Results after 9 weeks increase levo But no T4 result advice please

[Timetraveler67]

Can I have some advice please? I increased from 75 to 100mg of levo 9 weeks ago after I developed a goyta and managed to have a face to face with my gp who agreed to the increase even though my levels were normal range TSH 6.7 T4 16.4 anyway new results are back and I was surprised there’s no T4 yet I have a T3 result! Always been refused so can’t understand at all. My TSH has dropped to 0.35 (Range 3.10-6.80 pmolL and T3 is 4.1 (Rang 0.27-4.20 mlU/L can you please tell me if this is good? I have constant sore eyes, red eyelids under eye bags, aching joints but I have arthritis so maybe that’s not a thyroid symptom I don’t know but I’m in so much pain somedays I don’t know what to do. I had to stop better you spray with K2 as I felt worse so just taking Vitamin D on it’s own now. Brain fog and sleeping all the time but never feel rested. I have cfs so I don’t know if this is thyroid related or not but it’s definitely got worse. Swollen legs and ankles is also causing me concern too. I’m due a phone consultation in December with my endo who I’m angry with because she told me to stay on 75mg until Christmas that my brain just needed to catch up. Sorry this is so long but I’m desperately trying to give you all as much information as I can so hopefully you can advice me we’re I go from here. Thank you x

[SlowDragon Administrator]

Are you on same brand levothyroxine as before

Are you still strictly gluten free

When were vitamin D, folate, ferritin and B12 last tested

Give the new dose time to settle

Suggest you retest again in another 6-8 weeks

Always test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

[Timetraveler67 in reply to SlowDragon]

Hello slowdragon thank you for your reply, yes I’m on same brand MP I try to stay GF but I do make the odd mistake and pay dearly for it. My levels were last checked in July by Medichecks. - Ferritin 64 Vit D 71. Folate serum 17.2. B12 was 139. Do I need to test Everything again? Do I need my T4 checked as well? My gp won’t test my thyroid again now as levels are normal

[SeasideSusie Remembering]

Timetraveler67

My TSH has dropped to 0.35 (Range 3.10-6.80 pmolL and T3 is 4.1 (Rang 0.27-4.20 mlU/L can you please tell me if this is good?

I just want to point out, in case you haven't noticed, that you have the ranges mixed up. They are

TSH: 0.35 (0.27-4.20)

FT3: 4.1 (3.1-6.8)

Also

my gp who agreed to the increase even though my levels were normal range TSH 6.7 T4 16.4

If the range was the same your TSH was not in range back then at 6.7

It's a shame you haven't got an FT4 result because it would be interesting to see how well you convert T4 to T3.

What your results do show is that currently your FT3 is low in range at just 27% whereas this is the most important result because T3 is the active hormone that every cell in our bodies need and the one that tells us if we are over or under medicated. Low T3 causes symptoms.

[Timetraveler67 in reply to SeasideSusie]

Thank you seasideSusie for replying to me, please can you tell me what to do about my T3 being on the low side and if I should get my T4 tested privately? I never feel well I’m trying so hard to gather information from here I really appreciate your advice

[SeasideSusie Remembering in reply to Timetraveler67]

Timetraveler67

You need TSH, FT4 and FT3 all tested at the same time. If TSH is below 1 this will give the highest possible FT4 so you can then look at FT4 and FT3 to see how well you convert.

Good conversion needs optimal nutrient levels so maybe retesting those at the same time just to make sure there are no problems (Medichecks Advanced Thyroid Test - which incidentally is on special offer today - or Blue Horizon Thyroid Premium Gold).

When you've got the whole picture we can see if any nutrients need improving. If they're all optimal then a high FT4 and low FT3 will show poor conversion and that may then mean you need the addition of T3 to your Levo.

[Timetraveler67 in reply to SeasideSusie]

Thank you I will order a test from Medichecks right now and post my results. really appreciate thank you again x

[SlowDragon Administrator in reply to Timetraveler67]

Only do private test early Monday or Tuesday morning

If taking any supplements that contain biotin (like vitamin B complex) stop this a week before test as biotin can falsely affect test results

[Timetraveler67 in reply to SlowDragon]

Thank you, I’ve ordered the test and will do exactly what you have said, I will stop the B vitamins I take. Thank you I will do it Tuesday morning x

[HappyHealthyGirl in reply to SlowDragon]

Dear SlowDragon

Please could you tell me in what way Biotin affects test results?

