Latest Results from Endo

Hi There, would someone please kindly give me opinion on these results I have never had an in range tsh for well over a year always suppressed I'm still on 100mcg Levo but couple days I take bit under 100mcg I see my T4 has dropped and T3 I'm surprised to see a tsh actually within range but my problem even when it was in better ranges T3 t4 the fatigued n hairloss was bad so now I was thinking its iron but neurologist and endocrine both say I'm not anemic it's just the neurologist said you have small red blood cells but your okay you have lots of them.... My Endo now says he will trial me on T3 again and he will supply it not my GP I will see Endo on 28th June not seen him for 15th months my T3 t4 ranges were always top of range supressed tsh but never felt well Endo thinks these results are good I know why because tsh finally in range he has always gone on about it but if he is willing to trial again on T3 do I take the offer?

[SlowDragon Administrator]

Looking at previous posts…you have PA and Hashimoto’s

Looks like you take vitamin B complex too?

Presumably you know to stop vitamin B complex a week before all blood tests

Do you supplement vitamin D

Are you on strictly gluten free diet?

Do you always get same brand levothyroxine at each prescription

Ft4 is 74% through range

Ft3 is only 41% through range

So poor conversion of Ft4 to Ft3.

[Hidden in reply to SlowDragon]

Hi There, Yes all b complex stopped at least 2 weeks supplement vit d too am gluten free the only thing I've done different is taking slightly under 100mcg 2 days a week up until this test I've been top of the range both T3 n t4 supressed tsh so no conversion problems it's just my gp was going on at me due to tsh supressed all the time and was cutting my Levo down and my Endo no where to be heard or seen he has finally called me after 15 month I went off his radar n got forgotten

[SlowDragon Administrator in reply to Hidden]

Grain …GP obsessed with TSH is endless issue

[Hidden in reply to SlowDragon]

I was having no choice but to cut down Gp would have done it so I just took a tiny bit off the 100mcg my Endo wasnt keeping my appointments finally called couple weeks ago so I'll see him 28th in person offered to trial T3 with t4 but I've never felt good on t4 only but I'm still think iron as well as my ferritin finally has now dropped to 79 in March after rising for months never had bad nails like this either crumbling thin ones so complicated when your left to yourself to work it out only get by because of this forum!

[SlowDragon Administrator in reply to Hidden]

Well endo will need to instruct GP to ignore TSH

On almost any dose of T3 TSH is almost always suppressed

[Hidden in reply to SlowDragon]

Havent been on any T3 t4 only that's why gp going on at me but Endo said a trial again should have left me on it in the first place 2 years ago

[SlowDragon Administrator in reply to Hidden]

Once we are on levothyroxine TSH is frequently very low. It’s irrelevant, as long as Ft4 and Ft3 are within range

See reply by Diogenes (thyroid research scientist)

healthunlocked.com/thyroidu...

the best paper on this that I have seen indicates that a TSH of 0.03-0.5 is best on therapy. Above that is insufficient and below MAY or MAY NOT indicate slight overdosing

academic.oup.com/jcem/artic...

Interestingly, patients with a serum TSH below the reference range, but not suppressed (0.04–0.4 mU/liter), had no increased risk of cardiovascular disease, dysrhythmias, or fractures. It is unfortunate that we did not have access to serum free T4 concentrations in these patients to ascertain whether they were above or within the laboratory reference range. However, our data indicate that it may be safe for patients to be on a dose of T4 that results in a low serum TSH concentration, as long as it is not suppressed at less than 0.03 mU/liter. Many patients report that they prefer such T4 doses (9, 10). Figure 2 indicates that the best outcomes appear to be associated with having a TSH within the lower end of the reference range.

[Hidden in reply to SlowDragon]

Thank you

[Hidden in reply to SlowDragon]

Same Brand always MP