My Levo dosage was increased from 50-75 12 week ago Mercury Pharma
Bloods drawn 24hrs since last medication and 8am show the results below
TSH 0.14 (0.27-4.2)
T3 4.6 (3.1-6.8)
T4 23.3 (12-22)
Vitamins and minerals all within normal ranges
Previous result before increase
TSH 2.53 (0.27-4.2)
T3 4.2 (3.1-6.8)
T4 17.4 (12-22)
So I am thinking there might be a conversion issue as the T3 didn't move much at all the T4 going out of range
Would be grateful for any suggestions or comments thank you
Or, it could be that the FT4 has gone up so much, more of it is being converted to rT3 and less to T3 now. That often happens. Try reducing your levo a bit so that the FT4 comes back at about 19/20ish, see if that raises the FT3.
Vitamins and minerals all within normal ranges
Just being in range doesn't mean that the results are good or optimal. The ranges are too wide. If I were you, I'd post the exact results and ranges and let people have a look. 
Thanks greygoose the T3 didn't move much at all 0.4 T4 jumped by 5.9 I feel ok no palpitations but to be honest not feeling any improvement in Hypo symptoms I had prior to the increase
No, well, if the FT3 doesn't rise, there won't be any improvements in symptoms. It's low T3 that causes symptoms. Taking more levo won't improve them unless it converts to T3. And I explained why that might not be happening.
Yes I understand what youre saying regarding the T4 going to rT3 which is why I am going to try and get them to check my rT3 because my T3 hasn't increased by much at all but I know the Gp will insist that I go back to the previous dose and I will have gained no knowledge or improvement in symptoms I'm thinking of going down the private referral route again to see if NDT would be a better replacement for me . I was also wondering if people who have the DI102 gene have similar issues? I haven't been tested I may add
The NHS won't test rT3, and with good reason: it is very expensive, it takes a long time because it has to be sent to the US, and it doesn't give you any useful information that you can't get from the other tests.
Wish an FT4 that high, you are going to have high rT3, there's no doubt about it. And, your GP wouldn't know what he was looking at, anyway, with a rT3 test - he doesn't even understand the FT3.
Your FT3 hasn't risen because you are a poor converter. That could be because your FT4 is too high. So, the next thing to do is to reduce your levo, take your FT4 down to about 19/20, and see if that helps increase T3.
Another reason for poor conversion is low nutrients, but you haven't posted those results so we don't know if your nutrients are low. I really think it would be a very good idea to post them, along with the ranges, so people can tell you if you need supplements.
Poor conversion doesn't necessarily have anything to do with gene mutations. There are many, many reasons for poor conversion, but it's best to start off by looking at nutrient levels.
NDT might help you - although it doesn't help everyone. But, you don't need a private doctor for that. It's very, very difficult to get it prescribed on the NHS, so you'd probably be better off buying your own on-line. People here can help you with dosing. It would be cheaper in the long-run. But, in any case, to get the best out of NDT - and T3, come to that - all your nutrients need to be optimal, not just in-range.
I was told over the phone that levels of Vitamins and Nutrients were all within range so I have asked for a print out from the Gp but that can take up to 31 days I've been told as they can't be accessed online.
Last time they were taken again I was told within the optimal range except for Folate which was low and I was prescribed Folic acid by the Gp which I have been taking as well as Iron which was also low so was prescribed Ferrous Fumarate. I've asked for both lots of results to be printed for my reference
Once I get the printed results I will be able to accurately post them with the ranges too.
I don't know if I am comfortable looking for NDT online and self dosing I have found a clinic that has been mentioned on this forum who deal with patients possibly benefiting from NDT and supporting them whilst receiving prescriptions from a pharmacy. I know that going through my Gp will be fruitless even for a trial of T3 so I am not going to waste my time going down that route.
Never, ever accept your doctors opinion on your nutrient levels. They know nothing about it. Always get the actual numbers. As I said, just being in-range is not the same thing as optimal. Doctors don't learn about nutrition in med school, but they often have some weird ideas about it! lol
And, taking folic acid without knowing your B12 results, is not a good idea. Taking just one B vit is not a good idea, either. They all work together and need to be kept balanced. Folic acid is synthetic folate and not the best form for absorption - although it is the cheapest, which is why doctors prescribe it.
Good luck with the clinic. I don't know it, myself.
