Test Results T3/T4 - TSH low consultant want me to decrease!

[Bellthyroid]

TSH 0.02

T4 14.5

T3 5.5

Taking 87mcg liquid T4 (Brill Pharma brand)

and 18.125mcg T3 spaced over the day (Morningside brand)

Any comments /help would be greatly appreciated.

[Ansteynomad]

Can we have the reference ranges for those results please? They vary from place to place so are vital for accurate interpretation. Thanks

[SlowDragon Administrator]

Please add ranges on Ft4 and Ft3

Was test done early morning, ideally before 9am and last dose levothyroxine 24 hours before test

Last 1/3rd of daily T3 should be approx 8-12 hours before test

How are you taking 18.125mcg T3?

Morningside do 5mcg, 10mcg and 20mcg tablets

Do you have Hashimoto’s

What vitamin supplements are you currently taking

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

[Bellthyroid in reply to SlowDragon]

TSH 0.27 - 4.2

T4 12-22

T3 3.1-6.5

I take Morningside 5mcg and cut them up so its a bit of a guestimate

I don't take any vitamin supplements

I don't have Hashimoto's.

No test was done at 2.30 as getting a blood test is tricky at the moment and you have to take what they offer. I know this is not ideal. I have just requested another blood test and will try to get an early morning slot.

Vitamins were done in March/April

Serum Vitamin B12 144ng/l Range 130-88

Serum Vitamin D 52nm0l/l Range 25-300

Serum Folate 5.9ug/l Range 4-27

Serum Ferritin 160ug/l Range 13-150

Thanks for replying.

[SlowDragon Administrator in reply to Bellthyroid]

Serum Vitamin B12 144ng/l Range 130-88

Serum Vitamin D 52nm0l/l Range 25-300

Serum Folate 5.9ug/l Range 4-27

Can you check range on B12

Are you vegetarian or vegan?

Serum B12 under 500 is too low

B12 so low you MUST be tested for Pernicious Anaemia

Likely to need B12 injections, even if not positive for PA

Folate far too low….needs to be at least half way through range

Vitamin D …also far too low

At least minimum 80nmol and around 100nmol maybe better

[SlowDragon Administrator]

Vitamin D

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

GP will often only prescribe to bring vitamin D levels to 50nmol. Some CCG areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But with thyroid disease , improving to around 80nmol or 100nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via NHS private testing service when supplementing

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7.

One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

Another member recommended this one recently

Vitamin D with k2

amazon.co.uk/Strength-Subli...

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average

Vitamin D and thyroid disease

grassrootshealth.net/blog/t...

Vitamin D may prevent Autoimmune disease

newscientist.com/article/23...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Great article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

Only add one supplement at a time. Then wait at least 2 weeks to assess before adding another

[SlowDragon Administrator]

B12 and folate

GP should have tested for PA in Spring after this very low B12 result

See GP for repeat test and test for Pernicious Anaemia BEFORE starting any B vitamins

Do you have any Low B12 symptoms

b12deficiency.info/signs-an...

Also ask advice on PAShealthunlocked

healthunlocked.com/pasoc

[SlowDragon Administrator]

About 90% of primary hypothyroidism is autoimmune thyroid disease also called Hashimoto’s

Have you had BOTH TPO and TG thyroid antibodies tested

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

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

Last 1/3rd daily dose T3 approx 8-12 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Testing at 2pm will have given (possibly significantly) lower TSH

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

bluehorizonbloodtests.co.uk...

Low vitamin levels tend to lower TSH too

[SlowDragon Administrator]

FT4: 14.5 pmol/l (Range 12 - 22)

Ft4 only 25.00% through range

FT3: 5.5 pmol/l (Range 3.1 - 6.8)

Ft3 64.86% through range

Was last dose levothyroxine 24 hours before test

You might agree to reduce T3 to 3 x 5mcg …..and increase levothyroxine a bit….perhaps 100mcg daily

Do you normally split your liquid levothyroxine

Most members on liquid levothyroxine find it better to split dose