Blood Test Help Needed: Hi My most recent... - Thyroid UK

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Blood Test Help Needed

Sparklingsunshine profile image

Hi

My most recent MMH results from today are:

TSH 0.01 range (0.27-.4.2)

FT4 20.3 (12-22)

FT3 6.8 (3.1-6.8).

I've been feeling a bit off the last few days, jittery, jelly legs, a bit weak and shaky, a bit sweaty, wondering if I'm a bit overmedicated. Felt the opposite at end of June when my results were much lower. So tired and lethargic. I added some Thyroid S in as well.

I bought it about 3 years ago but wasn't diagnosed with a thyroid problem then even though I've long suspected my thyroid was struggling. I tried it back then but didn't know anything about thyroid dosing protocols. I didn't feel any better so just stored it away, probably because I didn't know enough.It's the old 1000 tablet size.

Although I think I've overdone it my results have never been this high on Levo,I'd like them to be a bit lower so I don't feel so wired but wondering if a lower dose of Levo and some Thyroid S might be a good combo for me. Levo just doesn't seem to cut it on its own. If so how would I go about dosing.

Also is there a speedy way to reduce my FT3 level so I can feel a bit more normal. Not enjoying this sensation. hank you.

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Sparklingsunshine
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15 Replies
Lalatoot profile image
Lalatoot

Sparkling dosing a combo is trial and error. It took me 2 years to find doses and dosing regimes. It is also quite individual You need to go by what you think suits you. Change only 1 thing at a time, wait 8 weeks and do bloods. Then decide how to improve things again if a change is need. Working slowly and methodically is the only way.

Changes in t3 are made in 5mcg. Changes in levo are made in 12.5mcg or 25mcg.

Sparklingsunshine profile image
Sparklingsunshine in reply to Lalatoot

Hi

I'm a novice when it comes to NDT but my frees have never been this high on Levo alone. So that's a positive. I've been on Levo for just over 2 years and my levels have fluctuated so much.

I think this might be a good combo for me but I'm unsure of where to go from here. I'm meant to take 150mcg of Levo a day so was thinking one grain of NDT and 50mcg of Levo might be a good place to start or not? Or more NDT and less Levo? Thanks for the reply.

Lalatoot profile image
Lalatoot in reply to Sparklingsunshine

Sparkling This is what I would do if it was me.

Look at your results on levo alone. If ft4 is at the top of range or over range then you reduce levo dose. If ft4 is not up to 80% through range then I wouldn't reduce levo.The starting dose for adding not is either a quarter or half grain. This is to make it gentle on your body.

If reducing levo reduce by 25mcg then wait a week for levels to drop

Add in quarter grain ndt. Wait a week

If ok then add in other quarter grain either to first dose or as separate dose.

Add in quarter grain every 2 weeks until your reach daily total of 1 full grain.

Hold this dose for 8 weeks do bloods.

Having said this pennyannie makkes a fair point below.

Sparklingsunshine profile image
Sparklingsunshine in reply to Lalatoot

Hi

Thank you, my results in June on 150mcg were rubbish, FT4 at 13 and FT3 was 3.6. Same range as above. I felt so fatigued. My results this time are so much better, the best they've ever been. I just feel slightly overmedicated so just wanted to reduce my dose a bit.

SlowDragon profile image
SlowDragonAdministrator in reply to Sparklingsunshine

You don’t say how much NDT you added

Was it 1/4 of a grain?

Sparklingsunshine profile image
Sparklingsunshine in reply to SlowDragon

HiNo I dropped Levo to 50mcg a day and added a grain of NDT, I was trying to replicate the 150mcg dose of Levo and had read one grain of NDT was equivalent to 100mcg Levo.

On reflection I probably added too much NDT too soon. I didn't realise how potent it was. When I originally tried it a few years ago it didn't seem to do much 😄

SlowDragon profile image
SlowDragonAdministrator in reply to Sparklingsunshine

Should only ever start on 1/4 grain

Sparklingsunshine profile image
Sparklingsunshine in reply to SlowDragon

Hi

I'm thinking of trying the NDT on its own, I'm pleasantly surprised at the difference its made. I've been on Levo for just over two years and have never managed to push my levels up. The highest they got to before was FT4 17 and FT3 was 4.7.

