Help with bloods

[SAUK]

Please help with some blood results please! GP wants to speak to me and likely drop my T3 and raise my T4.

TSH 0.003 (0.35-4.75) been like this for 2 years since being on liothyronine and levo combo.

T4 9 (10-12)

T3 6.6 (3.5-6.5)

Iron 54 (15- 250) was 33

I'm on 75mcg T4 and 40mcg T3. I also take 200mcg of ferrous sulfate ( 5 hours away from thyroid meds), 3000mc spray of Vit D and B vit complex (in am hour after thyroid meds)

Can anyone tell me why suddenly my T4 is dropping and T3 rising? Haven't changed my meds in a year. Only other issue is fibroids.

Thanks

[jrbarnes]

How do you feel on this combo?

[SAUK in reply to jrbarnes]

Been great for about 16 months now! A little tired now and weight gain so asked for bloods again. These were the results

[SlowDragon Administrator]

Was test done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

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

When were vitamin D, folate, ferritin and B12 last tested

Need full iron panel test to check iron isn’t too high

Have you recently had Covid or vaccination?

[SAUK in reply to SlowDragon]

Yes T4 taken 6am day before, T3 4pm. Test was 8am the next day.

I asked for vit D repeat but they forgot this. D was 72 (76-250) in March. Folate and B12 in Dec were in the middle of ranges.

Do GP's do full iron panel test?

Have you recently had Covid or vaccination? Dec 2020 and March 2021. Few side effects but all cleared after 4 days.

[SlowDragon Administrator in reply to SAUK]

So last T3 was 18 hours before test for that’s slightly too long and falsely low result

Vitamin D better at least around 80nmol and around 100nmol maybe better

Is your ferrous fumerate prescribed ?

If yes, GP should do full iron panel test every 3-5 months

If need to test privately, Medichecks do full iron panel test

[SAUK in reply to SlowDragon]

Thank you for your advice. You are always great at sharing info.

I've done bloods this way for the last 16 months as cannot take T3 after 4 as will be up at night and cannot take iron later. My T3 is high not low. Will this still give false negative?

I can increase spray of Vit D but wanted new result this time. Thanks for reference range.

My ferrous sulphate is prescribed

Will ask GP for repeat D and full iron panel

Thanks

[SlowDragon Administrator in reply to SAUK]

My point is that your Ft3 result is high with 18 hours gap

Obviously Ft3 would be higher still with only 12 hours gap

So yes you might need to try reducing T3 a little

Plus increase levothyroxine dose a little, which will/should likely increase Ft3 and Ft4

[SAUK in reply to SlowDragon]

Oh that makes sense. Thanks. Will give that a try and see what happens. Just scared to have too little T3 and then feel unwell again

[Yeswithasmile]

I see you had the coil fitted a few months ago. I believe that the hormones in this can affect thyroid medication. A bit like hrt. Might be worth checking if it’s that having an effect.

[SAUK in reply to Yeswithasmile]

Not yet fitted. Due on the 15th July

[Purpledreamer in reply to SAUK]

Hi I would be very cautious with the medina coil. If it is your only option then maybe keep a diary now and continue when you have it to make notes of any changes. I had a terrible time with mine (others have been fine) a friend of mine was experiencing terrible Terrible mood swings and it was only because of my own experience that I was able to tell her it may well be the merina - she got it removed and became much better again. I honestly would be very cautious with it. X

[Purpledreamer in reply to Purpledreamer]

I would also be very weary of changing your thyroid medication at the same time as having one fitted as how can you know what’s helping/not helping when two changes happen at once? Goodluck x

[SAUK in reply to Purpledreamer]

Thank you. Was thinking the same thing. One thing at a time 😀

[FancyPants54 in reply to SAUK]

I love the Mirena for HRT. I bled all the time, constantly and heavily, on body identical progesterone Utrogestan. The only downsides for many of us is the fitting process (soon over) and the fact that you might cramp and spot and things for a few weeks. When I had my first one for birth control I felt fat and miserable for 3 months. At my review I talked about having it removed. My GP at the time said "give it another 3 months, they can take time to settle." After another couple of weeks it did settle and then I never thought about it again. I was fine. This time, having it fitted for HRT I was great from day 2. Good luck with yours. Check your thyroid bloods 3 months into the coil.

[FancyPants54 in reply to Purpledreamer]

The Mirena coil doesn't suit everyone. If it's not going to suit it usually causes mood issues. But for many thousands of us it is a wonderful way of protecting our uterus lining whilst taking HRT. It's the oestrogen that can lower the active thyroid hormone in the blood a little in most cases, so it's normal to have the Mirena fitted and check thyroid results 3-6 months later.

[SAUK in reply to FancyPants54]

Thank you

[Purpledreamer in reply to FancyPants54]

Oh- this might explain why I was diagnosed with hypothyroidism within weeks/months of having it removed. If only a doctor knew this vital piece of information- that was eight years ago.

[Yeswithasmile]

Well you’ve got me then …. 🤔. I suppose it could still be hormonal?

[SAUK in reply to Yeswithasmile]

Thanks. Will ask about this tomorrow.

[Yeswithasmile in reply to SAUK]

I have fibroids. Found that out in 2015. Was offered the coil but I have a few friends that tried it. Not good experiences. So I declined. I take transemic acid for heavy flow. I have just ordered a female hormone blood test. Be interesting to see how the land lies there in order to work out optimal thyroid treatment. It seems strange that you’re body has decided to work a bit differently but I do believe that hormones can really affect things. I was hoping for the menopause but no luck so far. Boo.

[SAUK in reply to Yeswithasmile]

Thanks. I have fibroids but periods changed from very heavy to almost nothing. Hormones apparently normal. Not sure where all the iron is going then?? Hoping progesterone will counteract the oestrogen an level out thyroid. Will let you know.

[janeroar]

It might be worth repeating the test. The main point is you’re feeling well. Would be a shame to drop medication solely on basis of a test result if you’re feeling good.