I can see this gets asks quite a lot and I now find myself asking the same - I would really appreciate any advise on mine - itās the first time I have had a T3 test also, so would be very grateful for any advice on if these seem ok. Thank you very much
Overall comment
20/09/2021
Please note, TSH is the most important parameter when considering efficacy of thyroid hormone replacement. A decision to change treatment is based upon both laboratory test and clinical considerations and should be made only in consultation with your healthcare provider.
THYROID STIMULATING HORMONE
20/09/2021
1.56 mu/L
TSH levels normal (normal range 0.27 - 4.2 mU/L)
THYROXINE
20/09/2021
16.8 pmol/L
FT4 levels normal (normal range 12 - 22 pmol/L)
TRIODOTHYRONINE
20/09/2021
3.8 pmol/L
FT3 levels normal (normal range 3.1 - 6.8 pmol/L)
Written by
MurphysMama
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First up - ignore the comment. TSH is the LEAST important result when you're on thyroid meds,
The actual thyroid hormone results aren't particularly great. Free T4 is only 48% through range and free T3 utterly feeble at 18.9%. So neither is high enough and you don't convert very well.
If it were me I'd be increasing levo by 25 mcg, and see how things look when free T4 is a good 3/4 through range. If free T3 is still languishing in the shallow end, I'd then start looking into an endo to give a trial of lio.
And it would be worth testing key nutrients and optimising these as necessary. Good luck x
Looking at previous posts and profileā¦youāre only on 50mcg levothyroxine?
Which brand of levothyroxine are you currently taking
Do you always get same brand levothyroxine at each prescription
Have you had thyroid antibodies tested
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.
Very important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimotoās or Ordās thyroiditis)
Low vitamin levels common as we get older too
Recommended on here that all thyroid blood tests should ideally be 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)
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
If TPO or TG thyroid antibodies are high this is usually due to Hashimotoās (commonly known in UK as autoimmune thyroid disease).
About 90% of all primary hypothyroidism in Uk is due to Hashimotoās. Low vitamin levels are particularly common with Hashimotoās. Gluten intolerance is often a hidden issue too
Request GP test vitamin levels ā¦.likely to be low
And request 25mcg dose increase in levothyroxine
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
guidelines on dose levothyroxine by weight
Even if we frequently donāt start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months. RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.
For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25ā50Ī¼g daily and titrate up every 3 to 6 weeks as tolerated.
For ALL other patients start at full replacement dose. For most this will equate to 1.6 Ī¼g/kg/day (approximately 100Ī¼g for a 60kg woman and 125Ī¼g for a 75kg man).
If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.
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