Most recent blood results showing worsening levels. I started an increase from 50mcg to 100mcg levo at the end of last year. My results on 31st January after 7 weeks on 100 mcg were:
Tsh - 0.92 (0.27 - 4.2)
Free t3 - 3 88 (3.1 - 6 8)
Free t4 - 17.7 (12 - 22)
Folate - 6.95 >3.89
Ferritin - 54 (13 - 150)
Vit D - 70.4 (50 - 200)
B12 - 83.1 (37.5 - 188)
After some advice from here from @slowdragon I decided to stick to 100mcg for a while longer then re-test whilst also working on vits and minerals. Recent results below which show a higher TSH and lowered ft4!!
11/03/2022 - still on 100mcg
TSH - 2.73 (0.27 - 4.2)
Ft4 15.8 (12 - 22)
Ft3 3.7 (3 1 - 6.8)
Has my body perhaps just gotten used to the 100mcg and now demands more? Also should I increase t4 first before looking at t3? My conversion doesn't seem great but I am working on vitamin and mineral levels. I also have coeliac disease. I have never had antibodies registered as abnormal despite a couple of tests.
All bloods done under the recommended protocol. I have also just started HRT - had my first patch on for 5 days when bloods were taken. Interestingly I also had covid when taking my bloods...
Previous results below
March 2020 - diagnosis
TSH - 4.84 (0.27 - 4.2)
Ft4 11 (12 - 22)
No ft3 tested
April 2021 - on 50mcg
TSH - 2.78
Ft4 - 14.8 (12 - 22)
Ft3 - 3.9 (3.1 - 6.8)
8/12/2021 - after 6 weeks on 75mcg
Tsh - 2.41 (0.27 - 4 2)
Free t3 - 4.11 (3.1 - 6.8)
Free T4 - 16 (12 - 22)
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Moog77
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Has my body perhaps just gotten used to the 100mcg and now demands more?
Also should I increase t4 first before looking at t3?
Yes to both questions …..make appointment with GP for 25mcg dose increase in levothyroxine (make sure it’s same brand levothyroxine at each prescription)
FT4: 15.8 pmol/l (Range 12 - 22) 38.00%
FT3: 3.7 pmol/l (Range 3.1 - 6.8) 16.22%
Most people when adequately treated will have Ft4 at least 60% through range, if not higher and Ft3 at least 50-60% through range
As coeliac you are likely to need addition of T3 prescribed alongside levothyroxine once you have levothyroxine dose fine tuned and all four vitamins optimal
Interesting how bloods have changed in that time period from almost OK (TSH and ft4) to eek I need more. I suppose its the difference between optimally dosed and not.
I have managed to get a prescription for Thybon Henning so ready to go with T3 once everything else is optimal.
Interestingly I also had covid when taking my bloods...
We should wait a few weeks after an infection before thyroid test, this is because non thyroidal illness can give abnormal results and TSH may be raised due to this.
HRT in patch form avoids the liver and so in theory shouldn’t affect thyroid hormone levels but some members have complained of needing a small increase in thyroid meds upon supplementing patch/transdermal HRT.
I attribute this to the amount of HRT that is recycled, so going through the liver, elevating transporters and binding a small proportion of thyroid hormone. Given our sweet spots are so precise, any tiny change can have substantial repercussions.
FT3 & FT4 are both too low in range meaning you need an increase in meds.
Vit D and Vit B12 are also low, and ferritin is only 29% through range. Optimising these will help thyroid hormones to work more effectively.
I'm just quite shocked in the difference between 7 weeks and 12 weeks.
The thing is I'm about to start progesterone in tablet form shortly - for 12 days of my cycle - so I might see a further impact from that? I strongly suspect I am suffering from a mix of thyroid and hormone issues.
Most women (on this forum) are unfortunately. I am not hugely well versed with the intricacies of progesterone but have seen other members advocate for it.
It appears (in contrast to oestrogen) to increase the effects of thyroid hormone by decreasing TBG. Therefore, your under medicated state might end up being quite beneficial.
It really isn’t recommended to make changes to differing hormones in so close a time frame as it becomes difficult to know why is driving what.
I'll be wearing an oestrogen patch all the time but am required to take progesterone in tablet form for 12 days every 28 as I still have a menstrual cycle. Unfortunately there is no way round it. However as you say increasing levo just now might end up muddying the waters 😬
Hi Moog77. It was my Endo who put me on HRT as I still had so many symptoms which I thought were thyroid linked but he said they were menopause linked too. The first 2 months I felt like a new women then slowly I started to lag back. It seemed that introducing the HRT had impacted my thyroid meds so I needed to up the thyroid meds again to get all back in balance. I take Estrogel & Utrogestan progesterone. It will be a bit of trial and error for you to get all these hormones back in balance but many, like myself, do need to increase thyroid meds after introducing HRT. Good luck in seeking wellness it is such a journey but you will get there. Keep educating yourself.
Thyroid, adrenals & female hormones are all interlinked....altering one will affect the others. So can well believe you felt better initially but ultimately its your thyroid that is failing so thats the true cause. Balancing your thyroid needs would've in all likelihood improved your female hormones too. Am no medics but it sounds like its your endo who has muddied the waters not you! 😊
I take HRT and every time I increase it I have had to lower my thyroxine. But for quite a lot of people it is the opposite and they need to increase thyroid meds. (I take it HRT topically)
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