Blood test results opinion please!

[MiniMum97]

Just had my bloods redone.

Previous results in February:

TSH 1.22 (0.27-4.2)

FT4 13.1 (12-22)

FT3 5.1 (3.1-6.8)

I was on 10mcg T3 and 50mcg T4 before these results. Increased to 75mcg T4, T3 stayed at 10mcg.

Results last week (after about 3 months):

TSH 0.44 (0.27-4.2)

FT4 15.6 (12-22) - 36% through range

FT3 5.3 (3.1-6.8) - 59% through range

I initially felt much better on the above dose - I have been able to go the gym and exercise without a post-exercise thyroid slump and have wanted to socialise; however, in the last 4-5 weeks I have been feeling very run down - like I have a bug. I have had bowel cramps and excess wind on and off, dark and smelly urine on and off, (am waiting for GP to get back to me re a test for infection). feeling chesty/mild cough, sore throat, had some chills yesterday, headaches constantly. I've been unable to exercise in this time as I feel unwell, but generally I am not getting thyroid type tiredness. Heart rate is normal. No constipation. I could just have a bug of course (and am conscious I am 49 so likely also perimenopausal) but wondered if my T4 needs to increase a little? Would welcome views.

NB I took T3 24 and 12 hours (split dose) before the test, and T4 24 hrs before. Test was early morning on a empty stomach.

Thank you!

[SeasideSusie Remembering]

MiniMum97

You may need a higher FT4 level, it's all about how much the individual needs and finding that by trial and error. I take Levo plus T3 and couldn't function with your level of FT4, I need both FT4 and FT3 over half way through range, nearer 70% is better for me.

[Lotika]

Hmmm, hey fellow traveler! I suspect you are not going to know for sure how you feel on this dose until you shake that other thing off, assuming you have what sounds like some kind of bug? I feel like it is potentially clouding the issue? I say this as someone who feels they may have missed their correct dosage because of antibiotics destroying LT4 absorption about 14 months ago. I should have tried a particular dose for longer, but my view got clouded by the absorption issue, I suspect.

Otherwise, I agree that there is potentially room for more T4, even if one has an endo to please on TSH(!) particularly as you have ridden this dose for long enough to return an accurate test result. But how we feel is more important than the numbers, and it would be great if this was the right dose for you, given the quack-pleasing TSH!

I am randomly finding that I am feeling better as I am dropping a bit of T4 as the endo wants to run interference (i.e. do a blood test) and I am worried about my TSH causing him cardiac arrest, resulting in withdrawal of my NHS T3 prescription (he’s one of those!) So, I’m also learning that more is not necessarily better. Before, I would have thought differently.

All this having been said, it’s your body, you know best!

[SlowDragon Administrator]

4 months ago your ferritin was very low at 37

Presumably you have been working on improving

Have you retested levels since

I would agree with SeasideSusie to try increasing levothyroxine

Do you always get same brand levothyroxine at each prescription

[MiniMum97 in reply to SlowDragon]

Thanks for your reply. I've been working for about 6 years to get my ferritin up with very little success. When I first became ill, the very first thing that was identified was low ferritin (8). Unfortunately it's gone down slightly to 32 this time, and I did start getting some breathlessness last week which I've just remembered is something I always get when my ferritin dips (usually when it's below 30, but it's not much over that). I have tried pretty much every suggestion on this forum and elsewhere to get my ferritin up and it does not want to play ball! I had got it up to over 40 at one point, but it plummeted again after I had covid last year and I've been struggling to get it up again since - I know I am aiming for much higher than that. I'm trying to really focus on remembering to split my dose as this has worked the best in the past, but I have ADHD so remembering anything and sticking to routines is very difficult. I'll retest again in a 6-8 weeks and see if that's working.

I always get the same brand of levo (which involves me driving to a pharmacy half an hour away!).

[SlowDragon Administrator in reply to MiniMum97]

I always get the same brand of levo (which involves me driving to a pharmacy half an hour away!).

Me too …….lovely helpful independent pharmacy 10 miles from my home

Large pharmacy chains frequently not interested in accommodating patients clinical need to remain on same brand levothyroxine

[crimple]

Are you on a Gluten free diet?

[MiniMum97 in reply to crimple]

Yes