Could someone review my results please

[Ste1]

Please see blood results below from 15/06/22, taking 125mcg Levothyroxine daily. Vitamins quite good apart from Ferritin and Vit D, I have increased Vit D and am taking co-factors and have also started eating Black Pudding and Liver Pate as I have seen advised here on other posts and as advised by Thyroid specialist. I currently feel ok ish, but still have bradycardia, low body temp, swollen scalloped tongue, occasional pulsatile tinnitus and occasional skipped heartbeats.

Medichecks 15/06/22

TSH 0.04, range 0.27 to 4.2

FT4 18.9, range 12 to 22, 69% through range.

FT3 5.76, range 3.1 to 6.8, 72% through range.

Folate 19.8, range 3.89 to 20.58, 95% through range.

Vit D 75, range 50 to 200, 17% through range.

Ferritin 141, range 30 to 400, 30% through range.

B12 Active 116, range 37.5 to 150, 70% through range.

CRP HS 0.91, range 0 to 5, 18% through range.

Thyroglobulin Antibodies 11, range less than 115.

Thyroid Peroxidase Antibodies less than 9, range less than 34.

Following the results above my Specialist advised to increase Levothyroxine to 137.5 mcg daily for 6 to 8 weeks and retest just TSH, FT4 and FT3 with the hope of raising FT4 a little and hopefully FT3, as she thinks I may need to be higher in the FT3 range. My most recent Monitor My Health blood test results are shown below:

Monitor My Health 09/08/22

TSH 0.05, range 0.27 to 4.2

FT4 20.4, range 12 to 22, 84% through range.

FT3 5.0, range 3.1 to 6.8, 51% through range.

Vit D 121, range 50 to 200, 47% through range.

Triglycerides, Cholesterol, HbA1c are all within their ranges.

Why has my FT3 reduced following an increase to Levothyroxine?

Do I need to add in some T3 to optimise my FT3 and maybe improve my symptoms?

Are there any risks with a suppressed TSH?

Any thoughts and advice most welome.

Many thanks

[greygoose]

Why has my FT3 reduced following an increase to Levothyroxine?

Probably because your FT4 is now too high, and converting to more rT3 than T3.

[Ste1 in reply to greygoose]

Many thanks greygoose for your reply.

[greygoose in reply to Ste1]

You're welcome.

[SlowDragon Administrator]

Try splitting your levothyroxine into 2 smaller doses

62.5mcg waking and 62.5mcg at bedtime

You might find this improves conversion rate

Retest in 6-8 weeks

Do you always get same brand levothyroxine at each prescription

If yes, which brand

[Nifty7312 in reply to SlowDragon]

My blood test came back to my doctor years ago that my body overdosed on Levothyroxine. So the .025 I have to split in half. I hope you get yours figured out soon.

[Ste1]

Hi SlowDragon, thank you for your reply and suggestion, whilst I was on 125 mcg my FT3 was 5.76 and 72% through range. If that could be improved by splitting the dosage that would be great. I have been reluctant up to now to introduce some T3 but am getting close to going down that route I think as proposed by my Thyroid Specialist. I have a consultation with my Specialist next Monday and will raise your suggestion. My usual meds are Northstar/Accord 100mcg and 25 mcg typically Northstar (Teva). Thanks again for your advice.

[SlowDragon Administrator in reply to Ste1]

Teva brand upsets many many people

Suggest you get 50mcg Accord and cut 50mcg in half to get 25mcg

(also boxed as Almus via Boots or Northstar via Lloyds )

[SlowDragon Administrator]

Teva contains mannitol as a filler, which seems to be possible cause of problems. Also contains acacia that upsets many people

Accord only make 50mcg and 100mcg tablets

Accord is also boxed as Almus via Boots, and Northstar 50mcg and 100mcg via Lloyds ....but Accord doesn’t make 25mcg tablets

25mcg Northstar is Teva

List of different brands available in U.K.

thyroiduk.org/if-you-are-hy...

Posts that mention Teva

healthunlocked.com/search/p...

Teva poll

healthunlocked.com/thyroidu...

Once you find a brand that suits you, best to make sure to only get that one at each prescription.

Watch out for brand change when dose is increased or at repeat prescription.

New guidelines for GP if you find it difficult/impossible to change brands

gov.uk/drug-safety-update/l...

If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient. If symptoms or poor control of thyroid function persist (despite adhering to a specific product), consider prescribing levothyroxine in an oral solution formulation.

academic.oup.com/jcem/artic...

Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

Similarly if normally splitting your levothyroxine, take whole daily dose 24 hours before test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

REMEMBER.....very important....stop taking any supplements that contain biotin a week before ALL BLOOD TESTS as biotin can falsely affect test results - eg vitamin B complex

[Ste1]

SlowDragon, many y thanks for all of the useful info.Kind Regards