After posting last week about a funny tender thyroid episode (and feeling hypo), I did my bloods again. Looks like TSH has come right down, was 9.5 around diagnosis time in March, and free T4 has gone up, but free T3 has reduced.
Caveat - these bloods were done just after heatwave which seemed to precipitate this funny tender thyroid issue (which settled).
TSH 0.45 (0.27 - 0.42)
FT4 19.9 (12 - 22)
FT3 4.3 (3.1 - 6.8) - my previous reading was 4.8 when I was first diagnosed in March
T4 140 (59 - 154)
Vit D 65 (75 - 175) - this is a big improvement and although have supplemented a little - have also spent a lot more time outside.
Ferritin 17 (13 - 150) - this was 5 at time of diagnosis and I had an iron deficiency anaemia - believe is resolving but room for improvement.
So technically think I should be feeling great, but have still been feeling tired etc. (albeit improved since diagnosis), and just wondered about the significance of the FT3 going down. Might I need T3 also? Am just on 75mcg per day of levothyroxine currently.
Thanks all in advance for any wisdom you may have to share on this
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kreamtee
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Ferritin 17 (13 - 150) - this was 5 at time of diagnosis and I had an iron deficiency anaemia - believe is resolving but room for improvement.
So technically think I should be feeling great, but have still been feeling tired etc
Your Ferritin is a major problem and still a long way from optimal. This could well be the cause of your fatigue. It's recommended that Ferritin is half way through range although some experts say that the optimal level for thyroid function is 90-110ug/L.
Vit D is recommended to be 100-150nmol/L according to the Vit D Council, Vit D Society and Grassroots Health so a fair way to go there.
Have you had B12 and Folate tested?
Optimal nutrient levels are needed for thyroid hormone to work properly and good conversion, particularly Ferritin, and you would need to address these before considering T3.
Thanks very much for the reply. And is a useful reminder for me - yes, will keep plugging away at the ferritin and Vit D for sure. Not v keen on iron tablets have to say!
B12 and folate were normal at diagnosis, so hoping they still are now too
My "Active B12" was 48 mmol/L (37.5 - 150) - not quite sure if the same test you mention.
And just looking for it, but I can't see a folate result - albeit there is an entry that says B12/folate in normal range - think must have meant the B12!
Will ask to see if GP would mind adding these again, as I did these blood tests privately, but am due another set hopefully before my first appointment with the endocrinologist - thank you!
Hello SlowDragon. Yes, I had B12 and folate done at time of diagnosis and they were all good. Vit D is going up but will keep supplementing. Have had iron tablets from GP, and did have full iron panel which initially showed a microcytic iron deficient anaemia, but next test showed no longer anaemic or microcytic, which I took as a good sign. I did give up on the iron tablets as not keen on them, but may have to revisit! Also still struggling to lose weight at all, despite blood tests seeming to go in right direction (but know that there are many things that affect weight of course). Thanks again for the good advice.
In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency
Look at increasing iron rich foods in diet
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron
Thanks so much indeed! Really appreciate your time in replying - will work my way through this and was just looking at how can get more chickpeas and beans in my diet too! Am also wondering if I drink too much tea and coffee (helps with the tiredness though). Certainly a lot to think about and change
kreamtee Hiya, just wading in to say, I was in this situation a while back, very low iron and I was drinking too much tea (obvs if it contains milk the calcium will block iron absorption, so that doesn't help), but I honestly think tea /caffeine in itself has also caused some of my issues. I was on maybe 6 cups a day relying on caffeine to counter the fatigue from low iron, am down to 0-2 at most now and feeling much better. All other comments are right on - low iron is a significant cause of fatigue and general weakness, irrespective of TSH (obvs that also contributes). Reducing milk intake (from the tea drinking) also helped me, as milk - as you probably know, can be an issue for us with thyroid issues and can cause leaky gut.... Ie. more gut disbyosis, ie. even less nutrient and mineral absorption it's frustrating as there's so much to think about. But keep with the iron tabs (eat with an orange or other piece of fruit to make it easier on the belly) and try switch to herbal teas or similar alongside working on your bloods, small steps, good luck!
I am on iron tablets and really struggle to take them. But honestly glad I persevered as I'm just starting to get some energy back and ferritin levels slowly going up. If I can recommend anything it's to keep persevering with iron supplements. If your bloods show up as microcytic anaemia again, talk to your GP about a referral for an iron infusion at the hospital. I think once your Hb is up they don't offer it. Just something to bare in mind. Hope you start to feel better soon.
As Slowdragon says your b12 looks too low. The bottom of b12 standard ranges does not preclude the possibility of deficiency (which is serious with many unpleasant symptoms) and low levels are almost certainly suboptimal. I would be cautious about most GP's assessment of b12 levels. Have a look at B12d.org for a good introduction.
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it's frustrating as there's so much to think about. But keep with the iron tabs (eat with an orange or other piece of fruit to make it easier on the belly) and try switch to herbal teas or similar alongside working on your bloods, small steps, good luck! 
Back again for help with recent blood results. Am i still a poor converter?
Help wanted before endo visit.
Help with blood results, still don't feel better.
Do anyone have any advice or success stories of HEALING A THYROID NATURALLY? 
blood tests say over medicated on levo but feel awful without it 
