Free T3 (triiodothyronine) 5.08 pmol/L (2.5 - 5.7)
Free T4 (thyroxine) 14.37pmol/L (9 - 23)
Thyroid Peroxidase Antibodies 1.84 IU/mL (0 - 5)
Antithyroglobulin Antibodies 1.11 IU/mL (0 - 40)
Ferritin, Folate, cortisol etc. were all tested and are all in the normal range. Vit D was was at the bottom end of the range so I started taking Vit D.
I was diagnosed with an enlarged thyroid and hypothyrodism as a teenager growing up in Germany (I now live in the UK). I've been taking levothyroxine ever since (first 50 ug/day, then 75 ug/day since ~10 years). 8 years ago, I had a scintigram done privately in Germany, which showed some cold nodules.
My energy levels have always fluctuated a lot and I had phases where I had little energy followed by phases where energy levels were ok. Over the past 5 years or so, my energy levels have gradually declined and I went from being very active (climbing 3x/week, running, yoga, cycling everywhere) to barely able to go for a stroll some days with some post-exercise fatigue thrown in. I gained 40 kg in that time, a good 10 of which in the last year. I've been struggling to concentrate for years, which makes my work a lot harder than it should be. I also get bouts of insomnia although that's been ok recently. Other symptoms include pins and needles in my fingers (waiting for the results of a neck MRI) and IBD like symptoms (I have a gastro appointment in September, coeliac blood test has been negative, no inflammation found in the gut).
Every time I go to see the GP, they tell me all blood results are normal. Several GPs (I moved house a fair few times in the last 11 years) have refused to refer me to a specialist or to increase my levothyroxine dose. I feel very frustrated and left alone with the whole situation (despite a supportive family).
I will be booking a private appointment with an endocrinologist but would appreciate your thoughts, ideas and advice.
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Yellow_Duck
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Free T3 (triiodothyronine) 5.08 pmol/L (2.5 - 5.7) 80% of the way through the range
Free T4 (thyroxine) 14.37pmol/L (9 - 23) 38% of the way through the range
You mentioned taking 75mcg T4 per day. I'm assuming no T3?
Your Free T4 is rather too low for many of us to feel well.
However, to have a Free T3 80% of the way through the range is very good, and it suggests you're a very good converter from T4 to T3.
But another interpretation of your good Free T3 is that your body recognises that you don't have a lot of T4 so is frantically converting what it can into T3.
I think you need a raise in your T4 level of, say 12.5mcg per day, and then retest in 6 - 8 weeks. You may need another 12.5mcg after the test, but just wait for the results. If your GP is refusing to raise your dose you may have to buy your own Levo online. You would need to write a new post asking people where you can buy Levo. Your post would be closed and you would receive any responses by private message - we aren't allowed to discuss suppliers on the open forum. Once you've investigated the responses you get you can ask one of the Admins if they have received any bad feedback on the one you've chosen. You always have to be wary of scammers who might respond to your request for sources.
Thyroid Peroxidase Antibodies 1.84 IU/mL (0 - 5)
Antithyroglobulin Antibodies 1.11 IU/mL (0 - 40)
The results above suggest that you don't have Hashimoto's aka autoimmune thyroid disease, but be aware that results for thyroid antibodies can and do fluctuate. It is possible for people to have Hashi's without positive test results. With negative results for the condition the only way to tell is by having a scan of your thyroid. I can't help with interpretation of ultrasound scans, I don't know anything about them.
Ferritin, Folate, cortisol etc. were all tested and are all in the normal range. Vit D was was at the bottom end of the range so I started taking Vit D.
You really should post those results you have including the reference ranges. Doctors tell patients that any result within range is "normal". This is not helpful though.
Suppose three patients A, B, and C had a ferritin (iron stores) test done and the reference range was 15 - 150.
A : Result of 15 - bottom of range
B : Result of 85 - roughly mid-range
C : Result of 150 - top of range
Many doctors would declare all the results above to be normal, although some of the better ones might prescribe iron supplements to patient A.
From a patient's point of view, the person feeling best would be B, the person feeling worst would be A.
Patient experience tells us that many people with thyroid disease need ferritin to be around 90 - 120 to feel at their best.
Similar comments about what level is optimal apply to other nutrients, although be aware that optimal isn't always mid-range or high in range. It depends on the nutrient being tested.
If your doctor has told you all your results were normal there could still be lots of wiggle room for improvement. So, if you have the results, please post them and the reference ranges.
Other symptoms include pins and needles in my fingers
In your shoes my first suspicion would be of your Vitamin B12 and/or folate levels.
I also get bouts of insomnia
This could be low or high cortisol, or the wrong levels of thyroid hormones.
IBD like symptoms
One effect of hypothyroidism is to reduce levels of stomach acid. This is why so many of us struggle with low nutrients levels, bloating, diarrhoea, constipation, gut pain, etc.
There are lots of posts on the forum about gut issues. Search for posts referring to "vinegar" or "betaine".
I will be booking a private appointment with an endocrinologist
Be very careful. Most endocrinologists are diabetes specialists and have almost no knowledge of the thyroid at all. Thyroid UK does keep lists of endocrinologists and doctors, private and NHS, who have been helpful to somebody - possibly only one person though so keep your expectations low.
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