Feeling down and upset

[beesretreat123]

I am upset that my GP will not discuss my thyroid results or increase the levothyoxine So that I feel better. Also iI am not sure if my T3 levels are ok or not?

[Sparklingsunshine]

Hi

You will need to post your results with the lab ranges so that members and admin can help you.

[beesretreat123 in reply to Sparklingsunshine]

Hello

These are blood results from tests taken on 18 October 2021.

Thyroid function test 0.74mu/L (0.3 -4.2)

Serum TSH level 16.4 (10.0-22.0)

Serum free triiodothyronine level 3.8 (3.1-6.8)

Maybe my T3 is low??

I don’t really understand the results properly. I only know I feel awful, sluggish, tired, very depressed, cannot lose weight easily, thin hair and brittle nails.

Can anyone identify with this please?

Thank you.

[Sparklingsunshine in reply to beesretreat123]

Hi

It certainly looks like your T3 is too low. Your T4 could certainly do with being higher as well. Most hypo patients benefit from the results being in the top part of the range.

Are you on Levo, how long have you been on it and what dose? My T3 was 3.6 a couple of weeks ago and members suggested I could be a poor converter of T4 to T3. Maybe you are too. Hopefully one of the more experienced members will be along soon to advise you.

[beesretreat123 in reply to Sparklingsunshine]

I am on Levothyozine and have been on 100 mcg for over two years. I was on 175 mcg then 150 mcg then down to 100 two years ago. I feel dreadful and I can’t get any help anywhere.

My hypothyroidism was diagnosed in 1990 so I do know a bit about the levels to feel well.

Thank you.

[fuchsia-pink in reply to beesretreat123]

I suspect your TSH is 0.4 and it's free T4 that is 16.4 - which is 63% through range. Free T3 is only 19% through range.

Most of us need our "frees" higher than this - in the top third or higher of the lab range - and I certainly wouldn't be able to lose weight with free T3 this low. I'm not sure how much levo you're taking, but you certainly have plenty of space in these lab ranges to add another 25 mcg a day, at which point you should feel better.

It's also worth testing key nutrients - ferritin, folate, vit D and B12 - as many of us hypos are deficient and need to supplement - and you need good levels for your levo to work properly. I've had some success with my GP by saying that these are the tests recommended by Thyroid UK. Additionally, your symptoms suggest poor levels. But if the GP can't or won't test these, you will see LOTS of posts here about private testing

Once your free T4 is higher - say 75% though range, you will have a better idea of how well you convert free T4 to free T3.

Don't forget to take your levo on an empty stomach, just with water, an hour before or two hours after other food and drink and well away from other medication. And always have an early morning (before 9am) fasting blood test, when TSH is highest, with a 24 hour gap from your previous dose of levo (to ensure a good representative level of hormone rather than a just-taken-your-meds "spike") x

[beesretreat123 in reply to fuchsia-pink]

Thank you so much. My GP won’t listen to how I feel. I am going to obtain 25 mcg of thyozine privately. I hate doing this but I can’t go on feeling so dreadful all the time. I feel that being on an extra 25 mcg taking my levels up to 125 mcg a day should make me feel better. I don’t think it can do any harm.

Thank you again to everyone who has helped.

[Sparklingsunshine in reply to beesretreat123]

Hi

When you were on a higher dose of Levo did you feel better, what were your T3 and T4 levels back then. Why was your dose dropped? A 75mcg dose decrease is not a small amount. Something tells me your GP looks at TSH levels only and not the other results. Sadly this seems common amongst many doctors.

[beesretreat123 in reply to Sparklingsunshine]

I did feel much better. I was going into hospital for an operation and they picked up that I was slightly over. The GP then cut the amount from 175 to 100 daily. I was so reluctant to go down under 125 but she wouldn’t have it. Now I feel dreadful two years on.

[Sparklingsunshine in reply to beesretreat123]

Hi

I'm so sorry you are feeling bad. Problem is many doctors are so fixated on numbers they don't take into account how patients feel and their symptoms. Could you try another GP at the practice. I've found they vary quite a bit.

My old GP who I had for over 30 years was excellent and very good for many things was very by the book for thyroid. If your TSH was in the range that was it as far as she was concerned. No matter if you felt like death.

I was convinced I was hypothyroid for years before I finally got diagnosed in 2020 but because my TSH was high normal I just got fobbed off.

She's now retired and I've actually been pleased that some of the newer, younger doctors at the practice are looking at my FT4 and testing my FT3 and adjusting my dose accordingly. They aren't just looking at TSH results. It might be worth trying a different GP or if you can afford it, go private. There are private GP's around. They can prescribe on the NHS though.

I really hope you can get something sorted. You shouldn't have to feel as bad as you do.

[SeasideSusie Remembering in reply to beesretreat123]

beesretreat123

Thyroid function test 0.74mu/L (0.3 -4.2)

Serum TSH level 16.4 (10.0-22.0)

Serum free triiodothyronine level 3.8 (3.1-6.8)

I just want to point out that you have presented your results incorrectly. For clarification it should be

TSH: 0.74mu/L (0.3 -4.2)

Serum FT4: 16.4 (10.0-22.0)

Serum free triiodothyronine (FT3): 3.8 (3.1-6.8)

Your FT4 is actually 53.33% through range and your FT3 is 18.92% through range.

Calculator here: chorobytarczycy.eu/kalkulator

The aim of a treated Hypo patient on Levo only, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges if that is where you feel well. You could do with more Levo but it wont necessarily improve your FT3 level much because your conversion of T4 to T3 is poor.

Good conversion needs optimal nutrient levels. Have you had these tested? If not then it would be a good idea to do so before doing anything else. Optimal levels are:

Vit D - 100-150nmol/L according to the Vit D Society and Grassroots Health, with a recent blog post on Grassroots Health mentioning a study which recommends over 125nmol/L.

B12 - top of range for Serum Total B12, for Active B12 over 100 would be good.

Folate - at least half way through range, if the range doesn't have a top and bottom limit and just says something like >2.9 then you're looking at aiming for double figures.

Ferritin - half way through range although some experts say the optimal level for thyroid function is 90-110ug/L.

So these need checking first and if any low levels or deficiencies they need addressing.

[beesretreat123 in reply to SeasideSusie]

Thank you for clarifying this.

I am already on vitamin D and B12. I will look at the other two things you mentioned too.