Third blood test in 4 months

[PottyDotty]

Good evening. I have just received my results from the latest blood test taken on Wednesday 4th May. I have a face to face GP appointment on Monday and know I’m going to have yet another battle on my hands to remain on my current prescription of Levothyoxine 175mcg.

My results are ..

TSH 0.16 ( 0.3 - 5.0 )

T4. 25. ( 12.00 - 22.0 )

T3 3.1 ( 3.1 - 6.8 )

It looks to me like I’m not converting from T4 to T3 but if he reduces my dosage, surely I’m likely to be worse?

My results from 15 April 22 was

TSH 0.06 ( 0.3 - 5.0 )

T3. 3.2. ( 3.1 - 6.8 )

T4 omitted on that test.

My results from 27 Jan 22 was

TSH. 0.08. ( 0.3. - 5.0 )

T3. 4.0 ( 3.1 - 6.8 )

T4. 22.7. ( 12.0 - 22.0 )

It looks like my TSH is rising slightly, but so is my T4 whereas my T3 is on a downward trajectory.

I would appreciate any comments and ways to fight before my appointment on Monday morning.

Many thanks.

Dot

[tattybogle]

Hi Dotty , once fT4 goes over a certain level ( which is individual ) you actually get less conversion from T4 to T3 .. so as you can see , your T4 is going higher , but your T3 is now going lower. And as the fT4 goes higher the TSH goes lower ... which also means you get slightly less T3, because TSH has role to play in T4 to T3 conversion ).

And also if fT4 is too high this speeds up how fast the T3 you do have is 'got rid of' .. so less T3 again.

So it would probably be a good idea to very slightly reduce your Levo dose ( eg. 150 /175 on alternate days ) to get your fT4 to come back down a little ... you will probably find this gives you slightly better fT3 levels again . You may have to wait quite a few weeks to notice any improvement in how you feel, as dose reductions often feel rubbish for the first ? 5 weeks , and in the early weeks you will probably be convinced you are undermedicated , but i suggest you give it a try for a couple of months at least , then re-test.

some people may need a little added T3 if they still don't convert T4 very well once they have optimised everything else , but the first thing to do is to get the T4 little lower to get the most T3 you can out of levo.

There are other things to check to see if there is anything else you can optimise to improve how your body can use the thyroid hormone you take .. have you had Ferritin /Folate /Vit B12 / Vit D levels tested as recommended by others on here ?

Also did you do all your tests as recommended on here with a 24 hr gap from last dose levo , and an early morning blood test ?

[PottyDotty in reply to tattybogle]

Thank you tattybogle. Yes, my test was at 0845hrs and I didn’t take my thyroxine after Tuesday morning. As for iron, ferritin, vit B. My surgery never tests those, but I do take iron and B complex supplements alternate days, so should be ok. If you think I should slightly reduce my thyroxine, I’ll suggesting that to the GP. He will think he’s won

[tattybogle in reply to PottyDotty]

'more' is not always better .. but 'smarter' is better ... so if he looks like he thinks he's 'won' ask him "what a deiodinase is ,and how it works on T4 " ... then you will soon see who's smarter , you or him . bet you 50p he hasn't a clue.

( Deiodinases are what convert T4 to T3 (and T3 to T2) by removing one iodine atom from T4 (4 iodine atoms) to make T3 (3 iodine atoms ) .. hence "de -iodine -ase" )

I totally understand the instinctive reluctance to reduce dose ,and the feeling of 'he's won' ..... they do it to us by years of belittling how unwell we feel and making out hypothyroidism is such an insignificant issue, and making us fight so hard for diagnosis, and giving the idea that it's not really important etc when we feel awful and it has massive effects on out lives , so somehow we find the suggestion to reduce dose feels like they are saying "you need less , because you are 'less' unwell" ... so we resist.

But really, thyroid hormone is extremely fussy about being at exactly the right dose for us .. a little bit too much is just as rubbish as a bit too little . the exact right dose fro us as individuals up ,or down , matters just as much as it does for someone on warfarin or insulin.

I'm no good at advice about the vitamin levels but hopefully someone else will be along who is .

my brain is past it's best at this time of night so i'll shut up now and leave it to someone who can still type straight

[PottyDotty in reply to tattybogle]

Thank you, and have a good night.xx

[SlowDragon Administrator in reply to PottyDotty]

Do you always get same brand levothyroxine at each prescription

When were vitamin D, folate, ferritin and B12 last tested

Important to stop taking vitamin B complex 5-7 days before all blood tests as contains biotin

If taking iron supplements you need to do full iron panel test 3-4 times year

Medichecks iron panel test

medichecks.com/products/iro...

Test vitamin D twice year and folate and B12 annually

[PottyDotty in reply to SlowDragon]

Thank you SlowDragon. Yes, I’ve always been given the same brand. Unfortunately my GP doesn’t test for anything other than TSH and recently, T3 and T4. I do take lots of supplements, including vit D, K2 and B Complex, but did stop them 5 days before my last test. I only take one gentle iron tablet every other day, as suggested here.

[SlowDragon Administrator in reply to PottyDotty]

You need to test vitamins annually and shouldn’t supplement iron unless test full iron panel at least 3 times a year.

When were iron and ferritin levels last tested

Are you pre or post menopause

[PottyDotty in reply to SlowDragon]

Thank you for your response. The only time my Vitamin levels were tested was when I was originally diagnosed in 2015. I was told to take iron supplements for my restless leg syndrome as it really does help that condition. I’m definitely post menopause at 75 years old! I’ll have a chat to the GP on Monday about it all and see what he says. Xx

[SlowDragon Administrator in reply to PottyDotty]

Iron should be tested regularly as is toxic if you take and no longer need it

GP should test at least 2-3 times a year if you are supplementing on their advice

[nellie237 in reply to tattybogle]

"Deiodinases" - I might sound reasonably aware...............if I knew how to pronounce it? 🤣

Is the ei pronounce eye, or ee ?

[tattybogle in reply to nellie237]

eye ~ i think

I'm going with " Dee eye oh din ase "

because they are removing iodine ie, de-iodinating

[nellie237 in reply to tattybogle]

I hate getting old.......how did I not get that.

[tattybogle in reply to nellie237]

it's ok ,, it took me about 3 months before it was obvious too . I was spelling it dioedinase in my head for ages which didn't help lol