So I’ve just had my recent bloods done, last time I came on here it was recommended I increase my Levo dose from 200mcg to 225mcg. As the Aristo brand comes in only 100’s I’ve had to cut the tablets so half every other day with my other 2 tablets.
So I’ve been ok been feeling a little anxious and on edge as of this last 2 weeks my heart at night is going to pop it’s that loud and fast.
Should I quarter my tablets to every other day so rather than 225mcg, it would be 212.5? Is this the done thing? Advise please.
Anyway here are my results;
Tsh 0.29 (0.38-5.50 mlU/L
T3 5.5 ( 3.50-6.50pmol/L
T4 18.7 (10.00-18.70
Vit D 94.4 is this now adequate should I still take vit d?
Serum iron 15 (9.00-30.00umol/L
Serum transferrin 2.2 (2.50-3.80g/L
Saturation iron binding cap 55 (45.00-81.00
Transferrin saturation index 27% 15.00-50.00%
Serum ferritin 114 (10.00-291.00ug/L
I usually take 20ml of sytron liquid iron (sodium feredeate this is about 27ml of iron per 5ml.
I’ve had a calprotectin faecal test and that was 114 which is slightly out of range and could mean I’ve Inflammatory bowel disease, but I’ve to have another test and then if raised referral to gastroenterologist.
This could explain my poor iron results and problems with absorption, though the gp was worried about toxicity from these results. Any views??
I am very stressed right now but not sure if the increase in Levo has caused this? Or not helped? I’ve had to eat gluten too the last 4 weeks to have bloods test for coeliac disease, which were negative.
Any guidance would be helpful.
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Cheekycharlie1981
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Yes I am strictly dairy free. I do on odd occasion still have a little barley in foods so that’s some gluten content. I’m finding it hard to think the gluten would cause raised heart beat? I stopped the gluten over a week ago and my body is just not right. Should I adjust my thyroxine? Have more or less iron?
I’ve had t3 and did not cope well but my iron levels where worse than and I was advised to be more optimal before taking t3 again. It made me feel like a space cadet. but it did make my head clearer in some ways. I was taking 200mcg one day and 250mcg the next. I think think it’s a little too much?
Hi thought I’d reducing it to 200mcg one day and then 212.5mcg the next? Would this not be enough? Or should I just take the 250mcg every 3rd day? Confusing. How would you bring in the t3? Should I try a lower Levo then get bloods and then see if t3 is the way toward?
I honestly cannot remember it might of been 200mcg the day before and then I took the 250 after my blood draw.
So if I took 225mcg one day and 212.5mcg the other. I’m I right that works out at 218mcg per average week as apposed to my current dose at 200mcg and then 250mcg averaging at 225mcg. Sorry I’m terrible at math and my mind hurts thinking about it.
If I did introduce the t3 should I wait once I’ve adjusted the Levo?
Your FT3 isn't too bad, even though your conversion isn't brilliant. If I were you, I'd try 1/4 tablet T3 and see how it went. You probably don't need a lot.
Should I reduce the Levo first with my symptoms? And then introduce the t3? With my experience I’d probably try a few dust bits as last time it blew my head off. But my iron was lower then. Should I go back to 200mcg then add 2.5 t3 then build it up and reduce from there?
Then after 5 days added 2.5mcg T3 waking and 2.5mcg mid afternoon…….it was not much more a speck of dust
After about 5 days reduced levothyroxine by another 12.5mcg .
Then 5 days later increased T3 to 5mcg waking……still 2.5mcg mid afternoon
After week increased afternoon dose to 5mcg (so on 10mcg in total per day
Held at that dose for 8 weeks ……felt better and worse in almost equal measure. Often going for short walk around the block or even around the garden….just to shake it all up
Bloods retested after 8-10 weeks
Endocrinologist then increased dose T3 to 20mcg daily …that was back in 2017
It’s soo hard to kick the barley, I’m fighting histamine intolerance too and that eliminates everything good for the thyroid and vice versa. My diet is already a total nightmare.
Just had a read on healthline - yep that makes it more problematic (understatement). Hopefully over time you will be able to establish a diet that works for you. I think I’ve had leaky gut and suffered with thrush for years (Candida). Since cutting out the gluten that has abated - also there are combinations of food I’ve identified don’t work for me. It’s taken me about a year to get where I am now (think I’m on right dose of levo and think it’s working 😬🤞).
