Please help interpret my bloods since T3 added

[Mazzer]

Hi me again.

Back in November on 150mg my bloods were as follows:- TSH 0.1 (0.27 - 4.2)

T4 22.8 (12 -22)

T3 4.96 (3.1 - 6.8)

I was still symptomatic and my nails and hair have changed since my thyroidectomy.

I finally saw an NHS Endo in November who reduced T4 to 100mcg and added T3 10mcg x 2 daily. I added this gradually and have had some improvement some of the time. Still experiencing tingling legs, heat irregularity and variable energy.

I have waited 6 weeks and have these results today.

Same ranges for each-

TSH 0.03

T3 5.56

T4 15.

Vit D is in range but not optimal - 72.2 ( 50 -200)despite mainlining vit D spray and eating well.

B12 >150 (37-188)

Ferritin 93.8 (13-150)

I suspect the Endo will freak at the TSH and stop the T3 as “it hasn’t made you well”

Oh and I have the D102 variant

Thanks folks

[Lalatoot]

Mazzer it has taken me 2 years of slowly and gradually adjusting Levo and lio T3 doses (one change at a time) to find doses I feel able to be on longer term. It is not a quick fix. My endo gave me a trial 6 months to a year initially so it is early days for you yet.Taking lio T3 tends to suppress TSH so there is no surprise there.

[Mazzer in reply to Lalatoot]

Thank you for your reply Lalatoot. It's getting me down to be honest. Looks like ive swapped the percentages round T3 from 50%now 66% and T4 dropped from 110% to 30.

[SeasideSusie Remembering]

Mazzer

You may be like me, also on combo therapy, where I need a higher FT4. Yours is 30% through range, I am very unwell when it is that low, I need it nearer 60-70% through range, same with FT3. Suggest to your endo to take more Levo and see how you feel with a higher FT4.

[Mazzer in reply to SeasideSusie]

Thank you Seaside Susie. I expect he will want to stop the T3 due to suppressed TSH. If that happens I guess I can go back on increased Levo only and sort my own T3

[SeasideSusie Remembering in reply to Mazzer]

Some endos know that taking T3 lowers and often suppresses TSH, it's a case of yours accepting this.

[Mazzer in reply to SeasideSusie]

Yes. Ill keep positive. Thanks

[Cheekycharlie1981]

Interesting reading your post, I was on t3 but went terribly wrong for me as I had adverse reactions. Endo has took me off it, until my iron levels to rose to a better place. I’m now at that point just waiting on bloods again as I had to reduce my Levo.

What case did you give to your endo to take t3? Mine is now again trying to deny it. Also want brand are you on? I struggled with brands and dosage.

It’s very long journey and I do miss been more stable on dosages like I used to be.

[Mazzer in reply to Cheekycharlie1981]

I have D102 variant and a total thyroidectomy in 2020. I have relentlessly harassed the NHS since. I take Accord and Morningside T3.

[Mazzer]

Thanks Jonathan. It’s a 6 week test. I am trying to work out if I need more T3 or T4. What a palaver.

[SlowDragon Administrator]

What’s the range on Ft4 and Ft3

I would try a small increase in levothyroxine first

Perhaps 112mcg daily. This should increase your Ft4 and Ft3 a little

Retest in 6-8 weeks

Essential all four vitamins are optimal

How much vitamin D are you currently taking

Increase dose

[Mazzer in reply to SlowDragon]

Hi Slow DragonThe ranges are the same as the November test results at the top of the message. I am taking 4,000IU Vit D. Thanks

[SlowDragon Administrator in reply to Mazzer]

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

Did you split T3 into 3 doses day before test

10mcg waking, 5mcg mid afternoon, 5mcg 9pm (assuming testing 9am)

Last 5mcg T3 approx 8-12 hours before test

Ft4 is only 30% through range

Many of us on levothyroxine plus T3 would find that Ft4 result too low …..it’s trial and error what suits each person

Ft3 better at 66% through range

So you probably need 6000iu vitamin D to improve levels…then might be able to reduce to 4000iu

[Mazzer in reply to SlowDragon]

I took last Levo 24 hours before and 10mg T3 at 5pm previous evening. Did test at 6am before meds and no food or fluids.I didn’t think to split it 3 ways as Endo suggested 2.

