Results help please : T4- 18. (11-26) T3- 4.7 (... - Thyroid UK

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Results help please

Angie10116 profile image
19 Replies

T4- 18. (11-26)

T3- 4.7 (3.9-6.8)

Tsh 43 (0.27-4.2)

These results were on 100 mg of levothyroxine. I don’t really know what this means, if anyone has any suggestions would be great. My doctor has now changed me to 75 mg levothyroxine and 5mg t3 once a day.

I take tablets on an empty stomach and wait an hour before food

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Angie10116 profile image
Angie10116
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19 Replies
tattybogle profile image
tattybogle

so you were on 100mcg Levo for a couple of months , and then took this test. your post a few days ago said doctor reduced to 100mcg /alternating with 75mcg levo.

now this post says 75mcg Levo +5mcg T3.

So if i understand correctly, your doctor has reduced Levo in order to add some T3 ?

previously ... on 75mcg levo your TSH went up to 75, and fT4 was bottom of range (11)

So they increased to 100mcg.

you did a private test after just 4 weeks on 100mcg and TSH had reduced to 26 , f4 was near top of range 23[12-26], but fT3 was below range. But 4 weeks was a bit too soon to test.

So after a few more weeks TSH has started rising again to 43. (fT4 is a lot lower ,and fT3 is a bit higher )

The TSH rising again from 26 to 43 seems to show the body is not yet getting enough thyroid hormone....

So now doctor has decided to try adding some T3 ... which sounds sensible to me.

but I'm not sure if they needed to reduce your Levo dose by so much, since it is only 46% through range at 18[11-26]

See what happen on 75 Levo +5mcg T3 ... it might be you will need more T3 than 5mcg, and it might be that they didn't need to reduce levo by so much .... but see how it goes.

(This is assuming your rather wild TSH results are correct results and are not being affected by any technical problems in the lab process... and also that you were consistent about time of last dose Levo with each test)

Angie10116 profile image
Angie10116 in reply totattybogle

Thank you so much! Yeah it’s been a bit all over the place. Do you think I still have the right to feel under medicated? Because my T4 and t3 are okay

tattybogle profile image
tattybogle in reply toAngie10116

well according to your TSH ,your pituitary gland obviously still thinks you are VERY undermedicated .... (and any doctor will tell you TSH always right.... lol )

and the body likes stability ... whatever is going on with your TSH levels , it's not 'stability' ....... so yes .. you have every right to still feel 'all wrong' :)

Angie10116 profile image
Angie10116 in reply totattybogle

Thank you very much for the reassurance😅☺️

SlowDragon profile image
SlowDragonAdministrator

When were vitamin D, folate, B12 last tested

What vitamin supplements are you currently taking

Looking at previous posts

You had low ferritin but iron was ok

Have you increased iron rich foods since then to help improve low ferritin levels

Angie10116 profile image
Angie10116 in reply toSlowDragon

I think it was tested in September and it was all good. I have tried to add more iron rich foods, but I’ve also started taking iron because I was told that it will increase my ferritin

SlowDragon profile image
SlowDragonAdministrator in reply toAngie10116

SeasideSusie explained 2 months ago you should NOT take iron supplements as iron levels fine

Just to look at increasing iron rich foods in diet

healthunlocked.com/thyroidu...

Serum iron: 55 to 70% of the range, higher end for men - yours is 70% so you don't want to take it any higher.

Saturation: optimal is 35 to 45%, higher end for men - yours is just short of that but not low enough to worry about considering your serum iron level.

Transferrin: Low in range indicates lack of capacity for additional iron, High in range indicates body's need for supplemental iron - yours is a touch above mid range so not high enough to suggest supplements.

pennyannie profile image
pennyannie

Hello again :

You had RAI this year didn't you - in around April ?

RAI is a slow burn and there is no specific time line on how long it takes for RAI to totally burn out and fully disable the thyroid.

Your TSH feedback is not worth measuring as your HPT axis - the hypothalamus/ pituitary/ thyroid feedback loop is now broken as the "T" in thyroid is now disabled.

It is more difficult to treat primary hypothyroidism caused by RAI and as I've said before RAI can trash your vitamins and minerals which need to be optimal for any thyroid hormone to work effectively.

Your TSH is irrelevant and you must be dosed and monitored on your T3 and T4 levels with the intention to have both these vital thyroid hormones balanced , within the ranges, and at a high enough level to restore your well being both mentally, emotionally, physically and psychologically.

I wonder if you may do better on liquid T4 ?

I see you now have T3 prescribed and this has a much shorter "active " life span than T4 - you may well benefit by taking additional, small amounts of T3 throughout a 24 hour period to keep you feeling more stable.

I see you asked about NDT ?

I am self medicating and taking NDT and am much improved.

I was refused both T3 and NDT on the NHS and on T4 monotherapy I thought I was suffering from dementia.

