hello can anyone help give me a steer on my blo... - Thyroid UK

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hello can anyone help give me a steer on my blood results?

jsy_girl profile image
18 Replies

I've had my bloods done for my next appointment and same day got medichecks done. I haven't had the consultant ones back but medichecks has come through. Just for testing, I did it fasting at 8.15am, T4 last dose 24 hours before and T3 throughout the day (10mcg in morning, 10mcg at 3.30pm, 5 at 9.40pm).

I am now pretty happy with my dosing but I still sometimes feel a bit hypo later in the day and I certainly dont feel like my brain is as sharp as it could be although I have more energy and sustained a 2 hour bike ride on holiday last week. I take my dose on a normal day as 20mcg on waking and 5mcg at 6pm. this works well for me but I would like to try 20 and 10 if I could get the doctor on board...

I have the following thoughts/questions, all help appreciated.

1) with a TSH of 0.07 (or lower as my consultant test was at 9am so a bit later in the morning) will my doctor try to reduce my T3?

2) I still want to increase my T3. Since increasing from March, my fT3 hasn't really improved that much and i'm still low in range and feel i could just use a bit more. I think another 5mcg and I might feel it. do you think these numbers support that or will TSH impede my quest? I read other posts saying to ignore TSH but is there a point at which you can't ignore it, or is my only blocker the "health professional"?

3) Failing increasing T3 I would like to at least try increasing levo.

4) I stopped all multi vitamins etc because my B12 was sky high last time. I clearly need folate and suspect over time B12 will drop further. I might use thorne basic b which is lower B12 and higher folate.

5) Since stopping iron supplementing my ferritin has rapidly dropped. Will try the GP because according to NICE guidelines they are meant to be monitoring this... clearly they aren't. Reckon I might fail here due to the glass vial shortage. If i do, should i just restart myself or should I get an iron panel done first. I stopped supplementing previously as my serum iron had moved toward the higher end. I was hoping that diet alone could sustain it.

6) I will increase my Vitamin D to 3000 iu day (was 2000iu since march and 8000iu to get me there).

Many thanks for taking the time to read my post!!!

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18 Replies
SeasideSusie profile image
SeasideSusieRemembering

jsy_girl

Increasing T3 has lowered your TSH (as expected) and lowered your FT4 (as expected). It's very individual where we need our FT4 when on combination hormone replacement but your level at 12% would have me very unwell and hypo. Maybe you need more Levo at this stage to increase your FT4 and this is likely to also increase your FT3 to a certain extent. If you add more T3 at this stage your FT4 will lower even more.

To answer your questions:

1) with a TSH of 0.07 (or lower as my consultant test was at 9am so a bit later in the morning) will my doctor try to reduce my T3?

Possibly, some doctors may realise that taking T3 lowers TSH and not worry too much but many just freak out at low TSH.

2) I still want to increase my T3. Since increasing from March, my fT3 hasn't really improved that much and i'm still low in range and feel i could just use a bit more. I think another 5mcg and I might feel it. do you think these numbers support that or will TSH impede my quest? I read other posts saying to ignore TSH but is there a point at which you can't ignore it, or is my only blocker the "health professional"?

Depending on which lab does my test (GP or private) my TSH can show as low as <0.005. My GP doesn't see my private test results. The NHS lab test lower limit is 0.02, my GP test comes back either as 0.02 or <0.02 and my GP doesn't like it and tells me I am overmedicated. I point out that I can't be because my FT4 and FT3 are within range (she doesn't know I take T3).

As mentioned in answer to (1) I think you may be better increasing Levo at this stage.

3) Failing increasing T3 I would like to at least try increasing levo.

I think this is the better idea at the moment.

4) I stopped all multi vitamins etc because my B12 was sky high last time. I clearly need folate and suspect over time B12 will drop further. I might use thorne basic b which is lower B12 and higher folate.

Your current Active B12 level is good. I like Thorne Basic B, it's my choice of B Complex after trying a couple of others.

5) Since stopping iron supplementing my ferritin has rapidly dropped. Will try the GP because according to NICE guidelines they are meant to be monitoring this... clearly they aren't. Reckon I might fail here due to the glass vial shortage. If i do, should i just restart myself or should I get an iron panel done first. I stopped supplementing previously as my serum iron had moved toward the higher end. I was hoping that diet alone could sustain it.

I wouldn't restart iron tablets until you've done an iron panel. If GP wont do it then Medichecks do an iron test for £39 which is a fingerprick test.

6) I will increase my Vitamin D to 3000 iu day (was 2000iu since march and 8000iu to get me there).

Retest after 3 months to check level. Aim for 100-150nmo/L, Grassroots Health recent blog post recommends at least 125nmol/L. Do you take magnesium and Vit K2-MK7, the important cofactors needed when taking D3?

jsy_girl profile image
jsy_girl in reply to SeasideSusie

Many thanks for your really detailed answer. Thank you. I will do as you suggested and propose to increase levo with my doctor.

And yes I take the Thorne d that has k2 in it and I take magnesium

June25 profile image
June25 in reply to SeasideSusie

"Increasing T3 has lowered your TSH (as expected) and lowered your FT4 (as expected).

Hi SeasideSusie could you please explain why increasing T3 lowers FT4 if the dose of T4 is the same?

