This is an inflammation marker and being over range is showing there is inflammation somewhere. As it is non-specific it can't tell you the cause of the inflammation. It's likely that it's due to your Hashi's, as this can cause inflammation.
Ferritin - 70.5 Ranges 13-150
At first glance this doesn't look too bad. However, ferritin rises with inflammation and your CRP is high confirming inflammation. It's very likely that your normal ferritin level is lower than this although it's not possible to say by how much your level is raised due to the inflammation. I think it can be said that your normal ferritin level would be low and needs increasing.
Folate - 3.18 Ranges >3.89
This is below range and you need to speak to your GP.
Vitamin B12 - 50.9 Ranges 37.5 - 150
This is below range and again you need to speak to your GP. This is Active B12 and Active B12 below 70 suggests testing for B12 deficiency according to Viapath at St Thomas' Hospital:
Reference range:>70. *Between 25-70 referred for MMA
There is a link at the bottom of the page to print off the pdf to show your GP when asking for fjurther testing for B12 deficiency and Pernicious Anaemia.
It's possible you may need B12 injections, definitely supplements of one kind or another. Please DO NOT start any supplements/medication for your low folate until testing of B12 has been completed and B12 injections or supplements started.
These poor nutrient levels are very likely the result of your Hashi's.
SlowDragon may come along and give more information about how Hashi's affects the gut nutrient levels and make some suggestions.
Vit D - 115 Ranges 50-200
This is a decent level, the Vit D Council, Vit D Society andGrassroots Health all recommend a level between 100-150nmol/L.
TSH - 0.62 Ranges 0.27 - 4.2
Free T3 - 4.6 Ranges 3.1 - 6.8
Free Thyroxine - 14.8 Ranges 12-22
I have now just stating a trial of 75mg levothyroxine and 10mg of liothyroxine
I was on 125mg of Levothyroxine when the bloods were taken.
Your FT4 is 28% through range, your FT3 is 40.54% through range.
I simply don't understand your endos (?) thinking. These results do not suggest that you need T3. I'm assuming you are seeing an endo. Is this NHS or private?
Your FT4 is very low in range, normally it would be high in range with a low FT3 to show poor conversion to warrant adding T3. Your FT3 is much higher than your FT4 so you don't appear to have a problem with conversion.
What your FT4 result does
show is that you need more Levo.
By reducing your Levo from 125mcg to 75mcg what does your endo think is going to happen to your FT4 result? It will lower. Also, adding T3 lowers FT4. So you are in danger of having an FT4 result at the bottom of the range at best, and at worst below range.
I believe you have been set up to fail this trial of T3 but I really don't understand why you're being prescribed T3 when your FT4 is so very poor.
Thank you so much for your advice. I think I will send these tests through to the Endo and see if he can up my Levo.
How much T4 should I have as an optimum?
I have paid for this blood test as the NHS just test me for T4 and TSH.
I have asked to trial the T3 to try and loose weight because I just keep on piling on the pounds despite doing all the right lifestyle choices and its making me so depressed. But these results came just after I saw my consultant. (when i was still on 125 levo)
I actually havent thought about sending my blood tests on to my GP/Consultant but I will 100% do that and see whether they can check the above for me.
It really does worry me that I will never be my normal self again!
You can only increase levo 25mcg at a time, no more, then test 6-8 weeks later to check levels and see how you feel. Repeat until levels are where you need them to feel well. Nobody can tell you how much Levo you will need, you need enough to get your FT4 high up in range.
T3 is not a weight loss drug. The only way you will lose weight is by getting your thyroid levels optimal, and the way to do that is get your FT4 high in range, see where your FT3 lies to see how well you convert. You also need optimal nutrient levels for thyroid hormone to work. So once you have a high enough FT4 along with optimal nutrient levels then you will know if you need T3.
Thank you so much for your advice. All my answers are in bold for you. I really appreciate the time everyone has put in to answer to me.
How much T4 should I have as an optimum?
I have paid for this blood test as the NHS just test me for T4 and TSH.
