Hi all could anyone share an opinion on my GP results thanks
TSH 2.53 (0.27-4.20)
T4 17.3 (10-22)
T3 4.2 (3.1-6.8)
Will be having vitamin D B12 Folate early cortisol and full set of iron studies done in a weeks time.
When I insert results into calculaltor it looks like I am 60.83% for T4 and 29.73 for T3 would this indicate that I might not be converting as I should?
TSH has risen since last bloods taken and blood draw same time fasting and no levo for 24 hours previously I am on 50mg of Levothyroxine
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Katrina999666
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Thanks for replying Ferritin last time was out of range so it will be tested too in a weeks time. Stopped all Vitamins last week until blood draw in a weeks timeCoeliac bloods done last week waiting on results
Mercury Pharma brand have had no issues with the brand
Too early to say ...50mcg levothyroxine is only the standard starter dose
TSH is too high, Ft4 has plenty of room for increase in dose
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
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
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.
Thanks greygoose I decided to go privately to see an Endocrinologist as my GP was blind to the fact that there is more to diagnosing and medicating than the TSH levels so hopefully when I have my return appointment with all the results of the blood tests he has ordered my dose will be increased.
We generally feel better when the T4 is in the top quadrant of the range and thank you for doing the maths for me, you are currently at just around 61% so in the first instance a least one more dose increase of 25mcg T4 is needed.
T4 is a storage hormone and is converted by the body into T3 and it is T3 that gives you the symptoms of hypothyroidism, Ss an increase in T4 should result in your T3 rising as well.
Optimal ferritin, folate, B12 and vitamin D are needed to assist in the body being able to convert the T4 into T3 and see that these results are to follow.
The accepted conversion ratio when on T4 - Levothyroxine only is 1 / 3.50 - 4.50 - T 3 / T4 with most people preferring to come in at around 4 or under.
So to find your conversion ratio you simply divide your T3 into your T4 and I'm getting 4.10 so not too far out from centre and actually think with a dose increase in T4 plus optimal vitamins and minerals you will see and feel an improvement in your symptoms.
Your %ages are correct but that is only part of the story, it's too soon to conclude that conversion is poor.
Your FT3 is too low
Both Frees should be approaching 75% through ref range but we are all different so this may vary slightly
When medicated TSH should be 1 or below
TSH 2.53 is too high and suggests undermedication
50mcg is only a starter dose, first you need to add 25mcg levo ....you have room to add this while remaining in range. Your GP should have re tested before now!
For good conversion vit D, vit B12, folate and ferritin need to be optimal.
Suggest next action is to optimise the nutrients and increase levo by 25mcg
Test again in 6/8 weeks.
If conversion hasn't improved then it may help to add a little T3, but far too soon to consider that at the moment.
Thank you for taking the time to reply I am tired all the time, forgetful, gaining weight, cold, joints and muscles ache. I have been on levothyroxine for just under a year now initially on 25 then increased to 50 have been testing through Medichecks Gp not persuaded to increase dosage so I decided to consult an Endocrinologist privately after seeing a Liver specialist because of raised liver enzymes. He has asked the Gp to do various blood panels Iron, thyroid and cortisol as well as Vitamin D B12 and coeliac I will have more bloods taken in a weeks time so waiting on most of those results to be reported on. My Ferritin was raised and has been increasing since first diagnosed so I was tested for Haemochromatosis but my saturation levels were fine although my Iron was low but only marginal.
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