Please can someone look at my blood results, I had a complete thyroidectomy in 2013 since then I have never had good results. I am taking 100 of Levothyroxine and 20 of Liothyronine. I followed your advice about blood tests.
My results are: Serum free T3 level = 4.4 pmol/L
Serum free T4 level = 11.5 pmol/L
Serum TSH level = <0.05 min/L
They recommend I am over replaced but I know people who still have their thyroid and take more Levothyroxine than I do. I have a call booked with my Endo next week and would like to know what I should be asking.
Many thanks
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Baggieswidow
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Are you taking prescribed iron tablets for this dire Ferritin level? Below 30 is iron deficiency and your GP should be following NICE guidelines.
As for your thyroid results, when did you take your last doses of meds before the test? Last dose of Levo should be 24 hours before the test and last dose of T3 should be 8-12 hours before the test.
HiI took 100 levothyroxine and 10 Liothyronine early Tuesday morning, I then took 10 Liothyronine at 4.30 pm. My test was the next day Wednesday at 10am. I am also on various pain tablets, Gabapentin, Cocodamol, Ropinirole, Amitryptolin and Sertralin.
I took 100 levothyroxine and 10 Liothyronine early Tuesday morning, I then took 10 Liothyronine at 4.30 pm. My test was the next day Wednesday at 10am. I am also on various pain tablets, Gabapentin, Cocodamol, Ropinirole, Amitryptolin and Sertralin.
So you have a false low FT3 result, last dose should be 8-12 hours before the test so should have been between 10am and midnight-ish on Tuesday, you could have taken 5mcg at 4.30pm then the other 5mcg later on.
Are you taking those painkillers well away from your thyroid meds? We should leave at elast 2 hours between thyroid meds and any other meds.
Serum ferritin 20 ug/L (13 -200).
You didn't say what's happening about this dire ferritin level, what is your GP doing about it?
No, I tend to take my tablets all together except my lunch time painkillers.
There are many medications/supplements that affect absorption of thyroid medication. To avoid any absorption issues then we always advise to take them on an empty stomach, one hour before or two hours after food, with a glass of water only, no tea, coffee, milk, etc, and water only for an hour either side, as absorption will be affected. Take any other medication and supplements 2 hours away, some need 4 hours (iron, calcium, Vit D, magnesium, oestrogen and HRT, there may be others).
My GP has said my results are all normal
Then your GP is wrong and you need to discuss your ferritin result with him and suggest he looks at NICE Clinical Knowledge Summary
In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.
Your GP should perhaps do a full blood count and an iron panel, and with a ferritin level as low as 20ug/L then he should be prescribing something based on what he finds.
Please add ranges on these results (figures in brackets after each result)
When taking any dose of T3 it’s almost inevitable that TSH will be suppressed
Most important results are always Ft3 and Ft4
Most people need both Ft4 and Ft3 at least 50-60% through range
Blood tests should always be done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
When on T3, day before test, split dose into three smaller doses roughly equal 8 hour intervals. Taking last dose T3 at roughly 8-12 hours before test
So taking last 5mcg dose T3 approx 8-12 hours before test
Is this how you did this test?
Absolutely essential to regularly retest vitamin D, folate, ferritin and B12
B12 and folate are low you might benefit from supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial.
This can help keep all B vitamins in balance and will help improve B12 levels too
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
If serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months, then once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.
HiMy combined total bit D2 + D3 lvl 47.8 mmol/L (50-150)
It says on the results sheet
Note new in-house immunoassay method for total 25-hydroxyvitamin D.
Total Vitamin D thresholds as set by the National Osteoporosis Society (NOS):
30-50 nmol/L may be inadequate in some people
>50 nmol/L is sufficient
Sample received centrifuged.
Thank you for looking at my results, my GP has said they are all normal. Fortunately I have a telephone appointment with my endo on Friday so it would be great to actually know what to discuss with him.
I too am without a thyroid but mine was ablated with RAI back in 2005 :
I became seriously unwell around 10 years later and fortunately found this forum and started my own learning curve :
First and foremost it is essential that you build your ferritin, folate, B12 and vitamin D to optimal levels as no thyroid hormone works well if these are not maintained at good solid levels and dependant on ranges, aim to be at least around 50% through.
My ferritin was at 22 - single digits in range of around 150 - and read everywhere that this mineral needs to be over 70 for any thyroid hormone replacement to work effectively.
You may need to supplement these essential vitamins and minerals yourself as you may well be in the " range " and not qualify for a NHS pescription.
I was refused both T3 and Natural Desiccated Thyroid hormone replacement on the NHS in 2018 and then went on to self source these other options myself.
Both worked for me and I have settled on NDT - I notice you were on 30 T3 and were dropped to 20 and presume living with the additional anxiety of not knowing or trusting the system, so welcome to the club.
T4 is a storage hormone and needs to be converted by your body into T3 the active hormone that the body runs on, and I read T3 is around 4 x as powerful than T4 with the average person need to convert/ utilise / find around 50 T3 daily just to function.
A fully functioning working thyroid would be supporting you daily with trace elements of T1. T2 and calcitonin plus ameasure of T3 at around 10 mcg plus a measue of T4 at around 100 mcg.
Conversion of T4 into T3 can also be compromised by any physiological stress ( emotional or physical ) inflammation, depression, ageing and dieting and whilst we can't control all things in our lives, we can build back our core strength vitamins and minerals and turn some of these issues around for ourselves taking back some control and restoring our health and well being for ourselves.
Your serum Free T4 level is below range. Your serum Free T3 is near the bottom of the range. You cannot possibly be "overreplaced" with those numbers. The reason your TSH is low is because you are taking T3.
Your endo should know that it is a bad idea to try to rely on TSH for dosing when taking prescribed T3.
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Blood Results - help please 