I asked to trial the T3 to try and loose weight because I just keep on piling on the pounds despite doing all the right lifestyle choices and its making me so depressed. But these results came just after I saw my consultant. (when i was still on 125 levo)
answering your questions
Was test done early morning, ideally before 9am and last dose levothyroxine 24 hours before test Yes
Which brand of levothyroxine were you taking when on 125mcg levothyroxine
100mg -
25 mg -
Do you always get same brand levothyroxine at each prescription
Yes I think so
These results suggest
A) you needed 25mcg dose increase in levothyroxine
Can I do that now or do I have to wait 6 weeks for another test? The consultant wants me to wait 3 months for a blood test but I thought it was it was ok to test again in 6 weeks?
B) testing for Pernicious Anaemia before starting B12 injections or possibly daily supplements
Do I ask for this at the GP? Is this something they do on NHS?
C) Starting 48 hours AFTER 1st B12 injection……
folic acid supplement prescribed, or daily vitamin B complex
D) coeliac blood test BEFORE considering trial on strictly gluten free diet
I have been coeliac since I was 17, tried to get tested but it was inconclusive as I could only eat for 3 days on gluten before being so poorly that I stopped eating gluten again to make me feel better.
E) are you vegetarian or vegan
Nope
F) full iron panel test to see if iron is low …..ferritin may be falsely raised due to inflammation of Hashimoto’s
Do I ask for this at the GP? Is this something they do on NHS?
Your conversion rate looks remarkably impressive considering you have Hashimoto’s and very low/deficient B vitamins
Do you think that it is just a T4 issue and I should ask to up my levo in 6 weeks? or before if i feel rubbish? this morning was horrible but it was only my first day so it couldn't have been related that quick right?
Absolutely no reason, at this stage to prescribe T3……and absolutely definitely no need to reduce levothyroxine dose.
Likely to see Ft4 below range at next test ok
75mcg levothyroxine….if single tablet…..will be Teva yes that is correct
I asked to trial the T3 to try and loose weight because I just keep on piling on the pounds despite doing all the right lifestyle choices and its making me so depressed.
Approx how much do you weigh in kilo
Guidelines on dose levothyroxine by weight suggests most people are likely to need approx 1.6mcg levothyroxine per kilo of your weight per day
As you are gluten intolerant, you may indeed need addition of T3….but you are highly likely to also need a decent level of Ft4……at least 50-60% through range
Having trialled t3 last year, I was also on reduced levo. Felt utterly dreadful with below range ft4. Yours as mentioned above isn’t high anyway and when you add t3 is will drop more.
After a year of trying various combination doses I went back to levo only for some months before slowly adding t3 again now. I can say that I am far from perfect but vastly improved with an ft4 around 50 -60% of the range.
My advice? Ask the endo if he’s prescribing you t3 because your tsh is fairly low? It strikes me that they accept that t3 lowers it much more than t4 and so that sort of lets them off their tsh obsession. However I honestly would ask for an increase in levo instead. It’s so much easier to take a tablet once a day rather than possibly splitting doses and taking months to feel a bit better.
I realise these are your lessons to learn I would just say try not to learn the hard way like I did! 2021 absolutely sucked.
Like you…..before I started T3 (on 125mcg levothyroxine)
Ft4 was typically 19 (12-22) ….
Endocrinologist reduced dose levothyroxine by 25mcg and T3 added (initially 2 x 5mcg….after 6 weeks increase to 20mcg per day…taken as 3 smaller doses spread through the day)
After 4 months Ft4 was down at 13 (12-22) ….I felt absolutely dire
Eventually (after much trial and error) have ended up on 125mcg 6 days a week and 112.5mcg levothyroxine one day a week…..and 20mcg T3 per day
That really does show how sensitive it is doesn’t it? That small difference in your levo dose I mean. I’ll be very interested to see what my next results are. Encouraging to read yours and I thank you for sharing them.
Your endo didn’t reduce your levo too much. You read of 50mcg drops and I’m sure they have a tick box for tsh. With t3 they must be legally covered which just seems madness.
I think I’ll look at the gluten dairy free thing you mentioned in my post as I do seem to be on a higher dose of levo to get to my preferred limit. Think maybe I just don’t absorb too well.
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