Advice please re blood results

[Middleagedandtired]

I have been feeling unwell for years ( fatigued depressed overeating very bad brain fog on top of my Arthritis pains my usual sleep issues ) so decided to stop all the vitamins etc and have bloods checked . I stopped everything including self medicated T3(1/4 of 25ug tablet ) .

Previous bloods were taken incorrectly by myself giving false readings as can be seen from my earlier posts .

Blood was supplied 0950 hrs and 24 hrs after last Thyroxine .

I take 75mg as was told to reduce from 100 as TSH high by Dr.

I continued with my psoriatic arthritis meds of Secukinumab and Methotrexate.Also continued with Folate I purchase as stopped using the synthetic folic .

I see B12 is high , I was supplementing with recommended dose hoping to help with the fatigue , but stopped that along with all the other stuff .

Any advice kindly received and appreciated

[Jazzw]

I wouldn’t worry too much about the high B12–you have a reason for it being high. It could be worth taking a lower dose as in my experience it can drop really quickly once you stop taking B12.

Nearly everything else—on the face of it—would look ok to the average GP. But I think you need that T3 you were taking, or a higher dose of levothyroxine. Your FT4 is low in range and your FT3 isn’t that far off the bottom either—I know I’d feel rubbish with an FT3 that low.

I’m sure you already know if you’ve read posts here that doctors are wrong to alter dosages on the TSH level alone—TSH becomes meaningless in those treated with thyroid hormone replacement and it’s pretty useless for titrating levothyroxine dosages. Your doctor really shouldn’t have reduced your dosage from 100mcg to 75mcg, it’s as simple as that. If your FT3 and FT4 weren’t over-range you weren’t overmedicated.

So now you’re undermedicated.

[radd]

Middleagedandtired,

You shouldn't have suddenly stopped T3 dose as although small it is a necessary part of your meds that your body is used to. You will also have risked skewing FT3 blood test result. When did you stop taking T3 meds?

Both FT4 & FT3 are far too low. You need a dose raise of Levo, maybe T3 as well but you won’t know until you have raised Levo and tested after six weeks. Do not raise both hormones together as optimal Levo levels might end up supplying enough FT3 anyway.

Does your GP know you are self medicating T3? The small amount of T3 you are taking is most likely causing TSH to reduce which is what your GP is dosing Levo on. If your GP is uncooperative in offering more Levo have you thought of self-medicating Levo as well as T3?

You have no raised thyroid antibodies & no bodily inflammation which is great, but cortisol is very low for an 0950 hours reading and has probably been supporting low thyroid hormone for many years. Also the psoriatic arthritis.

Vit D good. Am with Jazzw re VitB12, but would take folate a little higher as works alongside VitB12.

Overeating can become a habit but if you are overeating through boredom, you could fill time & direct negative feelings with some positive & proactive cooking of healthy but yummy foods. This will mean good things in the fridge instead of reaching for that cake or chocolate bar.

Double up receipes & cook for the freezer, meal plan, aim for only end-of-week treats only. Maybe Weight Watchers or something similar might give you impetus. Improving thyroid hormone levels should help by giving energy & more positive focus for new activities, as fatigue, depression & sleep issues are all hypo symptoms.

[Middleagedandtired in reply to radd]

Thank you …the nurse who takes my bloods did mark down that I use black market T3 !! With a sneer on her face . Whether the Drs ( I see different ones) are aware , I don’t know . Yes I need to get my head around the eating lark I’ve done it before but am struggling at the moment . Hopefully as you say if I up my Levi back to 100 and see how that goes . Sorry I didn’t quite understand about the folate ?

Thank you

[radd in reply to Middleagedandtired]

Middleagedand tired,

Blackmarket T3! 😆. Honestly, the things we have to put up with!

Ideally they need to be balanced, so if you have middle-ish levels of VitB12, you need middle-ish levels of folate (although as your VitB12 is high, I wouldn’t take folate up to match but as close as a sensible level would allow).

Looking at it in reverse, the body encourages more transporters in a VitB12 deficiency but reduces transporters in a folate deficiency. This widens the gap further when levels aren't equal, and as they use basically the same pathways, this level of dominance is further intensified.

This is when things like a suboptimal level of VitB12 in comparison to folate will trap the folate as 5-methyltetrahydrofolate instead of allowing convertion, leading to a decreased synthesis of methionine & risking accumulation of homocysteine (which is bad news).

The amounts are important but also the balance. A bit like oestrogen & opposing progesterone, (actually that's a weird example 😁, but I'm sure you know what I mean).

[Batty1]

I have same issues fatigued from either being thyroid-less or the PSA and Im also on a biologic Cosentyx and soon Otezla as a bridge medication anyway its hard to determine which one is causing issues the PSA or the thyroid because both cause similar symptoms and I find that my biologic meds cause me to turn hyper for a couple of days after I inject (Endo doesn’t think this is possible) but sadly it is.

[Middleagedandtired in reply to Batty1]

Yes sadly a lot of us out there feeling like it !!! I though have not noticed any highs with the injections although they have def helped the psoriatic arthritis immensely