Latest medichecks results

[Joad467]

Hello here are my latest results please would someone help me decipher them,I had levo cut to 75 from 100 the last few weeks, yet report says so am over medicated,I don't understand it,thank you 🤯

[SeasideSusie Remembering]

Joad467

report says so am over medicated,I don't understand it

This is where there's no point in having doctor's comments. They are NHS trained so they think the same as our GPs and only look at TSH not the actual thyroid hormones - FT4 and FT3. So your TSH of 0.01 is way below range and that is telling the doctor you are overmedicated. But look at your FT4 andFT3 - FT4 is bottom of range and FT3 is 32.16% through range.

It would appear tha you are getting no benefit from the 75mcg Levo, it's doing nothing for you, if it was your FT4 would be higher in range. However, it's unusual to have such a low TSH with such a low FT4. So let's see if there is a reason that maybe the results are skewed.

Did you drink just water before the test (coffee affects TSH so we expect other caffeine containing drinks might also.

Did you take B Complex in the week before the test?

Something must be wrong because when you posted your Medichecks results a couple of weeks ago they were

FT4: 22.3

FT3: 4.85

so it doesn't make sense that your FT4 has now plummeted to 12.

[Joad467 in reply to SeasideSusie]

Thank you Seaside Susie,I left off the levo the night before,had no supplements all week,did r the test early in the morning the only change was the reduction on levo 🙄

[SeasideSusie Remembering in reply to Joad467]

Joad467

So am I right in thinking that these results were on 100mcg Levo:

FT4: 22.3

FT3: 4.85

and these latest results are on 75mcg Levo:

FT4: 12

FT3: 4.39

I left off the levo the night before

Is nighttime your usual time to take Levo? If so we need to change time of taking Levo a couple of days before testing so that we only leave 24 hours between last dose and blood test. So it was more than 24 hours between last dose of Levo and blood test? In that case you have a false low FT4 but it's not possible to guess where your level would be if you'd done the proper time gap.

[Joad467 in reply to SeasideSusie]

Yes that's correct ,I do tend to take levo just before sleep,since the doctor cut my levo I had started adding small amount of tiromel thank for reply 👍

[SeasideSusie Remembering in reply to Joad467]

Joad467

If I were you I'd do the test again and make sure you change the timing of your Levo and only leave 24 hours between last dose and the test, that way you are going to get an accurate result and there will be no guessing.

If you do the test, say, on a Monday then you'd take Saturday night's Levo on Sunday morning, do the test Monday morning, take Sunday night's Levo immediately after the test on Monday, then take Monday night's Levo as normal.

If you're going to add T3 then you need to know where both FT4 and FT3 are so you can get advice on how to dose with T3.

[Joad467 in reply to SeasideSusie]

Ok thank you Seaside Susie👍

[SlowDragon Administrator in reply to Joad467]

since the doctor cut my levo I had started adding small amount of tiromel thank for reply

As I suspected

Adding almost any dose T3 will dramatically reduce TSH and that’s exactly what’s happened

How much T3 are you currently taking

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

Also common when adding T3 that Ft4 drops and dose levothyroxine often needs increasing ....as metabolism has improved

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

[Joad467 in reply to SlowDragon]

Thank you ,I have been taking 20 mcg

[Joad467 in reply to Joad467]

So would I still need to increase levo? Thanks

[SlowDragon Administrator in reply to Joad467]

Good grief that’s not a small dose

No wonder TSH is suppressed

Standard starter dose of T3 is 1/4 tablet (6.25mcg)

After week, assuming going ok.....add 2nd 1/4 dose 12 hours after 1st dose

2-3 weeks later add 3rd 1/4 tablet and change to dosing at 8 hour equal intervals

As you have missed all those steps

Suggest you now split dose

10mcg at 7am, 5mcg at 3pm and 5mcg at 11pm

Retest in 6-8 weeks

Day before test change times slightly

Testing 9am following morning

10mcg at 7am, 5mcg at 2pm and 5mcg at 9pm

[Joad467 in reply to SlowDragon]

Thank you SlowDragon am grateful for your advice will start doing what you recommend immediately 👍👏

[Joad467 in reply to SlowDragon]

Just to clarify I mostly take the tablets sublingually,is it better to swallow them instead,thank you

[SlowDragon Administrator in reply to Joad467]

Definitely swallowing on empty stomach and then nothing apart from water for at least half an hour (45-60mins better)

[Joad467 in reply to SlowDragon]

Thank you 👍

[SlowDragon Administrator]

Levothyroxine was reduced

Now Ft4 is right at bottom of range at 0% through range

and Ft3 only 29% through range

So you need dose increase in levothyroxine (despite low TSH)

Aim is for Ft4 and Ft3 to be roughly 60% through range minimum

Vitamin D is far too low

Folate borderline

Ferritin result?

What vitamin supplements are you currently taking

[Joad467 in reply to SlowDragon]

Thank SlowDragon,I know doctor won't increase levo,so that's a pain,I take vit D and K2, selenium,chromium,vit c,

Normal

[SlowDragon Administrator in reply to Joad467]

Then you need to see thyroid specialist endocrinologist

Roughly where in the U.K. are you

Many endocrinologist currently doing consultations on zoom ....makes it easier to see who you want

[SlowDragon Administrator]

Looking at previous posts

You are on strictly gluten free diet already I think

You have very poor conversion of Ft4 to Ft3, common when gluten intolerant

Likely to need addition of small doses of T3 prescribed alongside levothyroxine

But first step is to get levothyroxine dose increased back to 100mcg and work on getting all four vitamins optimal

Email Thyroid UK for list of recommend thyroid specialist endocrinologists who will prescribe T3

NHS and Private

[e-mail]

When adequately treated, TSH will often be well under one. Most important results are ALWAYS Ft3 followed by Ft4. When adequately treated Ft4 is usually in top third of range and Ft3 at least 60% through range (regardless of how low TSH is)

Extremely important to have optimal vitamin levels too as this helps reduce symptoms and improve how levothyroxine works

[Joad467 in reply to SlowDragon]

Thank you yes GF,I do have some tiromel but not sure how much to take 🙄

[SlowDragon Administrator in reply to Joad467]

You probably need levothyroxine dose increased first

Most people on levothyroxine and small doses of T3, need both Ft4 and Ft3 at GOOD levels

Almost any dose of T3 will suppress TSH, so it’s important to be taking high enough dose levothyroxine before starting on T3

[Joad467 in reply to SlowDragon]

I live in Devon

[SlowDragon Administrator in reply to Joad467]

Suggest you put up post asking members for any recommended thyroid specialists by PRIVATE MESSAGES who prescribe T3 in or near Devon

[Joad467 in reply to SlowDragon]

More

Normal

[Joad467 in reply to Joad467]

Great thankyou SlowDragon 👍

[SlowDragon Administrator in reply to Joad467]

Yes....waste of time reading “doctor advice” from Medichecks....they can’t even see that Ft4 is 0% through range....how can you possibly be over medicated

Results look like they are from someone on levothyroxine plus T3 (and in need of increase in levothyroxine)

[Joad467 in reply to SlowDragon]

Thanks,so I need to get more T4 and gradually increase?

[SlowDragon Administrator in reply to Joad467]

Yes. If GP won’t increase levothyroxine you need to see endocrinologist

[Joad467 in reply to SlowDragon]

Ok thank you 😊