I am taking T4 Levothyroxine 125mcg x1 with self-prescribed T3 25mcg x twice daily. I’ve been taking T3 for 5 years, and I feel I’ve hit the right spot with my current thyroid regime.
However, my bloods appear to read otherwise. Indeed, as far as I can see, they combine to form the picture of hyperthyroidism.
I don’t feel hyperthyroid (I have before, so I hope I would recognise the symptoms) and - other chronic conditions aside - I actually feel fine thyroid-wise. Plus my nails still peel apart rather than grow strong.
However, I have been bleeding on and off for a few months now, and I can’t tell if that’s due to 5 months of magic HRT (I started bleeding from month 3-5 inclusive) or a symptom of hyperthyroidism.
Before HRT I also bled frequently and irregularly, which I put down to perimenopause, but a couple of years ago the Endocrinologist told me it was due to an overactive thyroid.
I love how I feel on HRT and don’t want to stop - I’d keep bleeding if I had to! But I'd rather not bleed if I could at all avoid it, and again, I need to be sure it's not due to hyperthyroidism.
Apart from the obvious TSH, the bloods that the lab has Flagged could also pertain to hyperthyroidism, and potentially reinforce the hyperthyroid diagnosis from additional angles.
In anticipation of my GP calling to reduce my 125mcg T4 (which feels better than the 100mcg I was prescribed for years), please explain and help me make sense of the the following results.
I need to be able to plead my case, but I'd also prefer not to be bleeding all the time!
Each result will have the following layout:
Test: My result (Ranges Given & Measurement)
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C-Reactive Protein: <1 (0 - 5mg/L)
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Coag Screen
APPT ratio: 0.9 (0.8-1.2)
INR: 1 (0.8-1.2)
APTT: 28.9 seconds
Prothrombin Time: 10.5 seconds
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Ferritin: 72 (15-200ug/L)
(no other Iron, B12 or Vit D, unfortunately)
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Free T4: 13.4 (9-19 pmol/L)
TSH: < 0.03 (0.35 – 4.94 mu/L) Lab Flagged Low
^ I know I need a full panel of T3, FT3 tests etc, but the GP didn’t organise that for me. So for now, FT4 and TSH are all I have to go on in terms of direct thyroid tests. Apologies!
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Blood Count
Haemoglobin: 132 (120 – 150 g/L)
White Cell Count: 4.8 (4 – 10 10*9/L)
Platelets: 234 (150 – 410 10*9/L)
RBC: 4.2 (3.8 – 4.8 10*12/L)
HCT: 0.37 (0.36 – 0.46 L/L) Low
MCV: 87 (83 – 101fl) Low
MCH: 31.1 (27 – 32pg)
MCHC: 357 (315 – 345g/L) Lab Flagged High
RDW 11.3 (11.6 – 14 %CV) Lab Flagged Low
Neutrophils: 2.6 (2 – 710*/L) Low
Lymphocytes: 1.5 (1 – 3 10*9/L)
Monocytes: 0.4 (0.2 – 1 10*9L)
Eosinophils: 0.2 (0.02 – 0.5 10*9L)
Basophils: 0.1 (0 – 0.1 10*9L)
Absolute NRBC: 0 (0 – 0.09 10*9L)
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Liver Function
Albumin: 42 (35-50 g/L)
Globulin: 33 (20 – 35g/L )
Total Bilirubin: 6 (2 – 21mol/L)
Total Protein: 75 (60-80g/L)
ALP: 54 (20-150 u/L)
ALT: 22 (5 – 40 u/L)
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Haemoglobin A1C Diagnostic (IFCC): 31.1 (20-41mmol/mol)
HbA1c% (DCCT): 5 % (no range given)
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I'm aware there are additional blood tests that I could have taken to better read my the health of my thyroid, but the above is what my GP organised.
I have been coeliac and avoiding gluten for approx 25 years now
Many thanks for your time