Thanks

[SlowDragon Administrator in reply to Mazzer]

I would split 3 ways day before test….even if you normally only split into 2 doses

[SlowDragon Administrator]

Have you had coeliac blood test done

Are you on absolutely strictly gluten free diet

Do you always get same brand levothyroxine at each prescription

[Mazzer in reply to SlowDragon]

I have had a Coeliac blood test and I did go gluten free for 2 years without improvement. I can do without the stress of restricting my diet again at this point to be honest. I always ensure I get the same brand. Accord and now Morningside for T3.Thank you

[Charlie-Farley]

Hi MazzerI’m doing ok on just Levothyroxine at present (feeling lucky reading the struggles others are going through) but don’t be bossed about - you have a right to have a say in your own treatment.

TSH. Hmmm!🤔Most badly trained GPs and Endos are obsessed with TSH because they don’t know any better. Don’t presume they know more than you and if they are putting TSH above how you feel then I certainly would say they don’t know more than you. (Likely less)

Your symptoms are the most important diagnostic tool.

Reading around on this forum I’ve noticed this TSH being below range, or having some suppression is to be expected.. TSH thyroid stimulating hormone is produced by the pituitary in response to a lack of thyroid hormones in blood stream .

Simple analogy is if you take the oil dipstick in your car engine out, give it a wipe clean then dip it in again and when you pull it out there is oil at the full mark on the dip stick you wouldn’t add any more oil.

Many doctors/consultants are dosing by TSH range - a completely wrong strategy when you read around the subject and only baffling if you don’t take into consideration most of these arse policies are born out of a general lack of understanding and a drive to over simplify and the biggy - save money 😱

Feeling well or good on paper?

There is also the consideration of weighing up what you want. Do you want your bloods to be measured against a range that does not bring you to good health, but looks good on paper, or do you actually want to feel well? The many Endos and most GPs will want it to look good on paper.

I need to do another blood test and I’m pretty sure it will show that my TSH is suppressed, but I do not care because I feel great. I will not trade how I feel now to how I felt when all my bloods were within range and I felt damned awful and wanted to die.

You have to take everything in context there may be an increased risk of some issues, but that is by no means nailed down at this stage. Also they’re not looking at the issues of under medication and I think the health implications for that are far greater! But doctors do not tend to look at the bigger picture they are reductionist in their approach. Treating the lab results rather than the patient.

Even if it were to be proven that there was a very high risk of complications through over medication, which I don’t feel I am suffering from at the moment because my FT3 is within range (going by Toft’s explanation) the trade off for me is simple I’m living now and I’m blooming well enjoying myself! If it has an effect on any part of my body when I’m older I couldn’t give a damn, I’m not eeking out an existence - I’m living now.

After seeing the way the GPs dragged out my mother and fathers decline and extended their misery and their suffering, I have no desire to let them do that to me. (See profile) 😔👍

Be your own advocate 😊👍

[Mazzer in reply to Charlie-Farley]

Thanks Charlie.I don't intend to be dictated by an obsession with TSH. I am just after suggestions for next steps - more T3 or more T4.? I envisage that I will be going alone as the NHS Endo is sympathetic but restricted by the CCG and won't be able to increase the dose of T3 and seems unduly anxious about the suppressed TSH (that was on T4 only) so likely to be even more weirded out now its lower again on T3.

[Charlie-Farley in reply to Mazzer]

It is a shocking situation- no clinical excellence just money driven BS. I really hope you find your sweet spot 😔👍.

[Mazzer in reply to Charlie-Farley]

Thank you

[humanbean]

Vit D is in range but not optimal - 72.2 ( 50 -200)despite mainlining vit D spray and eating well.

You might find this link helpful :

grassrootshealth.net/projec...

[Mazzer in reply to humanbean]

Thank you. Excellent.