I have lots of symptoms when I’m hypo, but one of the most distressing is heartburn - it has been so bad when I was grossly undermedicated that I had to sit up in bed, I couldn’t lie down! As my levels improved and I worked out what caused big problems for me, with regards to the foods I was eating, things improved dramatically.
I was routinely prescribed omeprazole which did not work and actually started to make things worse.
This may be peculiar to me because, other people haven’t mentioned it, but I find if I eat carbs, fat and sugar in large quantities together it is the perfect storm for heartburn.
Even a gluten-free apple crumble will do it for me and I will be uncomfortable for the night. It really isn’t worth it - I’ve put it on my can’t be bothered with it anymore list.
So I thought I’d test my theory to the limit the other night and I ate a chicken Jalfrezi with vegetable pilau rice, but there was no sugar! My eyes watered my mouth burned pleasure/pain, but I had no heartburn.
I keep meticulous records of how I feel what I’ve eaten and how it’s affected me and this helps you learn what works and not work for your body.
You will get there it’s just overwhelming at this stage. Sending a virtual hug!
You may need to increase your stomach acid rather than repress it? I too have heartburn right now had it the last week. But it’s hard, could it be over medicated? Or getting to that age where things change? Or just what I’ve eaten? I’ve lots going on, I eat healthy, supplements etc and still feel like a mess. It’s a long journey for me. My iron is all over and the ranges are my top levels in years. My guts a mess, I’m stressed to hell.
I do watch my diet, don’t touch dairy, histamine trigger foods etc
I look pregnant most the time, I’ve no gallbladder either. The joys.
But I constantly feel tired and not with it, but with that I’m now anxious and on edge, but yet I want to sleep.
😢. I know that feeling, but dumping the omeprazole definitely helped me and just keep note of what aggravates to avoid it the next time. I do hope you get to a better place. It can take a long while for a leaky gut to improve so hang on in there. I have to say I flare up with beef chilli, but yet a hotter curry is fine there seems at time to be no rhyme or reason.
I saw there is a group formed for those with a histamine intolerance have you come across it? It was on the results when I googled it earlier. I’ll keep my fingers crossed you get sorted dietary wise. Oh for the times in the past when I was like a goat! I could eat pretty much anything with zero repercussions.
To be honest if you are having racing heart symptoms going to bed and you are feeling very anxious this amount of T4 may be too much for you. The resukts have you T4 in the upper range limit so this may be causing thise symptoms. I would reduce back to 200mcg for 6 weeks and see if that helps the symptoms. Being "optimally " medicatdd is different for everyone. Same thing happened to me in the past and I was getting similar symptoms which dissapearred when we reduced my dose. Hope you get it resolved
Two things. Racing heart can be caused by gluten if intolerant of it so you should avoid all gluten even tiny amounts. I went totally gluten free a year ago and it has made a big difference to me. But even tiny amounts of gluten can restart things back up again. So check your products in your kitchen, including gravey thickeners, sauces etc and bin them. Its not worth it! This will give you a clear page to cross check your heart rate alongside your thyroid treatment. Check that all your meds are gluten free too.
I think its always better to even your thyroid doses as much as possible so ts the same dose daily. When cutting tablets ensure you keep the remsining parts in the pill cutter so you can use then in the next dose.......this minimises any tiny imbalances in the cutting of tablets.
Lastly levthroxine is a storage form -T4. However if you are taking larger doses than your body needs and have good conversion from T4 to T3 your body will still use more to convert. A more clever bod on here will am sure explain why but thats my experience. Finding the sweet spot (ideal daily amount) is important for all forms of thyroid meds.
Oh and Imeant to say have you checked your B12 level because as you aare reporting problems with gluten and absorption issues this is also likely to be affected and we need B12 for all functions in our body including thyroid processes.
Thank you for the replies so the Aristo Levo can only be cut into half’s or quarters, if I try and cut them smaller they crumble into bits of dust. I was on 200mcg before and tired and ranges where definitely not even so suggested to take the extra 25.
I’m actually not sure what is best to do here, I think I do need a little more than 200mcg.
From my results I’m not converting t3 that great. I’ve upped my iron, my b12 is actually in a good range and so is my folate, that’s why I’ve not included them.
You're right you can't cut them smaller than quarters. You need one of the tablets to be a lower strength so you can cut this for smaller doses. Not easy I know. Cant help you with iron levels am afraid, but am sure someone like Sea-side Suzie will.
