I have Hashimotos and have a new GP. I've been feeling frequent heart palpitations and am wondering if I am over-medicated. A few years ago, after two years of desperate tiredness when my then GP kept switched my levothyroxine doses up and down between 50 - 75 - 100mcg depending on my TSH reading, I saw a private endocrinologist who advised my GP to keep my dose at 100mcg and it has been at that level ever since. I feel fine but I know I should not ignore the fact that I'm now having heart palpitations. On the other hand, I'm concerned that if I lower my dose I will go back to feeling tired all the time.
My new GP agreed to ask for a T3 test but thought the lab would not do it, and indeed it has not been done. Is it correct that it's difficult to test for T3 as you need to do it immediately or the T3 cannot be measured? If it is possible to test for T3, can anyone advise a private test I could have done before any reduction in my dose?
Here are my results, the blood draw was fasting, 24 hours after levothyroxine (100mcg daily), I supplement with vit B12 (Igennus Super B-Complex), vit D (Better You) and magnesium (ReMag), and have been gluten free since 2015. Thank you for any help you may have.
TPO antibodies: 284 (0.00 -34.00)
TSH: <0.01 (0.27 - 4.20)
Free T4: 20.5 (12.00 - 22.00)
Serum vitamin B12: 806 (>179.00)
Serum folate: >20.0 (3.90 - 20.00)
Serum vitamin D: 103 (>59.00)
Serum ferritin: 104 (13.00 - 150.00)
Serum magnesium: 0.9 (0.7 - 1.00)
Serum cholesterol: 5.2 (3.00 - 8.00)
Serum HDL cholesterol: 1.68 (1.16 - 1.68)
Se non HDL cholesterol: 3.5 (no range given)
Serum cholesterol/HDL ratio: 3.1
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Is it correct that it's difficult to test for T3 as you need to do it immediately or the T3 cannot be measured?
No, it's not true. My surgery's tests are sent to our district hospital. If blood is taken before 12 noon it gets picked up and taken to the hospital 50+ miles away. It tends to get tested the same day and results available next day. If blood is taken after 12 noon it's kept in the surgery's fridge and goes to the hospital next day. There is never any problem with the results.
I also do private tests, send blood off same day I do the test, generally it arrives the next day and presumably the test is done the day it arrives as I often get the results the day after I do the test.
If it is possible to test for T3, can anyone advise a private test I could have done before any reduction in my dose?
Never test FT3 on it's own, it needs to be done at the same time as TSH and FT4 and they all need to be looked at together.If you just want TSH, FT4 and FT3 then the cheapest private test is with MonitorMyHealth, normal price is £29 but discounted to £26.10 with code shown here:
Thank you SeasideSusie that is very helpful and I have now ordered the TSH, FT4 and FT3 test you. Ironically MonitorMyHealth sends its tests to Exeter which is 16 miles from my home.... but my local health centre's lab can't or won't do T3 tests!
It's ridiculous that the lab over-rides the GP request. It's a postcode lottery. I've had lots of tests that include T3. Sometimes I just ask the nurse to tick the form for me if the GP forgot. I've never not got a result back. Write to your MP.
Hi, I realise I forgot to ask, please could you guide me regarding TSH levels. Am I remembering correctly that it is optimal to have a reading of less than 1, even though it is below range? I just want to make sure before I speak with my GP. Thank you.
Most Hypo patients on Levo only tend to feel best when TSH is below 1. That doesn't mean it's below range, ranges usually start somewhere around 0.2ish. It is, of course, a very individual thing, we all need our levels where we need them regardless of where anyone else needs them.
How can blood tests be used to manage thyroid disorders?
.....
Occasionally patients only feel well if the TSH is below normal or suppressed. This is usually not harmful as long as it is not completely undetectable and/or the FT3 is clearly normal.
There are also certain patients who only feel better if the TSH is just above the reference range. Within the limits described above, it is recommended that patients and their supervising doctors set individual targets that are right for their particular circumstances.
3) Also, Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the professional magazine for doctors):
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l. In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l. This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).*"
*He recently confirmed, during a public meeting, that this applies to Free T3 as well as Total T3.
You can obtain a copy of the article by emailing Dionne at
tukadmin@thyroiduk.org
print it and highlight question 6 to show your doctor.
All your nutrients and other tests look fine but magnesium is an unreliable test. About 99% of magnesium is stored in bone, muscles and soft tissues, leaving about 1% in the blood. So testing what's in the blood isn't giving an accurate picture of our magnesium status.
A red cell magnesium test is the better indicator of magnesium status, not the standard serum magnesium test.
If you want to read the science, this information is from this article:
Does your Vit D spray contain K2? If not it is an important cofactor of D3 so you might want to consider supplementing with Vit K2-MK7. D3 aids absorption of calcium from good and K2-MK7 directs the calcium to bones and teeth where it's needed and away from arteries and soft tissues where it can be deposited and cause problems such as calcification of arteries and kidney stones, etc.
Thank you again for this further advice. I will read the link you sent on magnesium and consider a private red cell magnesium test. Yes my Vit D spray contains K2. I use one which was recommended on this forum.
ReMyte (Botanicahealth) might also be worth having a look at? I also take this with ReMag.Vitamin D3 might be best taken with K2 to direct the calcium away from arteries and into bones. Heart palpitations might be related to insulin resistance which can cause an electrolyte imbalance so try to monitor when it occurs and if related to fast release carbohydrate foods or high calcium foods.
Dr Isabella Wenz’s book Hashimoto’s thyroiditis is worth a read as is Dr Carolyn Deans book Magnesium Miracle.
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