Should I change thyroid med dosages?

[veecaa]

Followed guidelines on when to take meds before morning blood tests and attached results. I wasn’t able to get many of the tests I would normally have other than HbA1c with value 41 in range 20-42 mmol/mol. I have a call with my doctor tomorrow to discuss. I’ve been really sluggish and tired esp after having covid. I’m currently taking 100mcg thyroxine and 40 mcg liothyronine. Would really appreciate any advice on what I should do to optimise thyroid function and any advice on questions for doc. Thanks!

[tattybogle]

How do these T4 and T3 levels compare to your previous results on 100mcg levo + 40mcg T3 ? Pre covid , did you previously feel well on this dose with these T4/T3 levels ?

presumably your Doctor knows you take T3 ,and will also realise (hopefully) that reducing levo is unlikely to raise TSH while you are still taking 40mcg T3 .. so that note from the lab about " ?reducing Levo to raise TSH" is not really relevant to someone taking T3.

[veecaa in reply to tattybogle]

Thanks so much for reply tattybogle For the last year I’ve been struggling with health but at least thyroid had seemed more stable. On the same dose a year ago Free T4 was 16.8 but they didn’t do T3. There seems to have to be a periodic discussion with doc and about suppressed TSH related to T3 No doubt that will be the case for this upcoming chat

[SlowDragon Administrator]

Do you have autoimmune thyroid disease?

Diagnosed by high thyroid antibodies

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Recommended on here that all thyroid blood tests early morning, ideally before 9am last dose levothyroxine 24 hours before test

On T3 or NDT - day before test split daily dose into 3 smaller doses, spread through the day at approx 8 hour intervals, taking last 1/3rd of daily dose 8-12 hours before test

Is this how you do your tests?

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

[veecaa in reply to SlowDragon]

Thanks SlowDragon . I had to check on here about protocol and got guidance about when to take meds pre blood test. Did follow advice and these are results. I can see that Free T3 is right at top of range and T4 nearer the lower range. I can try to get the whole vitamin panel done privately. Honestly no ideas about antibodies. Can that test only be done when first diagnosed with thyroid? Do you think that I can tweak anything with my current thyroid meds ? Really appreciate any advice

[SlowDragon Administrator in reply to veecaa]

If your doing thyroid and vitamins via Medichecks or Blue horizon it will include thyroid antibodies

You might need to slightly lower T3 and increase levothyroxine….but get vitamins tested and supplement to OPTIMAL levels before considering any thyroid changes

Strictly gluten free diet often helps, and always worth trying.

But as with all thyroid issues…..only change one thing at a time or you can’t tell what’s helping

[veecaa in reply to SlowDragon]

Perfect SlowDragon . That’s a great plan. Will get tests done. With my T3 I do worry if doc reduces the amount then I will struggle to get this dose prescribed again if I need it. This T3 journey been a fight. Wonder if I can increase the thyroxine, reduce the Levo myself but keep prescription the same.

[SlowDragon Administrator in reply to veecaa]

Yes I would only experiment “on the quiet” don’t get prescription reduced, in case you want to increase again