B12 is now definitely over 500 it’s 634, so I’m still taking a b complex to get it a bit higher still. I take Aristo and it suits me, I’ve tried every brand and none other have suited me so well, sadly it’s only a 100mcg tablets available in the uk.
Everything I have is gluten free, but then my husband brings in things too tempting. I make most things myself so I watch my foods. Dairy and gluten is in everything nearly.
Thats hard to have to keep dairy and gluten free. I just do gluten free.....not too bad and the supermarket these days has a good range of products. When my daughter in law comes over who is lactose intolerant I find it far more tricky making a meal that is suitable for both of us and if my older son joins us, who is vegetarian, even more interesting!! Hope you get sorted soon.
SeasideSusie make any suggestion on my results? I posted last time with my previous results. Need help with iron results from bloods now to last time. Could I blame Inflammatory bowel disease for irregular iron results. It has increased since last time.
Your ferritin looks good. My doc likes it at about 100, and ThyroidPharmacist likes about 90.
Your levo dose is pretty high. Have you considered that the full replacement dose of levo is in the 1.5-1.7 mcg/kg body weight range? For instance, at 77kg, my max full replacement dose should be about 1.7*77=130mcg. 225mcg seems really high, unless you weigh about 130kg (286 lbs). T4 at top of range and TSH below range, say to me your dose is too high.
Hi Eddie, I definitely don’t weigh that, but I am over weight. I’ve never heard anyone on here refer to weight as a guidance for Levo dosage. Where did you this reference from? I’m probably about 203lbs. I’m not sure where to go my results last time were not perfect either on 200mcg of Levo? Is t3 the way forward? I feel like I’ve various different opinions on here and my head hurts.
I’m now taking 200 one day and 225mcg the next and so on.
My iron was poor, what maintenance dose would you suggest as I was taking 20ml at 27.5ml per 5ml.
The "full replacement dose" is an approximation that is widely used. As I recall, I came across the 1.7mcg/kg value in a Pfizer document. If you google "thyroid full replacement dose", the first ref you'll find says 1.6mcg/kg. Your numbers on 200mcg/day actually look quite good. Have you been observing the warning about absorption of levo, i.e. take it 1 hour before, or 2 hours after, food?
I don't know a lot about iron, but I do know that for many people, the ferritin test correlates closely with how they feel. For instance, my spouse has a ferritin down near 15 and she is not doing well. When I was low iron (on the heels of gluten enteropathy), I took 2 caps containing 52mg of chelated iron (iron bisglycinate) daily, until I got my ferritin to a reasonable level. Your ferritin and serum iron both are at reasonable in-range levels, do you have some reason to think that you need more iron?
I’ve documented my iron 2 months ago above and months before that I was 8 on the serum iron scale. My iron results didn’t make much sense. I don’t eat gluten and dairy though I do slip up with barley as it’s added to certain cereals.
I’ve just been tested for coeliac disease and it’s come back negative.
My gp thinks I’ve issues absorbing nutrients etc and might have inflammatory bowel disease, that’s to be investigated further.
So what dosage of Levo should I be on? What is your personal stance on t3? I’ve always been a poor converter.
I posted my previous results last time and recommended to add more Levo, I did and this is where I am now.
I’m well conversed on when to take Levo and supplment times etc
I use T3, as well as levo. It could be instructive for you to add a little T3 to see if you feel better. Just enough to get your FT3 about 50% up in range ... don't want to risk going hyperthyroid, as I did when I attempted to take too much T3. For me, at about 77kg, 100mcg levo + 7.5mcg T3 is good enough.
I tried t3 before but my iron etc was not as good. It made me feel off my head and instantly within a few seconds quite panicky and off. It took some time to past this stage but I was not coping on it. But this was bad advice from my endo and I took to much. But even on reduced dose I felt odd, but at times more alert like the brain fog cleared.
I might of reacted to the fillers so I haven’t found the t3 brand for me. I’ve tried quite a few. Any recommendations?
A spreadsheet with several active formulas which work out possible levothyroxine requirements including NICE NG145 guidelines. These formulas are referred to in the document above.
This is an Excel spreadsheet but is likely to work in other spreadsheet software.
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but it did make my head clearer in some ways. I was taking 200mcg one day and 250mcg the next. I think think it’s a little too much? 
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