Blood results.

[sirdar]

Hi I wondered if I could ask your thoughts on my blood results. I have been having palpations, feeling hot upset stomach and a bit anxious. I am taking 50 mcg Levothyroxine once a day and 20 mcg Thybon Henning twice a day. My blood test wasn't taken first thing I am afraid so understand I have mucked up but I could only get an afternoon appointment so took it otherwise would have had to wait a few weeks. My results are. Tsh 0.1 range 0.27 - 4.2

T3 8.4 range 3.1-6.8

T4 7.1 range 12 - 22

Thyroglobulon 18.3 range 0 - 115

TPO 52.4 range 0- 34

Ferritin 40 range 13 - 150

Folate 4.2 range 2.9 - 14.5

Vitamin b12 94 range 25.1- 165

Vitamin D 56 range 50 - 200

Any thoughts would be appreciated I understand that I should have had a morning blood draw and have mucked things up. Any help would be appreciated

[Lalatoot]

I wouldn't worry about a morning draw - i have my draw at 2pm every time for consistency. what is more important for the interpretation of your results is when you had your last doses. so how long a gap between your last dose of levo and your last dose of lio and the blood test?

[sirdar in reply to Lalatoot]

Thank you for your reply. My Levothyroxine was taken 7am and last Liothyronine was taken at 1pm blood was taken at 6pm so Gap between Levothyroxine and blood was 11 hour and Liothyronine was 5 hours. Thank you for reassuring it was OK for afternoon bloods.

[Lalatoot in reply to sirdar]

When you are on lio your TSH tends to be suppressed. Folks get an early morning blood test as this is when TSH is highest and this is important for those monitored by a GP who goes by TSH alone.What those of us on combo meds need to do is to be consistent particularly with the gap between our last doses and the blood draw. This is so we can compare like for like.

When we take our meds the hormones are absorbed and build up to a peak level and then fall back down again. Many on here think it best to measure our FT4 and FT3 at their low levels so we recommend a 24hour gap between last levo dose and bloods and an 8 - 12hour gap between last lio dose and bloods. This may mean that prior to a blood test we alter our dose timings.

Lio peaks 2 - 4 hours after a dose. By testing 5 hours after your lio dose your result is near to the peak result.

If those were my results and given that you are not feeling great I would reduce lio by 5mcg per day and retest in 6 weeks.

[sirdar in reply to Lalatoot]

Thank you for your reply. The information you have given me is very helpful. I will try reducing and retest as you advised. Thank you.

[m7-cola in reply to Lalatoot]

I agree with this advice

[sirdar in reply to m7-cola]

Thank you.

[fuchsia-pink]

So - your TSH is suppressed because you take lio. Ignore it. But free T4 is below range and free T3 is over-range. That says to me that you're taking too much lio and not enough levo. As others have said, I'd start by reducing lio - very slowly.

In terms of nutrients - these could do with a boost. You generally want things half-way through range and vit D in 3 figures. I'm tagging SeasideSusie and SlowDragon because they're both excellent on nutrients and how best to raise them

[sirdar in reply to fuchsia-pink]

Thank you for your reply and for tagging Seasidesusie and Slowdragon any help is much appreciated. I will start and reduce the lio and then retest as recommended by Latoot and see how I get on.

[SlowDragon Administrator]

Would agree likely too high a dose T3 and too low a dose of levothyroxine

Suggest you increase levothyroxine by 12.5mcg and drop T3 by 5mcg

What brand levothyroxine are you currently taking

Do you always get same brand

Bloods should be retested 6-8 weeks after constant unchanging dose and brand of levothyroxine and T3

Retest as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Day before test you need to split T3 dose into three smaller doses - 15mcg 7am, 10mcg at 2pm and 10mcg at 9pm (assuming test is 9am next morning)

Meanwhile working on improving low vitamin levels

Vitamin D, ferritin and folate all too low

What vitamin supplements are you currently taking ?

Presumably you know that high thyroid antibodies confirms autoimmune thyroid disease also called Hashimoto’s

Have you had coeliac blood test done yet. If not get that done ASAP before trialing absolutely strictly gluten free diet

[sirdar in reply to SlowDragon]

Thank you for your reply. I am taking Mercury farma Levothyroxine. I don't always get the same no . So this morning I have increased Levothyroxine and will take a lower dose of Liothyronine mid day. I have got b12, folate and Vit D supplements so will take those. I am a bit surprised with the vit D as I have been taking supplements but I will carry on and see how things are when I retest. I am not really gluten free I try to eat mainly non prossessed food cook everything from scratch include fruit and vegetables. I didn't realise I could get a blood test for celiac so will look into that as I don't feel great if I have bread ect. Thank you for all of your help it is so appreciated.

[SlowDragon Administrator in reply to sirdar]

You need to be eating gluten regularly for 3-4 weeks minimum (and ideally 6 weeks) before doing coeliac blood test.

If you know gluten affects you and don’t want to do that, just cut gluten out absolutely completely

[sirdar in reply to SlowDragon]

OK thank you for your help.