Hi all, can anyone provide feedback on these latest bloods please?
Took them in the morn before food or meds. Stopped taking all supplements a week before.
Currently taking 10mcg Liothyronine and 50mcg Levo a day.
Also been taking D3/K2, B-complex, Iron and vit C for a few months now.
Hello!
Welllll you are clearly still under medicated but we already knew that from your previous posts where your endo set you up for failure by massively cutting levo at same time as introducing lio.
What time was your last lio dose?
Do you think your endo will be supportive of increasing levo again? Likely need an increase in both but I’d probably start with levo as for myself I find a good stable base of that works well for me. I just want the lio as a cherry on top, top up. But that’s just me!
Feel so frustrated for you but glad to see you persevering.
When is your next appointment?
Thank you. That’s really good advice. I took the last lio dose on the morning before.
After seeing those results I was thinking of upping my Liothyronine, as I’m only taking half the amount he told me to, so if I increase now then wait 6wks at least I’ll be on the dose he prescribed. But then would it be bad to stay on 50mcg Levo? I don’t quite understand that the ratio should be when on combination?
HollieBerry
I took the last lio dose on the morning before.
In that case your FT3 result is showing a false low. You must have taken your last dose around 24 hours or so before the blood test. Last dose of T3 should be 8-12 hours before blood test, the 24 hours is for Levo only.
I wouldn't increase T3 at this stage. You need a test showing the correct levels on your current dose of T3 by doing it with the correct time gap. I'd increase Levo at this stage as if you also took your last dose of Levo the morning before then your FT4 result will be pretty accurate and it's far too low.
HollieBerry
Is that a Medichecks test? They seem to have changed their range for Folate and Active B12.
Did you take last dose of Levo 24 hours before test and last dose of T3 8-12 hours before test?
When on combination hormone replacement it's very individual where we need our FT4 and FT3 levels to feel well. I'm on combo replacement and with your FT4 I'd have a hard time getting out of bed and I'd feel very unwell. I need both FT4 and FT3 balanced at around 60-70% through range. So it could very well be that the first thing you need to do is increase your dose of Levo and get that TSH down and your FT4 up. Your TSH is far too high for someone on thyroid hormone replacement, especially when taking T3, you will probably feel better when it's down to 1 or below.
Increasing your Levo will probably raise your FT3 level as well as FT4, depending on how much natural conversion you have.
Did you know you have Hashi's?
Vit D could do with being a bit higher, it's recommended to be 100-150nmol/L by the Vit D Society and Grassroots Health. How much D3 are you taking?
B12 is good, what B Complex are you taking and how much? All you need now is a maintenance dose, it doesn't need increasing any more.
Ferritin is low and that wont be helping. It's recommended to be half way through range although some experts say the optimal ferritin level for thyroid function is between 90-110 ng/ml.
Is your iron tablet prescribed? Do you take it with Vit C to aid absorption and 4 hours away from your thyroid meds and 2 hours away from other supplements?
Right ok, thank you so much. Yes it was medichecks. I took both doses the morning before, at least 24hrs. I did know I had hashis, but only my own diagnosis from seeing antibodies raised when I’ve done home tests. My iron was prescribed but I’ve ran out now, I was taking it with vit c as you said. Also eating iron rich foods as much as possible. I will look for a new iron supplement, do you have a recommended strength/brand?
I thought that TSH seems high, and I feel like absolute crap to be honest so it makes sense now.
The problem I have is, I’m taking half the amount of Liothyronine that the endo said, so I’m worried about having my next bloods that he sends me for- He hasn’t sent me a blood form yet and I don’t have an appointment so feel I’m going solo at the minute 🤷🏼♀️
What do you think should I do next? Ring him and tell him I’ve been taking half he suggested and I’ve had my own bloods? Ask him if I can increase Levo before increasing lio?
I’m dreading the conversation, I feel so out of my depth.
HollieBerry
My iron was prescribed but I’ve ran out now, I was taking it with vit c as you said. Also eating iron rich foods as much as possible. I will look for a new iron supplement, do you have a recommended strength/brand?
I'm afraid I can't help with that. As your iron was prescribed then your GP should be monitoring you by regular testing and continue prescribing if she feels it's the right thing to do. I never advise on iron supplements anyway, iron is complicated and you need regular iron panel checks because if your serum iron and saturation % get too high then too much iron is as bad as too little. If your iron panel is good and all that is low is ferritin then iron rich foods such as liver, liver pate, black pudding, etc, is all that I would suggest.
The problem I have is, I’m taking half the amount of Liothyronine that the endo said, so I’m worried about having my next bloods that he sends me for- He hasn’t sent me a blood form yet and I don’t have an appointment so feel I’m going solo at the minute 🤷🏼♀️
I wouldn't worry at all about that, all you have to say is that you felt more comfortable taking it more slowly.
What do you think should I do next? Ring him and tell him I’ve been taking half he suggested and I’ve had my own bloods? Ask him if I can increase Levo before increasing lio?
It would help if you knew when you were next seeing him.
I responded above when you replied to jsy_girl but I'll copy and paste it here also, it's my opinion on what I'd do in your situation with the benefit of my own experience.
I took the last lio dose on the morning before.
(I took both doses the morning before, at least 24hrs)
In that case your FT3 result is showing a false low. You must have taken your last dose around 24 hours or so before the blood test. Last dose of T3 should be 8-12 hours before blood test, the 24 hours is for Levo only.
I wouldn't increase T3 at this stage. You need a test showing the correct levels on your current dose of T3 by doing it with the correct time gap. I'd increase Levo at this stage as if you also took your last dose of Levo the morning before then your FT4 result will be pretty accurate and it's far too low.
Remember to always do your tests no later than 9am, nothing to eat or drink except water, leave off B Complex/Biotin for 7 days, last dose of Levo 24 hours before test, last dose of T3 8-12 hours before test. Don't go beyond those times, alter times of doses the day before and split your T3 the day before if you don't already do that, split the T3 into 2 or 3 doses for that one day and take the last dose 8-12 hours before the blood draw. This will give you the most accurate results to base the decision on what to do next.
Ok thank you so much 🙏🏼really appreciate your advice x
Hey! I just wanted to say I’m so glad that you hung on in there and with those numbers, I can see how difficult it must have been! I believe one of the regular contributors has a way of working out what T3 might look like after 12 hours even if you test 24 hours after taking it, but I am not sure who... maybe Hidden ?
As for what next, I totally agree that raising levo seems like the obvious move as your fT4 is scraping the barrel... additionally, I am a bit biased towards having a steady and sensible fT4 level, probably because I imagine it makes life easier, given that T3 is a bit more volatile and wears off more quickly.
That having been said, every time I do a blood test, I allow myself a cheeky extra bit of medication afterwards as a “present”. (Yes, I am that crazy and hell, I think I’m under medicated, so why not?!) Yesterday I upped my morning T3 a notch and it felt good!
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