Hi - Assuming all the blood tests were all done on the same protocol (fasting, first thing in the morning is the easiest way to achieve this so that we are comparing like with like) then I would say - from my rickety understanding - that as your medication is increased, it starts to do the work for your thyroid, effectively taking over. On low levels of medication your TSH was probably not very suppressed, so the thyroid would have been able to produce some residual T3 on its own. On higher levels of medication your TSH is more suppressed, so you are relying on your body to convert the T4 medication into T3. Because of this, many of us actually feel worse when we first start taking medication as being inadequately medicated is - depending on your mileage - as bad or worse than not being medicated at all.
Optimum levels of ferritin and selenium seem to help the conversion process from T4 to T3. I would also say that with fT4 @ 54% through range, you look under medicated and more levo would be the next thing to try, as well as getting vitamin levels into a decent place: d, b12 and folate are also worth looking at. Most of us need fT4 towards the higher end of the range to produce enough fT3 and some of us, as I imagine you know, still don’t manage and need additional T3 medication. At this point, I don’t think it is clear which of those categories you fall into, as more fT4 to work with and some good vitamin levels might fix everything and get that conversion working. There is a big difference between vitamin levels “in range” and “optimal” of course, just as there is with thyroid hormones.
I imagine you feel quite unwell at present? I had very similar results recently and did not like them one bit!
Firstly I thank you for your reply.No not feeling great, I have ordered another test from b/Horizon so i will get that done some time this month.
Oct 2019 B12 1342. ( Consider reducing dose 569
Aug. 2020 B12 1311. (. Same as above
I haven't take any B12
Aug 2020. folate 7.00. (8.83 60.8
I did purchase folate
Vit D is on prescription those levels go from 70 to 129
Selenium I tried to take that but I terrible headaches
Magnesium have got a spray.
I just couldn't understand why ft3 had dropped.
I know my gp will not do an increase as she referred me to endrorinlogist, which was a phone call & who took some persuading to increase to 50, I recieved a letter from her in which she as stated she will not increase anymore, if things aren't resolved she will reduce back to 25.
I will just have to wait on the next blood test results.
Oh dear. It sounds as if - if I have understood correctly - neither the GP nor the endo are being very helpful? I am out of my depth with vitamins but I know that SeasideSusie and humanbean understand about these things, so I have tagged, I hope.
Getting an increase maybe difficult as the gp as passed things over to endrorinlogist who as not meet me, my consultation with her was a phone call, my gp hadn't given her any blood test results even though all b/Horizons results had been printed & handed into the surgery.
Conversation with endro. took me awhile to get an increase in October 2020, to the point I ended up with me saying I not stupid. Couple weeks later I received a letter from her also my gp had 1, she mentioned if my symptoms hadn't resolved the dosage would go back to 25.
Getting the same brand can be difficult I have had teva mercury & this month Almus boots say its what the get sent, think maybe supple issues at present.
All Blood taken around 9am - 9-30am, (yes to no levo & only water, had read about this sometime ago)
Vit D folate Ferritin & B12 done Aug. 2020
Folate was low 7. (8.83 - 60.8)
B12. 1311. Top range. 569
I have ordered from b/Horizon gold 1, for later this month, so see what those results show.
Igennus Super B is good quality and cheap vitamin B complex. Contains folate. Full dose is two tablets per day. Many/most people may only need one tablet per day. Certainly only start on one per day (or even half tablet per day for first couple of weeks)
Or Thorne Basic B is another option that contain folate, but is large capsule
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
Levothyroxine doesn’t top up failing thyroid....it replaces it
Regardless of age, once we start on levothyroxine, dose should be increased slowly upwards in 25mcg until TSH is always under 2. Ft4 and Ft3 should be at least 60% through range
guidelines on dose levothyroxine by weight
Even if we frequently don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose
Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months. RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.
For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.
For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).
If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.
Hi. I already have thyriodUK information, unfortunately there isn't anyone within reasonable distant to myself.Vit's
Igennus super B complex, I randomly take these due to my high B12 level, I have taken health leads folate due to being under range, vit D on script fultium 800iu daliy, but on some days use BetterYou 3000 with k2 mk7, magnesium spray on legs at night.
Thank you for the above information.I have received today my phone appointment with nhs endro for 27th of May, that's if it happens should have had 1 in January but never happened.
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