It’s been a while and with all the madness of the last year I recently realised I had missed my annual thyroid check. Paid to have a medicheck one this week.
I am not sure if my previous results are available on here so have put images in comments of trends. But my basic history is that thanks to you lovely lot I got prescribed T3 about 3 years ago. My symptoms have fluctuated but endo refused to increase dose. I am currently on 100mcg T4 and 20mcg T3 ( was splitting this but advised to take it all once about 6/12 ago and things were better).
Unsurprisingly this year I have felt pretty crappy at times as have most people, but the last few months have been grim. I did a lot of work with a nutritionist last year to improve overall fatigue and bowels which show in my other results of minerals etc but I am still knackered. Absolutely knackered. It doesn’t help I’m waking multiple times a night with palpitations ( fairly sure is work place stress related!) I also work full time, am studying and have 2 young kids, have put on a few lbs that won’t shift either - again suspect I’m not alone in that! Brain fog is awful , and I’ve exams in 2 weeks 😭😭😭😭There is zero point going to my GP as she will not touch my thyroid anymore. Anyway all that being said, here are the results.
I feel better when my TSH is over suppressed ( not sure why???) pbut each time they reduce my Levo dose. The medicheck dr comment said to tell them if I am on thyroid meds... I clearly told them in supporting health information! Did not take anything with biotin in either.
I basically would like to know if it is worth contacting the endo privately and asking for a review or just carry on? 🤓🤓 or whether to source my own T3 and T4 and top up?!!
Thanks
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It's difficult to comment on the fluctuations with those previous results unless we know if every test was done under the exact same conditions, we always advise testing no later than 9am, nothing to eat or drink except water before test, last dose of Levo 24 hours before test, last dose of T3 (or NDT) 8-12 hours before test even if it means splitting dose and adjusting time the day before if necessary.
Do you have autoimmune thyroid disease (Hashimoto's) generally shown by raised thyroid antibodies?
I feel better when my TSH is over suppressed ( not sure why???) pbut each time they reduce my Levo dose.
You take T3, and T3 tends to lower/suppress TSH. No point in reducing Levo to try and get your TSH back into range, it just wont happen if you are on T3.
So that we can interpret your results accurately, can you tell us exactly when you took your last doses of Levo and T3 before this current test?
As for nutrients, what supplements/dose are you taking? Active B12 is OK although I'd want mine over 100, Folate and Vit D are on the low side.
Hi Seaside Suzie, lovely to talk to you again thanks for the swift reply. Supplement wise I am currently using the Vit D spray Better You D Lux and taking a general multi Vit. Nothing else at the moment.
Ferritin level was 68.89ug/L ( 13-150).
Regarding TSH suppression they keep saying I need to reduce my T4 but I previously fought it. At one point was on 150mcg T4 and 20mcg -T3.
My Levo and T3 dose were taken 24 hours previously as test was first thing.
I had antibodies tested previously which were negative.
My Levo and T3 dose were taken 24 hours previously as test was first thing.
OK, so your FT4 will be accurate but your FT3 will be showing a false low because the time gap is too long. However, even allowing for that, if T3 was taken as advised I expect it would be low in range and when on combination hormone replacement one expects to see an upper range FT3 with a lower in range FT4.
So overall it would seem that you are undermedicated with both Levo and T3.
How do these results compare with your latest NHS results, do you have a copy of those results/reference ranges?
Supplement wise I am currently using the Vit D spray Better You D Lux and taking a general multi Vit. Nothing else at the moment.
If those were my results I'd increase the Vit D dose to get my level within the range recommended by the Vit D Society and Grassroots Health, which is 100-150nmol/L, and ensure I take D3's important cofactors - magnesium (helps the body convert D3 into it's usable form) and Vit K2-MK7 (directs the extra uptake of calcium from food [which D3 aids] to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems).
As for multivitamins, they are not recommended here. They contain too little of anything to help low levels, often contain the cheapest and least absorbable form of active ingredients, and often contain things that we should be tested for first, eg calcium, iron, iodine. If it contains iron then that affects absorption of everything else as iron needs to be taken 2 hours away from any other supplements or medication.
Folate is recommended to be at least half way through range. Medichecks actual range is 3.89-19.45 so with that range we're aiming for a level of 12+
Active B12 below 70 suggests testing for B12 deficiency, so even though you are above that, it would be better over 100.
For your folate and B12 I would suggest you consider supplementing with a good quality B Complex such as Thorne Basic B or Igennus Super B.
Ferritin is recommended to be half way through range, so around 82 with that range. Eating iron rich foods regularly should help raise then maintain your level, liver is the best way to raise ferritin (maximum 200g per week due to it's high Vit A content) or liver pate, black pudding, and other iron rich foods are listed here:
HiI don’t have an NHS test, as I said a lot of routine testing has fallen by the wayside this end. I did the medichecks test to see for myself if it was worth the arguing with the GP for an NHS test . Each time I speak to her all I get told is how much I cost her in T3! Irrespective of why I attend.
Looking back:
In Dec 2017 I did a medicheck test. As I felt awful a year after giving birth and was told I had PND.
