T3/T4 check

[Gophe]

Hi all.

I'm currently on 100mcg/day Levothyroxine and feeling pretty decent overall. My latest blood tests show my TSH is at 0.1, so my doctor is advising that I reduce my dose; however, she's allowing me to make the decision.

My decision is to stay at the current dose, but before I finalize that, I just wanted to run the details past you all in case I'm missing something.

I just had a new set of tests from my surgery last week. I'd had a full set of tests from Medichecks a couple of weeks prior that I shared with the surgery -- they showed my TSH very low and my T4 above normal range. My surgery wanted to do its own tests and agreed to check my T4 and T3 too.

Here are the results of my newest bloodwork from the surgery (these are after 24 hrs with no levo and 1 week with no vit B):

TSH: 0.1 (0.35-4.78 miu/L)

free T4: 17.2 (10-20 pmol/L) -- 72% of range

free T3 4.2 (3.5-6.5 pmol/L) -- 23% of range

B12 608 (200-900 ng/L)

vit D 108 (76-250 nmol/L)

Ferritin 28 (15-250 ug/L) -- I know this is low; it's something I'm working on

Folate 12.4 (>2.9) -- this result is from Medichecks not my surgery

From what I've heard from this group in the past, it's not a good idea to make decisions based on the TSH level; it's more important to go on how you're feeling and what your T3, T4, ferritin, folate, and vitamins looks like. So this looks pretty on-track to me (except the ferritin).

But let me know if it looks like I'm missing something.

Also, should I be concerned about my T3 level and pursue an appt with an endo to discuss supplementation, or, if I'm feeling generally well, should I leave it alone?

(Note: I have Gilbert's Syndrome, which means it can be hard for my liver to process some drugs and supplements, so I'd rather not add a new med unless its' really important. I plan to post a separate question to this forum about Gilbert's and Hashimoto's.)

[shaws Administrator]

The No.1 question is 'How do you feel on your dose'. If the answer is fine, well and symptom-free I'd say that's your optimum dose. I must also state I am not medically qualified but have had hypo since 2007.

[pennyannie]

Hello Gophe :

Well once your ferritin rises to a decent level of up and over 70 this should assist in the conversion of your T4 into T3 and rebalance your T3 up and your T4 level down and to a more even ratio:

I maintain my ferritin at around 100 : folate 20 : B12 500+ and vitamin D at around 100 :

What's most important is how you feel and to stop chasing a TSH and focus on where your T3 needs to be for you to feel as well as you can.

I'm with Graves post RAI thyroid ablation in 2005 and now managing lingering Graves, thyroid eye disease and hypothyroidism and self medicating.

[Gophe in reply to pennyannie]

Thanks, that sounds like really good advice. One issue I'm having with ferritin is that I was eating lots of liver to bring my levels up, but liver is really high in vit A, and with Gilbert's the liver has trouble processing vit A. So I'm struggling a bit on that front. Eating kidney/black beans every day and pumpkin seeds and chicken about once a week.

[pennyannie in reply to Gophe]

Yes, sorry I forgot to add :

There is liquid T4 - Levothyroxine just as there is liquid iron !!!

[Gophe in reply to pennyannie]

Oh, I didn't know that. What would be the advantage of the liquid form in my case? Are you thinking it would be easier for my liver to process?

[pennyannie in reply to Gophe]

Well, I'm no doctor but just thought it might be an option :