Wonky TSH and low FT4. What is happening?

[Moore-23]

TSH is slightly wonky. FT3 is better but FT4 is low. I have been taking Thyrogold for over a year now. What is happening? Advice really appreciated. (Vitamins levels seem OK.)

[tattybogle]

Presumably the TSH is higher because the fT4 is now so low. Your results from a year or so ago on Levo showed TSH was much lower when fT4 was nearer to top of range.

But do you feel alright ? or at least , better than on Levo ?

If you do, TSH doesn't matter (and some TSH is useful to have as it helps promote your own thyroidal production of T3 and also improves deiodinase conversion of T4 to T3.)

On the other hand if you don't feel alright, TSH 2.78 could be indicating you have room for a higher dose.

Having said all that , it's maybe a bit unusual to have a TSH level of 2.78 when taking something which (may ?) include some T3, as any T3 usually makes for really low TSH .

Have you had any other results done while taking Thyrogold to compare these to ?

[Moore-23 in reply to tattybogle]

Many thanks tattybogle for your reply. I do still feel sluggish and I probably do need to increase my dose of Thyrogold. I am much better for taking this rather than levothyroxine.

(I have not summoned up the courage to tell my doctor that I have switched over BTW.)

In fact I feel hugely better on Thyrogold. I find that it is hard to get the dosing right. At the moment I am on 4/7ths of a 150mg capsule which I know is a low dose.

I have tried to increase it by taking a higher amount but when I do I find it hard to sleep at night.

I wonder whether I could split the doses over the course of a day?

I could definitely do with extra energy as it takes me half a day just to get going. I still to have emphasize that I feel miles better on Thyrogold so really unwilling to try something else. It is also easy to purchase too.

I still need to do a Regenerus test on adrenals. I must do this very soon.

I am not good at taking magnesium so am thinking of switching over to magnesium maleate rather than magnesium carbonate.

Medichecks have stopped checking for folate unless blood is drawn by nurse or centre. I will go back to checking this when I can. (Have to pay extra for this which I am reluctant to do at the moment.)

Otherwise feel good and really appreciate your advice.

😀

[tattybogle in reply to Moore-23]

4/7ths of a capsule .. i bet that's fun to divide up :)I don't really know (only being on Levo myself ) but , i think it makes sense to use splitting dose over the day as a way of trying out an increase.

[Moore-23 in reply to tattybogle]

Many thanks tattybogle Yes, I need to keep working at it to get it right. Thanks again!

[fibrolinda in reply to Moore-23]

I had folate tested by fingerprint sample last test with medichecks. I believe they had so many complaints they added it back in to the finger prick test a couple of months ago... Maybe longer I have lost all sense of time.😒

[Moore-23 in reply to fibrolinda]

Many thanks fibrolinda I will double check on that. I really do not know why they took it out. Perhaps the cynical part of me thinks it might be another money making exercise.

I will double, double check - certainly on the next one. I live in the country and it is a real faff to go into the nearest city for a blood draw and I think to get a nurse to do it...it is now a £55 fee.

When I tried the nurse option they come later than 9am so it makes no sense to do this when trying to do a blood draw properly early before breakfast.

[SeasideSusie Remembering]

Moore-23

Is this your first test since starting Thyrogold? If not, what were other results and what dose?

Your current levels suggest either you're not taking enough or it's not right for you.

If it has any thyroid hormone content one would expect to see your TSH lower and FT4 at least within range with possibly a higher FT3 when taking the right dose for your needs.

[Moore-23 in reply to SeasideSusie]

Thank you SeasideSusie for your response.

Back in July 2020 here were my results:

Ferritin 152 ug/L (13 -150)

Folate serum >19.8ug/L (>3.89)

VitB12 Active >150pmol/L (>37.5)

VitD 107nmol/L (50-175)

TSH 0.168 miU/L (0.27-4.2)

FT3 4.26 pmol/L (3.1-6.8)

FT4 14.300 pmol/L (12-22)

TAs 419.000 KIU/L (<115)

TPOs 129KIU/L (<34)

Yes, you are right to get me looking at these results: they were much better. Maybe it is because I did not increase the dose over winter?

I do find it difficult to increase the dose but will give it a try. Can doses be split over the day?

I have had trouble getting to sleep when on higher dose even though it has given me tons of energy which feels marvellous.

[SeasideSusie Remembering in reply to Moore-23]

Moore-23

Were you on the same dose of Thyrogold in July as now? Certainly the July results look better and even suggest an increase in dose.

You can split dose, I believe people on NDT quite often split the dose, but experiment and see what happens, you'll find out what's right for you.

Make sure nothing interferes with absorption of your Thyrogold, so treat like any other thyroid meds and take on an empty stomach, one hour before or 2 hours after food, with water only and water ony for one hour either side, 2 hours away from other medication and supplements and 4 hours for Vit D, Calcium, Iron, Magnesium, HRT.

When doing thyroid tests take last dose of Thyrogold 8-12 hours before test. If you take a B Complex or Biotin supplement then don't take either for 7 days before the test because it can give false results.

[Moore-23 in reply to SeasideSusie]

Many thanks @SeasideSusie It was the same dose so something has gone awry. I think it may even be tea consumption combined with the effects of winter.

I will try and drop the normal tea habit. I have been very naughty and been taking my Thyrogold with tea in the morning. I have been thinking for a long time I should stop doing this and drink water. Then drink herbal teas during the day.

I think I lose iron this way and it stops absorption.

I will also try splitting doses and I will follow your instructions as to how to do this. This has all been very helpful. Thank you so much!

[SlowDragon Administrator]

Results suggest you are under medicated

Try increasing dose

Retest in 6-8 weeks time

Day before test - split dose into 3 smaller doses at roughly 8 hour intervals and take last 1/3rd of daily dose approx 8-12 hours before test

Are you still on strictly gluten free diet

[Moore-23 in reply to SlowDragon]

Hi SlowDragon Yes, I am on gluten free diet but occasionally eat minuscule amounts of gluten. Really tiny amounts but should avoid these I know.

I reckon you and others are right I am under medicated. From your reply it looks as if I could experiment with splitting doses and also before blood test as well, as you say.

That would make sense.

I think I need to try harder to see what works for me. It is definitely worth it as I am seeing good results overall.

Thank you so much to you and the others on this forum. I really appreciate all your advice!🙂

[greygoose]

Of course, you do have Hashi's, so some fluctuation in results is to be expected.

[Moore-23]

Thank you greygoose . I will keep that in mind!

[greygoose in reply to Moore-23]

You're welcome.