TSH 1.88 (0.27-4.2)
T3. 2.7 (3.1 - 6.8)
T4 12.4. ( 12-22)
Total thyroxine - 61.2 (64.5-142)
Thyroid anti. <10 ( <115)
Thyroid perioxidase 25.8 (<34)
Annual bloods Sept 2018 on 125mcg levo
TSH 0.01 ( 0.55- 4.78)
No T3 or T4 levels done
Referred myself to endo in April 2019 privately who started me on 10mcg T3 and 125mcg T4 .
Interim review with no bloods based on symptoms increase me to 125mcg Levo and 10mcg BD T3. For the life of me can’t find the blood result for that visit.
August 2019 (100mcg Levo + 10mcg BD T3)
TSH <0.0.1. (0.55-4.78)
T4 10.8 ( 10.1 - 18.7)
T3 3.9 ( 3.5 - 6.5)
Felt reasonable so was left for my annual check in August 2020 which didn’t happen and here I am .
I will get onto the supplements you recommend. Do you think it is worth me contacting the endo again? Is it likely that an increase will be beneficial?
Each time I speak to her all I get told is how much I cost her in T3! Irrespective of why I attend.
Oooh, ooooh, that would prompt me to reply with "Do you say that to your patients receiving chemotherapy?" I remember how much one round of chemo cost when my late hubby was receiving it, for some reason they gave him "one last round" two weeks before he died (and told him how much it cost) and I never did understand why they gave it to him, they'd already told him it was terminal and how long he had left!
Looking at past results both FT4 and FT3 appear to have always been low, but of course I don't know if the tests were all done under the same conditions.
OK, so if you can't get NHS tests done and just go by your Medichecks test, even taking into account the longer than normal gap between T3 and test, you would appear to need an increase in both, but we shouldn't increase both at the same time.
If those were my results I think the first thing I'd do is increase Levo by 25mcg and see if that brings FT4 into range, it should do and it should also increase FT3 a bit depending on how much natural conversion you still have. Wait 6-8 weeks then retest to see where your FT4 and FT3 lie and then make a decision as to whether it's Levo or T3 you increase next. You may need a few tweaks to get to where you feel good.
I don't know if contacting your endo is going to do you any good, he seems to have been reluctant to increase your dose before, and I don't understand that when your FT4 and FT3 levels have been so low.
Absolutely! I did point out to her last time that the T3 had made me go from basically a zombie to a fully functioning member of society and I didn’t actually ask to have a conversion problem. Also that I am a non smoker, very occasional drinker, not over weight, exercise regularly etc so do all I can to maintain my health and that of my family! Thankfully I’ve not been back to see her since 🤣🤣!
What an awful thing to say to your husband, shows a total lack of empathy, brain and kindness. I am sorry that you and he were exposed to someone like that.
I have no idea why he is reluctant to increase it, maybe a cost? He asked me outright I if I take the meds as it looks a bit off.
Regarding tests i have always followed the advice about 24hours, fasting , first thing testing. My old school GP who prescribed it to me in the first place and was far more interested in how I felt rather than a blood test told me to do that. How I miss him!
From a practical perspective I suppose I would be easier to source the T4 myself than T3?
I have no idea why he is reluctant to increase it, maybe a cost?
The British National Formulary currently shows the cost of T3 to be
28 x 10mcg tablets - £148
28 x 20mcg tablets - £136.96
and Levo costs:
28 x 100mcg tablets - £1.26
so your GP will be complaining about the cost of T3.
He asked me outright I if I take the meds as it looks a bit off.
Very likely you look "a bit off" because you are so undermedicated. I don't actually know how you're getting out of bed with those levels, I wouldn't be able to. I remember having a decent FT4 level with FT3 at 2.8 (2.8-7.1) and the endo was oh so happy because my TSH had just crept back into range (he had reduced my Levo with the aim of achieving that) and I was very ill, had to be looked after for 2 years following that and never worked again!
From a practical perspective I suppose I would be easier to source the T4 myself than T3?
Not necessarily. Some suppliers only offer T3, some offer both. Put a post on the forum asking for recommendations by private message, then send me a PM asking if I have any feedback on the recommendations you have been given
I do wonder how I am. I think I am on the verge of crashing but so hard to know if it is thryoid related, child related, stress related ( work in healthcare and my team is on its knees due to COVID redeployment, increased workload and vacancies) .
I feel like I have nothing left to cheer my team on with , or hold them together with. I’ve come to the conclusion that because I’m so bloody stubborn I just keep truckin on! 🙄🙄Suspect a combo of all 3. This is what triggered the blood test really. I’ve got exams in 10 days and I literally cannot remember anything. 🤯😭
I will pop a post up shortly. Thank you so much 💐💐
I feel so much for you, I don't know how you can keep going. At least I was able to stop work (we had a restaurant and my husband managed without me and my work could be done by him and others).
I’ve got an appt with my endo on 9.4.2021. Not holding out much hope as I’m worried he will reduce my levo but let’s see what he says before I source my own! 😢
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