Advice please

[Girl6789]

Hello

I've been struggling for a while with tiredness levels, heavy periods being put on several pills and still having near constant bleeding. I have a very stressful job but really struggling and with covid have just let it go the last few months i have gone from 65kg to 58kg at 5 ft 8.5 without trying. Think I need some more private tests but got some from doctors surgery and looking for any advice in the interim currently on 200 levo a day after completion thyroidectomy in January 2019.

Thank you

Serum ferratin 18 range (15-400)

Serum free T4 15 range (10-22)

Free T3 4.3 (3.3-6.8)

Serum TSH 0.44 range (0.3-5.5)

Total white blood count 7.8 10*9/L [4.0 - 10.0]

Red blood cell count 4.53 10*12/L [3.8 - 4.8]

Haemoglobin concentration 130 g/L [120.0 - 150.0]

Haematocrit 0.41 [0.36 - 0.46]

Mean cell volume 91 fL [83.0 - 101.0]

Mean cell haemoglobin level 28.8 pg [27.0 - 32.0]

Mean cell haemoglobin concentration 304 g/L [315.0 - 345.0]

Below low reference limit

Platelet count - observation 293 10*9/L [150.0 - 410.0]

Neutrophil count 4.9 10*9/L [2.0 - 7.0]

Lymphocyte count 1.9 10*9/L [1.0 - 3.0]

Monocyte count - observation 0.6 10*9/L [0.2 - 1.0]

Eosinophil count - observation 0.2 10*9/L [0.0 - 0.5]

Basophil count 0.1 10*9/L [0.0 - 0.1]

Any advice gratefully received.

[Lotika]

I am replying - not because I know much that will be useful - but because sometimes it is nice to get a quick reply, so please excuse enthusiasm and potential ineptitude!

I observe two things:

1. That the ferritin does not look good... others will have ideas in how to increase it - I am eating liver, onions, bacon and mash every Tuesday for mine, for example.

2. We are approx same height and weight right now and I would have better results on 100 mcg levo so I am curious about that. I wonder, are you - or have you tried - GF? It looks like the body isn’t getting great uptake from the levo and gluten or general poor gut issues could potentially have something to do with it? I am assuming you were Graves to have the thyroidectomy and therefore antibodies could be a thing?

On the other hand, fT4 suggests you need more meds...I like my fT4 higher. FT3 not awesome either, I’ve been worse, but it could be lower than you need to feel well.

Basically, I can see why the numbers would mean you are still symptomatic and it looks like the body’s not absorbing all the levo.

Do you take it 1 hr before tea or coffee and on an empty tummy? I assume you do... to me, it looks like an uptake issue... ? Hang tight and others who know more will surely arrive soon! Hopefully my response gets the discussion started for you nonetheless.

Just editing to ask if you have ever had tests for endometriosis? Some of this sounds similar to a friend of mine in that regard.

[SlowDragon Administrator]

Obviously your ferritin is far too low

Hopefully humanbean or SeasideSusie will comment on full blood tests

Important to also test vitamin D, folate and B12

What vitamin supplements are you currently taking

Was test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Are you on strictly gluten free diet, or tried it?

Currently results show poor conversion of Ft4 to ft3

Ft4 is 42% through range

Ft3 only 29% through range

Helpful calculator for working out percentage through range

chorobytarczycy.eu/kalkulator

This suggests you are still under medicated as Ft4 is under 60% through range

Are you lactose intolerant?

Or suspect you might be?

Lactose intolerance often results in needing high dose levothyroxine

Many people after thyroidectomy need addition of small doses of T3 prescribed alongside levothyroxine

[Girl6789 in reply to SlowDragon]

Hello, I had my test at 8:30 am earliest test of the day and 24 hours after last dose of levo with no food/drink except water. I haven't been taking any vitamins and will have to get these tests done privately I think as doctor is saying results are fine.I am lactose intolerant and am on a gluten free diet. Thank you for your help

[SlowDragon Administrator in reply to Girl6789]

So which brand levothyroxine are you currently taking ?

Obviously needs to be lactose free.

Are you on strictly dairy free diet too

[Girl6789 in reply to SlowDragon]

I'm taking teva and I'm on a strict dairy free diet.