I've not twigged that piece of info' before. 🧩

I take a number of B Vits (incl' B12 & Niacin), so I also take B-Complex to balance everything out. Many Multis contain Biotin too. 🙁

It would be really interesting to know what affect that might have had on previous test results.

Thank you for your help,

[SlowDragon Administrator in reply to HappyHealthyGirl]

Many labs use biotin in their testing equipment on a variety of different tests

It’s impossible to know if biotin is an issue with any particular test

Medichecks and Blue Horizon have both said it’s best to stop and supplements that contain biotin 3-7 days before tests

Generally it’s high dose biotin supplements that are the issue…..but standard advice is stop any biotin

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

[HappyHealthyGirl in reply to SlowDragon]

Thank you SlowDragon

The links to the 'papers' are particularly interesting & useful.

[Timetraveler67 in reply to SlowDragon]

I will do this thank you for your help and advice. I plan on doing the test Tuesday morning thanks again for advice

[Timetraveler67 in reply to SeasideSusie]

I have my results back from Medichecks would you like me to post them here or shall I make a new post so you can advice me on levels, thank you

[SeasideSusie Remembering in reply to Timetraveler67]

If you post them here it keeps all your information together and may save members asking questions already answered

[Timetraveler67 in reply to SeasideSusie]

Drs report said I have low levels of inflammation as well

Daylight

[Timetraveler67 in reply to Timetraveler67]

Hope these pictures are coming through ok for you

Daylight

[SeasideSusie Remembering in reply to Timetraveler67]

Timetraveler67

So these results are after increasing your Levo to 100mcg about 9 weeks ago.

TSH: 0.44 (0.27-4.20)

FT4: 20.1 (12-22)

TSH: 4.06 (3.1-6.8)

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.

Your FT4 is 81% through range but your FT3 is only 25.95% through range.

(Calculator here: chorobytarczycy.eu/kalkulator )

These results show poor conversion of T4 to T3.

**

Tg antibodies: 159 (<115)

TPO antibodieis: 330 (<34)

These confirm Hashi's which you already know.

**

Ferritin: 56.7 (13-150)

This is not optimal. Ferritin is recommended to be half way through range with some experts saying that the optimal level for thyroid function is 90-110ug/L.

You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet

bda.uk.com/resource/iron-ri...

everydayhealth.com/pictures...

Don't consider taking an iron supplement unless you do an iron panel, if you already have a decent level of serum iron and a good saturation percentage then taking iron tablets can push your iron level even higher, too much iron is as bad as too little.

**

Folate: 15.75 (?? range)

Medichecks range is either 3.89-19.45 or 2.9-14.5. Whichever range has been used your folate level is good.

**

Active B12: 150 (37.5-188)

This is a very good level.

**

Vit D: 80.5nmol/L

The Vit D Society and Grassroots Health recommend a level of 100-150nmol/L, with a recent blog post on Grassroots Health mentioning a study which recommends over 125nmol/L so you might want to work on improving this.

As your nutrient levels are essentially good, although improving ferritin may help, it would seem that you may benefit from the addition of some T3 to your Levo.

[Timetraveler67 in reply to SeasideSusie]

Thank you seasideSusie fit explaining the results for me. Yes the results are after an increase to 100mg. Do you think I could possibly bring my T3 up without adding a tablet of T3? Or should I ask my endo when I speak to her in December- or is that a silly idea- I don’t know. Thing is I’m so fatigued every day I have one or two good days then I crash and that’s been that way for years. The last 6 months or so my legs really swell up I’ve always got stomach ache which I’ve just discovered charcoal tablets which seem to help a bit. Thanks again for all your help x

[SeasideSusie Remembering in reply to Timetraveler67]

Timetraveler78

Thing is I’m so fatigued every day I have one or two good days then I crash and that’s been that way for years.

That is very likely to be due to the low T3 level, T3 is the active hormone that every cell in our bodies need, it's low T3 that causes symptoms. However, fatigue is a symptom of low ferritin so I'd certainly work on improving that level and see what happens.

Do you think I could possibly bring my T3 up without adding a tablet of T3? Or should I ask my endo when I speak to her in December- or is that a silly idea- I don’t know.

Even with the lowish ferritin, I think your problem is poor conversion and I think you may benefit from the addition of T3. However, you don't add a whole tablet, you start off with 1/4 of a tablet and slowly work up to what you need. Whether your endo will agree I can't say I'm afraid.

[Timetraveler67 in reply to SeasideSusie]

I will try to raise my ferritin and I will also buy some t3 as well encase my endo says she won’t prescribe Them. You have really helped thanks so much x