Results

[Owleyes]

Hello

Please may I have advise on my results

T4 13.4 range 8.0-17.0

T3 5.2 range 3.8-6.0

TSH 1.92 range 0.38-5.33

Glucose 5.8 range 4.1-5.9

B12 835 range 180.0-915.0

[pennyannie]

Hello Owleyes :

can you please state diagnosis and what medications you are now taking and was this a fasting blood test and all supplements containing biotin not taken for around a week beforehand.

[Owleyes in reply to pennyannie]

Hello

Had graves 2014 had iodene 2017

Levo 150 twice a week 125 5 days accord order North Star

Take at night

Fasting bloods 08.15

Stopped my vit b 7 days before

Take vit d drops

Selenium tabs

Magnesium tabs

[pennyannie in reply to Owleyes]

So you have Graves Disease and are post RAI thyroid ablation in 2017.

Graves is an auto immune disease, said to be driven by stress and anxiety, and now you are hypothyroid and reliant on thyroid hormone replacement as I'd imagine your thyroid is now fully burnt out and disabled in situ.

The thyroid is a major gland and likened to the body's engine being responsible for full body synchronisation including your physical, mental, emotional psychological and spiritual well being, your inner central heating system and your metabolism.

A fully functioning thyroid would be supporting you on daily basis with trace elements of T1. T2 and calcitonin, plus a measure of T3 at around 10 mcg plus a measure of T4 at around 100 mcg.

T4 is a storage hormone and needs to be converted by your body into T3 the active hormone that runs the body and said to be around 4 times more powerful than T4.

Conversion can be compromised by low levels of vitamins and minerals, especially those of ferritin, folate, B12 and vitamin D , inflammation, any physiological stress ( emotional or physical ), depression, dieting and ageing so it's important to keep a check on those things we can do something about.

Optimal conversion when on T4 monotherapy is said to be 1 / 3.50 - 4.50 - T3/T4 with most people feeling at their best when they come in at around 4 or under .

To find your conversion ratio you simply divide your T3 into your T4 and i find your conversion coming in at 2.56 - so a faster than normal metabolism which isn't surprising as you have Graves Disease.

It is where your T3 sits in the range that is the most important number as too low a level of T3 for you and you will have symptoms of hypothyroidism just as too high a level of T3 for you and you may have symptoms of overmedication and hyper type symptoms.

Once hypothyroid you can't become hyperthyroid again, but you can be over medicated.

It is essential that you are dosed and monitored on your T3 and T4 blood tests results to ideally, keep around a 1 / 4 ratio T3 / T4 and not dosed and monitored on a TSH that seems to be all that is routinely tested in primary care at the yearly thyroid function test.

Some people can get by on T4 monotherapy :

Some people find that T4 seems to stop working at some point in time and need the addition of a little T3 alongside the T4 to likely replicate their thyroid's lost T3 and T4 hormones :

Some people can't tolerate T4 and need to take T3 only :

Some people prefer to take Natural Desiccated Thyroid which contains all the same known hormones as that of the human gland and derived from pig thyroid dried and ground down into tablets referred to as grains.

I was well on T4 for around 8 years and then my dose of 4 adjusted down on my TSH readings and became in an ever decreasing circle of wellness. I was refused both T3 and NDT on the NHS so now I manage myself and buy my own full spectrum thyroid hormone replacement and manage my own yearly blood tests, more for my supplemented vitamins and minerals than where my T3 is as I feel well.

How are you feeling ?

P.S. You might like to read up on Graves on the Elaine Moore Graves disease Foundation website - I found this website the most well rounded of all that I looked into in around 2014 when I started my own research into Graves post RAI thyroid ablation.

[Owleyes in reply to pennyannie]

Hi thank you pennyannie

I’ll look that website up.

So you were given RAI. I had tablets.

I’ll be honest the numbers confuse me I think I’ve got it but no. My memory is horrendous. I take all I was advised to take.

I feel ok tbh.

I did keto religiously and lost a stone but have slipped off I keep to the same weight (not put the stone back on )by doing keto for a few days. But looking at my glucose I’m now going to get back on it proper. I also do fasting.

So do I need to adjust my Levo?

I have normal stuff at work, with mum and dad and my son. But don’t constantly feel stressed. I think I sleep well. Don’t feel tired.

How do you feel? Xx

[pennyannie in reply to Owleyes]

You can find more details of me on my profile page - and yes my RAI was a liquid in a tin can, with yellow and black sticky tape all around it everywhere, rather than it saying C.Cola !!!

As already mentioned your metabolism seems to be running quite fast at 2.56:

Your T4 is at around 60% through the range with your T3 at around 64 % - and generally we see a T3 at a lower % through than the T4 % through - so I am a little confused by your readings and presume you still have a part functioning gland and Graves antibodies causing this reading.

I became seriously unwell around 8 years after ingesting the RAI and prescribed anti depressants that did nothing, other than make me think it was all in my head.

With only a diagnosis of low ferritin in around 2014, I started reading up and found this forum which was instrumental in my getting myself as well as I could.

i was refused any other treatment option and so I decided to DI Myself and now it's 4 years later, I have my life back and my cognitive function has improved tenfold and around 18 months into self medicating I found I had dropped around 2 dress sizes - which was a welcome bonus.

