I am new here, and hoping for some advice. I had radioiodine treatment in 2020 and subsequently started on levothyroxene 75mg and have been on it ever since. I do not feel very well, the same symptons as before the treatment. I am so fatigued and tired. I am told my blood tests are normal. I have aprint of my tests and do not understand them. Tests as follows:
Serum free T4 level normal 15.3
Serum freeT3 level 6 normal
SerumTSH level normal 0.56
It states trimester ranges does tht mean anything.
I am putting on weight, but am not very active ( I am78) as I feel so unwell most of the time. My Doctors have said there is somethiong else wrong but cannot find anything, I have had so many tests. I am honestly so fed up with it all. Can anybody give me any advice pleeeeeeeeese
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nognora
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Can you please add the reference ranges for your results, these vary from lab to lab and we need them to be able to interpret your results. If you have a print out of your results the ranges should be at the side, perhaps in brackets, for example (and I've made up these numbers):
TSH: 2.5 (0.27-4.20)
FT4: 15 (12-22)
It states trimester ranges does tht mean anything.
Presumably this is by the TSH result? This is standard for some labs to include these, it's for pregnant patients and there are slightly different ranges depending on how far through their pregnancy they are. Obviously it doesn't apply in your case
I have had so many tests.
Can you please post the results and reference ranges for other tests you've had.
Particularly meaning full will be any key vitamin tests done, eg Vit D, B12, Folate, Ferritin.
Can you also tell us please if you did your test as we advise:
* Blood draw no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If looking for a diagnosis of hypothyroidism, an increase in dose of Levo or to avoid a reduction then we need the highest possible TSH
* Nothing to eat or drink except water before the blood draw. This is because eating can lower TSH and coffee can affect TSH.
* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw, if taking NDT or T3 then last dose should be 8-12 hours before blood draw. Adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.
* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (most labs use biotin).
These are patient to patient tips which we don't discuss with phlebotomists or doctors.
Also, do you take your Levo on an empty stomach, one hour before or two hours after food, with a glass of water only, no tea, coffee, milk, etc, and water only for an hour either side, as absorption will be affected? Do you take any other medication and supplements 2 hours away from Levo, some need 4 hours?
Thank you for replying so promptly. I will type out as shown, I am definitely not pregnant.Serum free T4 level -(NL1877) normal 15.3 pmol/L Serum free T3 level - (NL1877) - normal 6 pmol/L - 4.00-6.60pmol/L Serum TSH level (NL1877 - normal 0.56 mu/l 0.34-5.60mu/l This is complete gobbledegook to me. Apart from the trimester figure this is everything on the printout. Typical, have never been told about the early blood test, or vitamin B. I have had lots of b lood tests but have no results for those. I do take my thyroxene early morning about 4am, when I get up for the loo, no food or drink til about 9, so I think I am OK there.
The 15.3 is your result, please check to see what "normal" is for that test on the print out, looking at what else you've written "normal" is the range so we need that please for your FT4.
If other tests have been done with your GP then please ask for a print out of those.
The thyroid is a major gland 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 working thyroid would be supporting you daily with trace elements of T1.T2 and calcitonin plus a measure of T3 at around 19 mcg plus a measure of T4 at around 100 mcg.
We generally feel at our best when you T4 is in the top quadrant of the range as this should in theory convert to a good level of T3 at around a 1/4 ratio.
It's difficult to comment without the ranges but I'm guessing your T3 is a little high compared to your T4 :
Are you aware of your metabolism running a bit too fast for you ?
Fatigue is debilitating.
Were you on Anti Thyroid drugs, like Carbimazole or PTU before you had the RAI thyroid ablation.
What were your symptoms at diagnosis and do you remember having thyroid antibodies run and getting a diagnosis of Graves Disease ?
RAI slowly burns out the thyroid in situ and as it burns through, disabling your thyroid, you become progressively more hypothyroid and need to be prescribed T4 - Levothyroxine.
Primary hypothyroidism caused by RAI is said to be more difficult to treat.