I'm thinking trying to combine Levo and NDT might be challenging and lengthy as I understand from other members you should only change one part of the dose equation at a time, ie change the Levo on its own, or the NDT but not both.

pennyannie profile image
pennyannie

Hello Sparklingsunshine :

There is a unique balance of T3 and T4 in Thyroid S that suits thousands of people as a stand alone thyroid hormone replacement and by adding anything else into this mix you are eroding that uniqueness

Have you tried Thyroid S by itself as this may well suit you better ?

You have certainly enough grains there to give yourself a trial pf NDT and it's not as complicated as trialling 2 different treatment options at the same time.

Sparklingsunshine profile image
Sparklingsunshine in reply to pennyannie

Hi

Thank you so much, I did wonder about a straight swap. I'm meant to be on 150mcg of Levo. Not sure how to swap over, gradually or just take the plunge.

pennyannie profile image
pennyannie in reply to Sparklingsunshine

You swop over gradually :

The T4 - irrespective of the dose you are on - will take around 6-8 weeks to finally leave your body and in that time span you slowly build up your dose of NDT.

First you need to take bench marks of T3 and T4 to compare to - so we have them :

What dose of NDT are you currently adding to your T4 ?

Are your ferritin, folate, B12 and vitamin D up and maintained at optimal levels ?

OK - so in principle you stop the T4 one day and start the NDT the following -

Start on the dose of NDT you are currently taking and stay on that dose for a week :

Each week add a further 1/4 grain : to the relief of symptoms: monitoring symptoms :

Monitor yourself on blood pressure, pulse and temperature twice daily -

There comes a week when your increase doesn't sit well with you.

You might become edgey, and uncomfortable in your skin, and just not ' as good ' as the previous week - so drop down to the previous weeks dose and stay on that dose for 6-8 weeks, letting it bed in - and then run a blood tests to compare with your previous treatment option.

Your TSH will likely be low suppressed :

Your T4 likely lower than when on T4 only :

But your T3 should be higher than when on T4 only - but since you are on a mix of treatment options, and not well with the T3 you have achieved - your T3 will be where hopefully, you feel more comfortable.

If, when, you get to 2 grains stay on that dose for 6-8 weeks and then run a blood test to compare with the bench mark readings.

If happy on the results on 2 grains but still with symptoms repeat the process again taking 1/4 grain weekly increments and monitor on your symptoms, blood pressure and temperature.

I only managed to get to 1 + 3/4 grains before I knew I'd gone too far and dropped back down to 1 + 1/2 and stayed on that dose for 6-8 weeks and then took a blood test ,

My TSH was 0.01 - my T4 at 25% through the range but my T3 was at 100% through the range - and I felt as good as it's ever gonna get - with my T3 and T4 having swopped positions to when I was on T4 monotherapy.

My blood pressure and pulse remained constant and my temperature rose from 35.4 to 36.6 where it still hovers most days.

I don't have a thyroid as I had RAI thyroid ablation for Graves Disease in 2005 becoming very unwell around 8 years later and now manage lingering Graves, thyroid eye disease and hypothyroidism and started self medicating over 4 years ago.

Sparklingsunshine profile image
Sparklingsunshine in reply to pennyannie

Hi

I'm meant to be on 150mcg of Levo, so I kept 50mcg and added a grain of NDT, to get it to 150 roughly.

I had my folate done in June, it was low so I'm supplementing, my B12 is very high due to injections, ferritin slightly over range when tested. Recent Vitamin D was 89. So all good, apart from folate which is a work in progress.

So in a nutshell drop the 50mcg Levo, start on one grain of NDT tomorrow and then gradually increase starting from next Thursday add an extra quarter of a grain weekly until I hit two grains and then retest? Hope that's right? Thank you for your advice.

pennyannie profile image
pennyannie in reply to Sparklingsunshine

Sounds about right - good luck :

Same procedures as T4 - take on an empty stomach and wait at least an hour before eating or drinking anything - can't think of anything else at the moment :

Sparklingsunshine profile image
Sparklingsunshine in reply to pennyannie

Hi

I know you've said you use NDT, do you use Thyroid S? I just wondered how many use it. Probably easier to source than Armour.

pennyannie profile image
pennyannie in reply to Sparklingsunshine

Yes : and don't know :

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