Following on from my post last weekend, just as I was about to order private tests, the Doctor texted me at 5pm yesterday with T3 and Vitamin D results taken on same sample drawn on 25th March. So full results for that date are:
TSH 0.10 (0.27-4.20) -4.33%
Free T4 20.00 (10.5-22.0) 82.61%
Total T3 1.43 (1.08-2.90) 19.23%
Vitamin D 124
She didn't give range for Vitamin D but I looked at Health service website and >50 is deemed sufficient. I had been supplementing for about a month 800iu but had stopped two weeks before test.
The reason these results concerned me is that last year my results were:
TSH 3.96 (0.27-4.20)
Free T4 13.2 10.5-22.0)
Total T3 1.21 (1.08-2.90)
Since November I have not been great, suffering from fatigue, brain fog and awful bone/joint pain.
I am post menopausal, on HRT, 25mcg Patch 2x weekly and 100mcg Progesterone Daily. (I have just checked Chemist notes on my 50mcg Patches prescription and it says to cut in half and disgard 2nd half. I have never done this since 2019. Does this mean every 2nd patch has been a dud?) What I mean is I do cut the 50mcg patches in half but have always used the 2nd half.
My questions are:
Are my levels of T3/ft4 OK?
Is it a conversion problem?
Or is it estrogen interference or a need for an increase?
My Doctor wants to reduce my Eltroxin from 100mg, to what she didn't say....
Siobhan
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My Doctor wants to reduce my Eltroxin from 100mg, to what she didn't say
So she is adjusting dose by looking only at TSH which is wrong. TSH is a pituitary hormone, not a thyroid hormone. The thyroid hormones are T4 and T3 and these are the important tests. TSH is useful for diagnosis but once on thyroid hormone replacement it's not much use.
Are my levels of T3/ft4 OK?
Is it a conversion problem?
Your FT4 is 84% through it's range but unfortunately you have a Total T3 test which is not helpful. Total T3 measures the total amount of T3 which is bound to proteins and unbound (free). You can have a good amount of Total T3 but a poor amount of Free T3 and it's the free T3 that is available to the cells. So we need to test Free T3 so unfortunately we can't tell you anything about your T3 result or whether you have a conversion problem. To see if you have a conversion problem you look at the FT4 and FT3.
Also, it is the FT3 result that tells us if we are adequately medicated, or over or under medicated.
on HRT, 25mcg Patch 2x weekly and 100mcg Progesterone Daily
Or is it estrogen interference or a need for an increase?
We know that oral HRT/oestrogen can affect absorption of thyroid meds and there may be a need to increase dose, HRT patches maybe don't have the same effect but maybe not rule it out entirely. It's not something I have any experience of. It's a case of check your levels and see if they change, if they do adjust dose of thyroid meds.
Vitamin D 124
Is the unit of measurement nmol/L, if so that is a good result as the Vit D Society and Grassroots Health recommend a level of 100-150nmol/L.
If the unit of measurement is ng/ml then it is way too high and can lead to toxicity as the recommended level is 40-60ng/ml.
I had been supplementing for about a month 800iu but had stopped two weeks before test.
I did mention in my reply to your previous post that you shouldn't start your Vit D until you'd tested (and you said that you weren't going to), and that you need the important cofactors when taking D3:
With only taking it for two weeks then stopping two weeks before the test, it probably made no or little difference to your level anyway.
With the summer months approaching and the possibility that you may make Vit D from the sun, you may not need a maintenance dose for the next few months. You certainly wouldn't need more that the 800iu you mention. I would retest Vit D in October/November, this will tell you whether you need to supplement during the winter.
Hi SeasideSusie Thanks for your comprehensive reply again. So the action plan will be to go ahead with private test for:Thyroid Stimulating Hormone (TSH)
Free Thyroxine (FT4)
Free Triiodothyronine (FT3)
Thyroglobulin Antibodies (TGAB)
Thyroid Peroxidase Antibodies (TPO/TPEX)
Thyroxine (T4)
And to stay off Vitamin D until Autumn/Winter when I will retest. I believe the unit was indeed nmol/L on Health Service website.
I will try hold off on med reduction until I have these results.
I believe the unit was indeed nmol/L on Health Service website.
The important thing is what is the unit of measurement that the lab which does your test uses, it could be different from what's on the health service website.
Hi SlowDragon The company I will use is letsgetchecked.ie as I'm in Ireland. The full Thyroid check is €79 (ho hum). All my tests with the doctor are done at 9.30am with testing protocol recommended here.
These were also done on 24/2/2022 when original test that showed low TSH:
Serum B12 573 (109-771)pg/mL
Serum Folate 14.6 (3-26.9)ng/mL
Serum ferritin 131.0 (13-200)ng/mL
I was not on any supplements at the time because of supply issues.
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