RAI is known trash vitamins and minerals and this may well be where the issues are as you do need to maintain your core strength strong and solid throughout being hyperthyroid through to being hypothyroid.
Your ability to convert the T4 into T3 can be compromised by low levels of ferritin, folate, B12 and vitamin D plus inflammation, any physiological stress ( emotional or physical ) depression, dieting and ageing can also down regulate your ability to convert T4.
I would suggest you ask your doctor to run a blood test for your ferritin, folate, B12 and vitamin D and post the results and ranges back up on here :
You may well be in the NHS ranges but we need optimal levels of these 4 essential vitamins and minerals to equip us better to help support the thyroid hormone replacement.
P.S. Normal doesn't mean anything - just as being in a range doesn't mean anything - what does matter is where your T4 result sit its a range in relation to where your T3 result in its range and it's the ratio between these 2 vial hormones that needs to be considered.
NB.
Too high a T3 for you and you will experience symptoms of hyperthyroidism and feel unwell just as too low a level of T3 for you and you will experience symptoms of hypothyroidism and feel unwell.
What we need to try and find is a balance between your T3 and T4 results that works for you and gives you back your health and well being.
Some people get by on T4 only :
Some people need to add back in the T3 their own thyroid supported them with.
Some people can't tolerate T4 and take T3 only :
Some people feel at their best taking Natural Desiccated Thyroid which contains all the same known hormones as that of the human gland
Oh my goodness this all so complicated, I do not think I have been looked after properly. I was on carbimazole before I had the radioactive iodine treatment. I was put on Levothyroxine, it was upped to 75mg and thats where I have been for 2 years, I feel awful, what should I do now, and where do I go to get sorted out. Thank you for your advice.
I'm coming up for 75 and I've been where you are, as have many others and you can turn much of this around for yourself:
First we need to see a full thyroid function blood test to include TSH, T3, T4 inflammation, antibodies, ferritin, folate, B12 and vitamin D.
Generally referred to as " an advanced thyroid function test " and around 10 blood analysis results all just taken from 1 venous blood draw.
I use Medichecks and pay extra for a nurse to visit me at home to take my blood as it is less stressful.
There are other private blood companies who can do this for you, and dependent on where you live, offer a similar service.
When with your results simply start a new post with the results and ranges and you will be talked through what it all means and what you next need to do to get your health and well being.
Follow the instructions below from SDragon and its best to arrange the appointment for the first half of the week so your sample doesn't sit over the weekend in the postal system.
Thank you, I keep thinking I am going mad. I live in Devon so will see if I can get a private test done, it will be worth the expense as I feel so awful. Thank you again.
Yes I know - I'm in Cornwall and when I first found this forum, I too was in a state of shock.
That as some years ago now and Medichecks were the only company who offered a nurse home visit - you might be better served in Devon - I guess it all depends where about you are, your mobility to get out if you need to, and the local facilities,
Take good care, and if you feel like it, start reading up on other peoples questions and the answers as even if with that awful brain fog bits do sink in, and it's like a jigsaw puzzle and all the pieces do fit together given a bit of time and rereading the rereading !!!
P.S. Why were you treated with RAI - Graves Disease - like me ?
Hi thank you for replying. You mentioned "brain fog" yet another sympton, I never knew. I feel so bad at the moment. I have contacted Medicheck and I am waiting to hear from them as to where I can get a blood test. Thank you I am so grateful, you have all given me hope.
I have been touch with medicheck it appears they will do a home visit it costs £55, Its the nearest place is Dorchester far too far for us to drive to, think it is going to be a home visit, no outings for us this month. Anything to feel better.
So if you have booked with Medichecks you will get a small box through the letter box in around 2 days time - this is the blood test kit :
You will also get a telephone call in a few days time from a nurse to arrange a time and date for him/her to visit you and take the blood draw.
Arrange an appointment for the beginning of the week and follow the instructions that SDragon has explained to you on your other posts that I've just caught up with.
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