Thank you they did the B12 before stating me on the Folic acid it was 724 (197-771) I think you are right there is so much that Gp's don't understand about how the Thyroid works and because they rely on the TSH It's became apparent to me just reading forum posts that many many people are not correctly medicated and are constantly fighting against the system to receive adequate care. I have been taking the B vitamin Super B complex igennus that was recommended previously.
Yes, OK. Sorry, but it's not recommended anymore. It has vit C in it, and we now know that vit C negatively affects how the body uses B12. Thorne Basic B is a better one.
But, I'm glad to hear they did at least test the B12!
Oh dear and I have 2 tubs of it I will look up thorne basic B it's so complicated I was told to take vitamin C with the prescribed Iron for the deficiency as it helps the body absorb the Iron 😞
Yes, it's fine to take vit C with iron. But, iron should be taken at least two hours away from everything else, anyway. So, that vit C won't affect the B12.
Are you taking a sublingual B12 as well as the B complex?
I take Iron 4 hours away from any other meds no not sublingual
But are you taking a B12 tablet as well as the B complex?
Sublingual is best because it goes directly into the blood and bypasses the stomach, so you have a better chance of absorbing it.
No I have been taking just the B complex thorne basic B
OK, so, I would suggest that you get some sublingual B12, and take that together with the Igennus B complex, and that way you can finish up the Igennus without affecting the B12. Once it's all gone, you can just take a B complex without vit C as a maintenace dose. If any of that makes sense!
Yes perfect any suggestions for a sublingual B12
Jarrow sublingual methylcobalamin, 1000 mcg, is the one that is usually recommended. But, I find the tablets are much too large and take ages to dissolve. So, I'm sure that during that time, a lot of the B12 must just be swallowed, which defeats the purpose of sublingual. So, I prefer Solgar - if you can find them - I can't, at the moment. 
I will have a look for that thank you
You're welcome.
Was test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
Do you always get same brand levothyroxine at each prescription
If yes, which brand
What vitamin supplements are you currently taking
Do you have autoimmune thyroid disease, also called Hashimoto’s
Approx how much do you weigh in kilo?
Yes all the usual protocols prior to blood draw always same brand I do have Hashimotos taking VitD K stopped Vitamin B prior to blood draw 69kg
So as you have Hashimoto’s have you had coeliac blood test done
If not you need that BEFORE trialing strictly gluten free diet
Technically it’s Hashimoto's (with goitre) or Ord’s thyroiditis (no goitre). Both variants are autoimmune and more commonly just called Hashimoto’s
Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function with Hashimoto’s can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but further 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal
Before considering trial on gluten free diet get coeliac blood test done FIRST just to rule it out
lloydspharmacy.com/products...
If you test positive for coeliac, will need to remain on gluten rich diet until endoscopy (officially 6 weeks wait)
If result is negative can consider trialing strictly gluten free diet for 3-6 months. Likely to see benefits. Can take many months for brain fog to lift.
If no obvious improvement, reintroduce gluten see if symptoms get worse.
chriskresser.com/the-gluten...
amymyersmd.com/2018/04/3-re...
thyroidpharmacist.com/artic...
drknews.com/changing-your-d...
restartmed.com/hashimotos-g...
Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease
ncbi.nlm.nih.gov/pubmed/296...
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
ncbi.nlm.nih.gov/pubmed/300...
The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease
nuclmed.gr/wp/wp-content/up...
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
restartmed.com/hashimotos-g...
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
hypothyroidmom.com/how-to-l...
Eliminate Gluten. Even if you don’t have Hashimoto’s. Even if you have “no adverse reactions”. Eliminate gluten. There are no universal rules except this one.
Thank you yes tested and negative and no goitre
So if tested negative for coeliac you can trial strictly gluten free diet straight away
Likely to need further increase in levothyroxine after several months
Retest again in further 8-12 weeks
Meanwhile checking vitamin levels and improving if not optimal
I take 5 Brazil nuts a day. I read it helps convert t4 to t4 due to the amount of selenium in them. I have been on levothyroxine since February and increased from 50mcg to 75mcg in June July time . I felt terrible on levothyroxine for months then even worse after the initial increase. But then it eased and now for the last couple of months I feel fantastic. It was the people on this site that told me to stick to medication and gave me nutritional advice that kept me on the levothyroxine. Hang on in there. Its a slow slow process.
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