Dieting is not recommended - our bodies need a regular routine, and a good supply of nutrients rich foods, including fats, to maintain our core strength strong and solid and our body becomes confused when we go into starvation mode.

Do you have any results and ranges for ferritin, folate, B12 and vitamin D - and are you supplementing any of these ?

I don't know that I can add much more - as I'm a little confused by your blood tests. Please just make sure you always get T3 and T4 readings and not get stuck with just a TSH reading because that means diddly squat once on any form of thyroid hormone replacement, let alone after RAI thyroid ablation.

[Owleyes in reply to pennyannie]

Hi

Always have T3 T4 TSH done.

Supplement vit b complex magnesium vit d drops selenium

So I still have a part functioning gland? Is that why my levels won’t stay level ish?

[pennyannie in reply to Owleyes]

Well you're lucky then as I could only get in primary care was a TSH and primary are made me pay for a T3 and T4 blood test.

Are you still under an endocrinologist, maybe a scan or ultra sound can be arranged to check if your thyroid gland is totally disabled or still with some function ?

It could be a reason if your levels don't stay level-ish ?

Your B12 reading is near the top of the range ;

Do you have a vitamin D reading and folate and ferritin results ?

[Owleyes in reply to pennyannie]

No vid d or ferritin I’ll ask for them now

folate 13.4 (3.1-19.9

Been discharged from Endo.

Will ask for scan tho.

[Owleyes in reply to pennyannie]

Do you take CoQ10?

[pennyannie in reply to Owleyes]

No

[Owleyes in reply to pennyannie]

Sorry but if I’ve had RAI will the Levo stop working and I have to have the T3 pig grains. If so I’m done for I don’t eat pigs In any form. Lol. I don’t eat red meat either, I don’t drink aspartame.

I’ve been reading that website and I’m now in the process of sorting me vitamins out. And one article said about a knee or ankle injury causing graves. I’m not so much worried about what caused it I’ve got it and I’ve got to deal with it. But blooming Nora😳

I don’t get to talk to people about this we have no groups in Swindon.

I’m looking at my diet as well.

[pennyannie in reply to Owleyes]

The Levothyroxine does not stop working and it works better with optimal ferritin, folate, B12 and vitamin D:

As explained above some people choose other thyroid hormone replacements as we are not all the same.

You do not have to take anything other than T4 - Levothyroxine :

Graves is an auto immune disease and as such, it isn't cured whether having a thyroidectomy or RAI thyroid ablation or staying on the anti thyroid medication.

All that has changed is that you are now hypothyroid instead of hyperthyroid and the NHS believe that hypothyroidism is easier to treat in primary care.

Graves is said to be a stress and anxiety driven AI disease and there is likely a genetic predisposition, and a family member, maybe a generation away from you with a thyroid health issue.

Graves can be triggered by a sudden shock to the system like a car accident or the unexpected death of a loved one, and I found when looking back at my situation, some 10 years after my RAI thyroid ablation that this made some sense to me, as 4 months prior to diagnosis I was physically threatened and verbally abused by a man I employed as my assistant manager and was working alongside him while processing the work related disciplines.

It just helped me understand my situation better - and just thought it might help you :

As I wrote before I can't say much more :

I've written this twice and lost it as there is stormy weather and winds here, so I'll close this now before it disappears again.

[Owleyes in reply to pennyannie]

Thank you I do appreciate your help. 🥰🥰

[PurpleNails Administrator]

If you look at where your results are in the range you can see FT4 is 60% & FT3 63%

Most would feel ok with these results and from what you say you do feel quite well.

Many say they feel best when FT4 is top 3rd & FT3 upper half. So there is a little room to bring levels up. Perhaps your doctor agree to taking 125mg every other day? Your doctor likely say all ok as in range.

FT4 13.4 (Range 8 - 17) 60.00%

FT3: 5.2 (Range 3.8 - 6) 63.64%

It is more usual that FT3 is slightly lower in comparison to FT4 yours is just above so I would arrange to retest to monitor to see if this alters.

Your glucose level was high at time of test. Usually a HBA1C test is used as it looks at the glucose attached to red blood cells and gives an average glucose level for past few months.

This has a normal level - pre diabetic & diabetic level and is considered more accurate that current blood glucose level. So look to having this test.

Keto type diets which entirely cut out carbs can adversely affect FT4 to FT3 conversion. So can fasting, even if intermittently. 80 - 100g of grams of carbs daily is moderate and more achievable. Using a app to track food and automatically counts calories and carbs is a really useful method as you often don’t realise how many carb are hidden in certain foods.

[Owleyes in reply to PurpleNails]

Hi

Thank you for reply

Yes have keto app and stick to about 100 of carbs a day. Will stop the fasting. Tbh it hasn’t been working well for a while.

Will get my HBA1C doing.

Always have my T3 T4 TSH done.

So I take 125 one day 150 next and so on

GP let’s me do what I need to do from advice on here. And I’m glad because if I’d listened to them (and I did) I was in a right state

[PurpleNails Administrator in reply to Owleyes]

Go by how you feel If you felt you had hypo type symptoms I would say try an slight increase & retesting in 6 weeks to see how levels adjusts.

If you feel well you might want to stick as you are, especially as you mention you have a history of not being very stable.

When FT3 is proportionally high compared to FT4 it’s almost always due to erratic hormone release, which will be as a result of your Graves.