Latest Blood Results

[Devonlad]

Just had the latest NHS blood results in, which are

TSH: 0.15 mU/l (Range 0.35 - 4.94) -4.36%

FT4: 21.4 pmol/l (Range 9 - 19) 124.00%

FT3: 4.5 pmol/l (Range 2.9 - 4.9) 80.00%

This is on a dose of Levo 150mg 5 days and 125mg for 2 days a week (slight variations of the doses over the last 4 weeks maybe 4 days and 3 days). This test was done before 9am and I had not had any Levo for 24hrs before and only water to drink in the morning. I've just started Vit B complex (after blood test). I already take 1000 ius Vit D, but am increasing it to 1600 ius.

Previous percentages from bluehorizon blood test (4 weeks ago) were TSH 0.51=6.11%, FT4 25.9=139%, FT3 4.39=34.86%

Previous NHS test at end of June were TSH 0.5 =3.27%, FT4 20=110%, FT3 3.9=50%

As I'm no good at interpreting these results do these look right? I'm not feeling great, lack of energy, get a bit shaky and sweaty when walking and can't do too much without feeling rubbish. I also get a bit of chest pain, which I had originally put down to angina, but GP doesn't think so as I'm on meds for that. I did try 125mg for 4 or 5 days straight, but didn't feel good on that.

I know my consultant (he's not an endo) wants to keep my TSH low to reduce risk of any rogue cancer cells spreading following thyroidectomy last Sept, and I don't think he would be averse to T3 if pushed. I can't have RAI treatment due to dry mouth issues, but has TSH gone too low?

The recent hot weather certainly hasn't helped my issues.

Any advice would be really appreciated.

[SeasideSusie Remembering]

Devonlad

This is on a dose of Levo 150mg 5 days and 125mg for 2 days a week (slight variations of the doses over the last 4 weeks maybe 4 days and 3 days).

You really must be on a stable dose, no changes, for 6-8 weeks before testing.

However, your historic results show poor conversion with FT3 being so much lower than FT4. I would push for a trial of T3 and you will need a reduction of Levo first (a couple of weeks of dose reduced by 25mcg) before adding T3 which should be started at 5mcg daily and gradually increased by 5mcg. You may not need much, 10mcg is enough for some people, others may need 15mcg and some need 20mcg.

[SlowDragon Administrator]

Previous full thyroid and vitamin results

TSH: 0.51 mU/l (Range 0.27 - 4.2) 6.11%

Free FT4: 25.9 pmol/l (Range 12 - 22) 139.00%

Free FT3: 4.39 pmol/l (Range 3.1 - 6.8) 34.86%

T4 Total 135.0 nmol/L Range 66-181

Anti-Thyroidperoxidase abs = 92 Range less than 34 IU/mL

Anti-Thyroglobulin Abs = 151 Range less than 115 IU/mL

Vitamin D = 97 Optimal range 75-200nmol/L

Vit B12 = 330 Range 145-569 pmol/L

Serum Folate = 21.70 Range 8.83-60.8 nmol/L

Ferritin = 420 Range 30-400 ug/L

Mg = 0.98 Range 0.66-0.99mmol/L

I've just started Vit B complex (after blood test). I already take 1000 ius Vit D, but am increasing it to 1600 ius.

You don’t need to increase vitamin D by much….perhaps just higher dose October to April?

Low B12 and folate

These obviously need improvement

Getting there optimal may improve conversion rate of Ft4 to Ft3

Levothyroxine

Suggest you take 125mcg 3 days and 150mcg 4 days ….taking alternate days

Get weekly pill dispenser, so you don’t forget

Stick on EXACTLY this for 6-8 weeks

Retest thyroid (and ideally B12 and folate) in 6-8 weeks

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

[Devonlad in reply to SlowDragon]

Many thanks for very prompt replies. As it happened my consultant just rang in reply to my test (Wow I only had the test yesterday and results overnight- that's impressive). Anyway like you he wants to stabilise my meds for 6 weeks and we've agreed I'll go onto 137.5 daily (125 + 12.5mg) and then have another blood test.

[SlowDragon Administrator in reply to Devonlad]

If Ft3 is to low and/or TSH too high …..You may need addition of T3 prescribed after that This would lower TSH and improve Ft3

Devon CCG only allows 10mcg T3 per person per day (2 x 5mcg) regardless of clinical need

Many people are on 3 x 5mcg T3 per day

[Devonlad in reply to SlowDragon]

Thanks SlowDragon, as mentioned I'm now on 137.5mg Levo only and will be for the next 6 weeks until another blood test. On last week's blood test.TSH: 0.15 mU/l (Range 0.35 - 4.94) -4.36%

FT4: 21.4 pmol/l (Range 9 - 19) 124.00%

FT3: 4.5 pmol/l (Range 2.9 - 4.9) 80.00%

I notice that TSH is lower at 0.15, is this significant? Would this account for me not having any energy and generally feeling weak and below par? I know my consultant is very keen not to increase my angina, but is balancing this with trying to suppress any rogue cancer cells.

[SlowDragon Administrator in reply to Devonlad]

You may need less levothyroxine (Ft4) and T3 prescribed alongside levothyroxine

Quite a lot of thyroid patients can’t tolerate high Ft4, over range….as yours now is

It may improve by 6-8 weeks…..if not

Reducing dose levothyroxine by 25mcg and adding 10mcg T3 (as 2 x 5mcg doses) …..the endocrinologist may be reluctant though …