygoose]

Thanks. the last TG she had in November was <5 on a range of 0-34 so again very low. I presume that this makes Hashi's less likely. We will look at addressing the B12 and leave the dosage as it is for another 6-8 weeks or reduce by 12.5mcg. Thanks alot for the response

[greygoose in reply to Thyroidconfusion]

Makes it less likely, but by no means impossible. And, given the increase in your Frees in that last test, I would think it's very possible.

[Thyroidconfusion]

Thanks I have just read an article that has linked Levothyroxine with liver disease. Can anyone comment. Could this be the reason for high GGT and other liver scores? Thanks

[Partner20 in reply to Thyroidconfusion]

Liver damage due to levothyroxine is extremely rare, and usually seems to be associated with additives to the medication which are not present in UK meds. In addition to abnormal liver results, of which all seem to be abnormal, not just one or two, liver disease symptoms such as pain and jaundice are present. Your GP should run the liver panel again, and refer you to a hepatologist if abnormal results are returned again.

[Thyroidconfusion in reply to Partner20]

Thank you good to know.

[Gismo333]

Hi Just reading your post with interest and all the tests you have posted.

I don't like to make sweeping statements but I'm afraid it is the only way..

No thyroid test is accurate, you are only looking at blood serum levels, it is the cellular uptake of the thyroid hormone that matters. It really isn't any good looking a the blood, the tests were only brought in as a guide but then the medical profession took them as fact and used the TSH and T4 as the plan to treat hypothyroidism. Your wife will not get well on this regime however many times you test. Also T4, which was promoted by Dr Anthony Toft who brought the tests in over 40 years ago has now changed his mind and states that T3 must always be given with T4 in case of a conversion problem. I have spent 25 years studying this and have written a book which I hope will be out this year. I nearly lost my life on T4 and the TSH. I now go to a doctor in Belgium but she is now doing this online. There is no valuation like it in this country as the whole body is covered. If you would like anymore help or details just DM me I will be happy to help