further to my posting of last week's latest NHS bloods, which SlowDragon and greygoose kindly commented on - could someone advise on this FT3 result actually done by NHS and added to my list of results yesterday, please? what does this say about how well I convert?
We did establish last week that I'm undermedicated on 75mcg as TSH too high and FT4 too low (and I am symptomatic) so am pushing up to 100mcg.
(Of course, they haven't done the iron panel or Vit D again STILL because it's not important...)
So leaving aside comments about vitamins, as we did that last week - here are the thyroid results alone for relationship between T4/T3 : (as mentioned in last week's post, test done per protocol).
Serum TSH 1.69 (0.35 - 5.50)
Serum FT4 15.1 (10.5 - 21.00)
Serum FT3 4.9 (3.50 - 6.50)
also:
Serum Cortisol 529 nmol/L (>374) taken 8.55am
I don't know what the cortisol result means - from what I can research it looks about normal?
with my sincere and grateful thanks for your support.
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turquoisea7
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Bless you thank you so much for replying SlowDragon especially with the link for the calculator, that's so helpful.
I thought the conversion looked OK. You say 'currently', does it change?
I am around 73kg (no matter how little I eat, how much I try and push myself to exercise, it is still going up). On that basis I would need around 116mcg - not much more than I'm taking now and feels like it would be nothing like enough. On how I feel now and the blood numbers I'm thinking likely 150mcg at the moment to get me to the ranges people look for at optimum on T4 alone.
Avoid the temptation to pick a number and think it will be right for you. You need more certainly, but you can't predict how much more. That must be determined by slow and careful monitoring. You definitely need to go up to 100 now. But from 100 - 125, I would break that step into 2 and increase by alternating those two doses every other day for 6 weeks and test again, then, if necessary go up to the full 125 a day. I say this because it's so easy to miss our sweet spot. I've done it. And it's really hard to unpick it, slow and depressing too. Again, if 125 isn't enough, the move up to 150 should be slow, Something like 150 twice a week and 125 the rest for 6 weeks. It's learning to tweak and let the body catch up that is important.
thanks very much for this, I was thinking the same about going up slowly; however doesn't look like this is an option for me at present, my conversion has dropped and I've hit the top of the FT4 range and still symptomatic, so having to stop and rethink what next.
May I ask, is there anywhere reliable please, to look for or understand what it is that changes or reduces conversion rate? Is there anything useful/practical to be done when that happens, or is it a case of having to start looking at T3?
Conversion tends to reduce as TSH gets lower (catch 22)
optimal vitamin levels are essential for good conversion of Ft4 to Ft3
Hashimoto’s patients frequently have poor conversion
Splitting dose levothyroxine can help some people. Taking half dose levothyroxine waking and half dose at bedtime….might increase TSH/improve conversion
thank you. I have done everything right diet-wise, and I split-dose, but my conversion has dropped in the last 6 weeks; I stopped the B complex for a week or so to take the test, but as we have to do that, catch 22 again. I don't think this is an issue from just a week though, it seems more like the low TSH is the problem.
Thank you, yes I think it must have been your advice that made me get the separate B12 and folate - but will look up the Jarrow as am using Solgar. I do need the reassurance about the TSH issue. Despite reading everything I can and trying to stay level about it, the scare stories have got to me and I'm worried about what it's meant to do to your heart. Unfortunately with my bloods I seem to have no choice in the matter, it's either function and have no TSH or be immobile and have a TSH that will make the GP happy.
I am a little bit in love with you just for this, thank you thank you. I do need my hand holding with all this, if you hadn't said that I'd still be worrying. As it is if my FT3 doesn't clamber up to a feeling-well level I'll be looking at T3 supplementation. THANK you again for allowing me to breathe a huge sigh of relief and 'sleep' tonight (of course prior to having to battle GP just to stay on the dose I'm on.....)
Didn't I see a question a while back asking if TUK should run a helpline? This is exactly one of those days where I'd have used a service like that.
1)How long do you stick a dose out if you're concerned that you might be heading for over-medication on that dose? I read the 6-8 week advice here, I believe on the understanding that at 6 weeks you have maximum effect from a dose? What happens after the 6 weeks - does it continue to build, as I have read some people say, does it 'settle' and subside, or is there no way to know?
2) When is it considered OK to adjust or fine-tune your dose; and when it is it mucking about and not good for you?
OK thank you, sorry I should have said I'm more concerned about how long I stick at a dose after a raise, before testing and tinkering, if I'm worried about the question of taking too much. I don't understand why it would be a good idea to keep going for longer if I fear I may be heading for my FT3 getting to the limit or over the top?
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Blood Test Results.
PLEASE could somebody look at these bloods:-