I have Graves and am post RAI thyroid ablation in 2005 and started self medicating around 4/5 years ago and when my doctor referred to me as a conundrum I decided I'd had enough.

Angie10116 profile image
Angie10116 in reply topennyannie

I’m sorry that you’ve been through all of this. Yes I’ve had radioactive iodine. I’m just wondering why I still feel so bad because my t3/T4Are okay. It’s just my TSH that’s very high and I just feel awful every single day

pennyannie profile image
pennyannie in reply toAngie10116

Your T3 and T4 maybe " ok " for some one else but not for you as you still are unwell :

Your T3 and T4 are in the range but likely not at optimal levels for you :

Similarly your ferritin was too low in your other post I've just replied to - as everywhere I read it states ferritin needs to be oer 70 for any thyroid hormone replacement to work effectively.

Your TSH is irrelevant - you haven't a functioning thyroid but a thyroid full of Graves antibodies and RAI :

You must be dosed on your T3 and T4 and to a level of each hormone that then gives you back your health and stability :

Each dose adjustments needs time to bed in, so you must give yourself time to adjust and build up those vitamin and minerals to help support you core strength through this difficult period.

Angie10116 profile image
Angie10116 in reply topennyannie

Thank you very much. I don’t know what to do with my ferritin because people tell me that I can’t take iron for it, whilst other people told me that I need to take iron for it. And I literally don’t know what to do

pennyannie profile image
pennyannie in reply toAngie10116

I think I read that your Iron panel was ok - so there was no need to supplement - but we know as people having to take thyroid hormone replacement that we need optimal levels of ferritin, folate, B12 and vitamin D in order to assist the conversion of the thyroid hormone replacement medication.

My vitamins and minerals all look optimal, but that is because I'm supplementing.

Without supplementing they will likely fall through the floor again, as U am hypothyroid, and I also have low stomach acid and therefore have trouble extracting essential key nutrients from my food.

SlowDragon profile image
SlowDragonAdministrator

Vitamin levels from 3 months ago

B12 : 213 (range 180-900)

Vitamin D : 65 (range >50)

Folate : 4.5 (range >3)

Ferritin : 41 (range 15-300)

Since then I had 6 b12 injections and I have bloods in 3 weeks I believe to see if they’ve made a difference. Doctors said everything else was ok.

3 days ago I started taking selenium, mangmesuin, b12, iron, fish oil, and vitamin D

How often are you getting B12 injections now

As you have B12 injections it’s recommended also to supplement a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial.

This can help keep all B vitamins in balance and will help improve low folate and maintain B12 levels between injections

Difference between folate and folic acid

chriskresser.com/folate-vs-...

B vitamins best taken after breakfast

Thorne Basic B or Jarrow B Right are recommended options that contains folate, but both are large capsules. (You can tip powder out if can’t swallow capsule)

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

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

endocrinenews.endocrine.org...

You might wish to take separate folate and B12 supplements the week before blood test

How much vitamin D are you currently taking

You need to retest twice a year, especially early on while working out how much vitamin D you need .

Aiming for at least around 80nmol and around 100nmol maybe better

Vitamin D and thyroid disease

grassrootshealth.net/blog/t...

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.

Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

Angie10116 profile image
Angie10116 in reply toSlowDragon

I’m not taking any B12 injections anymore as my level is 600

SlowDragon profile image
SlowDragonAdministrator in reply toAngie10116

Then you will definitely be needing a daily vitamin B complex

You may still see B12 levels drop if injections have been stopped

Retest 4 months after last injection

If serum B12 result drops below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a daily B Complex (to balance all the B vitamins) initially for first 2-4 months, then once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.

B12 sublingual lozenges

amazon.co.uk/Jarrow-Methylc...

cytoplan.co.uk/shop-by-prod...

healthunlocked.com/thyroidu...

Angie10116 profile image
Angie10116 in reply toSlowDragon

I am taking b complex and b12 ☺️ Thank you!

pennyannie profile image
pennyannie in reply toAngie10116

Angie :

Are you still living at home or looking after yourself ?

It's hard enough at any age, reading and understanding everything you are being advised.

Having had Graves since a teenager and now just 20 and having had RAI thyroid ablation I just wonder if you have someone there you can talk all this through with as it's very much information overload and you must feel a bit, or a lot, overwhelmed.

Angie10116 profile image
Angie10116 in reply topennyannie

Yes I’m living with my parents. It’s just a lot isn’t it :( especially that high tsh can cause depression ect. It’s really not the best when you’re sensitive to dose changes, which I am very much. How’re you holding up?

pennyannie profile image
pennyannie in reply toAngie10116

It's not the high TSH causing anything it's that your T3 and T4 levels are not where they need to be for you to be well .

I'm now much better as I'm self medicating with Natural Desiccated Thyroid.

Thank you :

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