SeasideSusie profile image
SeasideSusieRemembering in reply to June25

June25

It's just what taking T3 does. I don't know the science I'm afraid but personal experience proves this and so does experience of members. For example look what happens when keeping to the same dose of Levo but increasing T3:

Me taking

112.5mcg Levo plus 12.5mcg T3

FT4 = 74% and FT3 = 62%

112.5mcg Levo plus 18.75mcg T3

FT4 = 65% and FT3 = 78%

and if you look at jsy_girls's results above:

112.5mcg Levo plus 15mcg T3

FT4 = 33%

112.5mcg Levo plus 20mcg T3

FT4 = 22%

112.5mcg plus 25mcg T3

FT4 = 12%

June25 profile image
June25 in reply to SeasideSusie

Thanks SeasideSusie , it's my experience too and I've been trying to understand it. This is helpful. I don't want to hijack this thread though, might start a new one about it and my own situation, June

jsy_girl profile image
jsy_girl in reply to June25

It is strange isn’t it. If you go back to my previous medichecks results when I was on a lower dose of T4 and T3 I can achieve the same numbers practically as what I’m on now. What’s *that* about too! Even when I start to think I understand it, something else perplexes me and I realise I still really don’t understand it.

June25 profile image
June25 in reply to jsy_girl

I've just posted "T4 depletion, what's going on?" on this subject. Would be great if you felt like contributing your thoughts. I find your analysis of your own results very good and clear.

June

SlowDragon profile image
SlowDragonAdministrator

I would suspect you might need more than 3000iu daily of vitamin D to increase vitamin D to around 100nmol

Then experiment with maintenance dose of 3000iu- 4000iu

Perhaps more in winter

Falling ferritin is obviously a big issue

Personally I would experiment with increasing levothyroxine a little, perhaps 125mcg 5 x week and 112mcg 2 x week

jsy_girl profile image
jsy_girl in reply to SlowDragon

Thanks SlowDragon - yeah I think you’re likely correct. I will maybe do 5,000 for 3 months and see what jt does.

SlowDragon profile image
SlowDragonAdministrator in reply to jsy_girl

I found, after much experimentation, I need 4000iu daily in summer, slightly more in winter

But we are all individual

jsy_girl profile image
jsy_girl in reply to SlowDragon

Hi SlowDragon

I did as you suggested and feel maybe in the last few days that I’m slightly over. I feel a bit anxious with my heart beat feeling stronger. Do you think I should keep going at this dose and test at the 6-8 week mark (4 weeks to go) or reduce already? I was thinking to try and do 3 days at 112.5 and 4 days at 125.

SlowDragon profile image
SlowDragonAdministrator in reply to jsy_girl

Personally as long as I wasn’t getting irregular or fast heart rate I wouldn’t alter dose …but wait till 6-8 weeks and retest

london81 profile image
london81

your chart is great ineed to set mine out like this

only thing that jumps out to me is : consider taking your weight out when showing to doctor they might think you are using t3 for weight loss ( i can see your free t3 is relatively low and as someone on ndt i understand but doctors tend to jump to these conclusions rather than accept we need t3 🙄🤣)

jsy_girl profile image
jsy_girl in reply to london81

Oh thanks I try to be organised haha. It’s annoying when all the tests use different ranges though.

It’s interesting but my doctor does actually use that almost to infer my dose isn’t high enough. Stable weight or weight loss is what he’s expecting to see if I was better dosed. It’s not happened so far my weights just climbed as you can see. Probably more the cake than the thyroid though!!!

OudMood profile image
OudMood in reply to jsy_girl

Lol @ the cake! 🙊😂

SeasideSusie profile image
SeasideSusieRemembering in reply to jsy_girl

jsy_girl

Probably more the cake than the thyroid though!!!

🤣

That's me all over! I openly admit I'm a total pig with no self control. What does my granddaughter do at Christmas - gives me all my favourite sweets/chocolates/etc. And me, once they're open, there's only one thing to do with them, empty the pack as soon as possible. And my son likes to treat Mom so he brings me treats regularly. I've had to beg him to stop and I've banned all naughties from my house for a couple of months. I've actually reached 1lb off my target weight today, I've lost 9 lbs by cutting them out, allowing myself just one treat from my son per week (he bought me flowers instead of chocolates yesterday because I'm not too well at the moment). I want to lose a couple more pounds then that will give me some wriggle room to have the odd treat now and again. And I will tell my granddaughter no choccies at Christmas!

jsy_girl profile image
jsy_girl in reply to SeasideSusie

It’s so hard isn’t it. I went on a total health kick last year. I have pcos too so I followed a protocol of trying to eat to stabilise blood sugar essentially. Did so well - I lost 2 stone. But it’s hard to maintain it all the time and I’ve regained a stone this year. I need to get back on it but just had a holiday where we found this really cute tea room.

TEA ROOM. it’s the ultimate horror for someone watching their weight. They had coffee and walnut cake, rolo cake, banana and pistachio cake, Victoria sponge, lemon drizzle. And all mounded high with glorious, bountiful icing.

Anyway 6 slices later and some bakewell pudding and the rest is history (over the week. Not in one sitting. I’m not a total pig). Hahahaha.

Good times. Ah well, life is for living. I just need to get back on the wagon. Very good effort on your part too. Moderation is definitely the key. Still having what you like, just less often. Sorry to hear you’re unwell currently. I hope you pick up soon. We need you here!!! 😆

london81 profile image
london81 in reply to jsy_girl

my weight has climbed 1st6 pounds since xmas. i was working with a pt and calorie counting, so some of that is muscle ( i had a dexa scan which confirmed high muscle but im def overweight as my fat is high too)

i lost 3 stone when i went onto t3 but have gained it all back even on 5.5 grains NDT ( 200 t4 and 49 t3)

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