my test results in the last few years have all been more or less constant with a suppressed TSH and FT3 and FT4 in the middle or upper end of reference ranges. Have been feeling ok but noticed I fall asleep again in the evening rather easily. These results then came as a surprise. The FT3 is low, FT4 is below reference and the TSH is the highest it has been for years.
I take 75mcg Levo and 10 mcg Liothyronine, both from Henning Sanofi and wonder what may be going on. Vit D is good, 103nmol/L, Vit B12 more than 150pmol/L, no figures for Folate and Ferritin but I am usually on top of reference range for Ferritin.
I know I have Hashimoto’s, but can anything change so unexpectedly? Took no Biotin containing supplements for 2 weeks before test, and did the test in the usual, recommended way.
Can my condition suddenly change to central Hypothyroidism?
Any comments gladly received!
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elkewilliams
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It could just be a Hashi's hypo swing and you need to increase your Levo at the moment. I'd try a 25mcg increase in Levo dose and retest in 8 weeks. I personally wouldn't increase T3 at this stage because increasing your Levo should, depending on how much natural conversion you have, increase both FT4 and FT3 levels.
There's no such thing as a 'Hashi's hypo swing'. With Hashi's, you are basically hypo, with occasional false-hyper swings. So, it loks like this is the real you.
How long ago was the last test? What were the results?
No, your condition can't change from Hashi's to Cental Hypo. Hashi's is for life, it never goes away. But, if you hava a bang on the head or something, your pituitary could be affected. But, I don't see how that would apply to you? Your TSH has risen due to your drop in Frees. The question is: why have the Frees dropped?
How long was the gap between your last doses and the blood draw?
Had my T4 about 24 hours and T3 12 hours before blood draw. But the last test was more than 6 months ago, always done using Medichecks.Good question- why have the Frees dropped? Have been put on Bisoprolol since an episode of AF last October after several episodes of Tachycardia where GP and Endo always blamed my depressed TSH and possible over medication.
A gradual worsening due to under,education is quite difficult to notice if you have had this condition for over 40 years. Usually it was the putting on of weight that alerted me but I am slim now, 58.5 kg.the falling asleep on the settee is the only symptom that I found increasingly odd.
No, I don’t. Have never been told or even thought about the fact that this could have an impact. I am careful with all the other supplements I take. I have now come across that it was suggested to have a 2 hour gap?
Thyroid hormone shoul be taken strictly by itself. It could indeed have an impact. Try taking it two hours away from your hormone, and see what happens.
I am very grateful for pointing this out to me- can’t believe that I never even thought about it! I am so careful with other supplements but wonder if I can take Bisoprolol at night( on it because of night time tachycardia episodes) rather than 2 hours after Thyroid meds in the morning. Will try and get some more info if that is an option.Thanks!
I'm also 58.5 kg but I alternate between 100mcg and 112mcg of levothyroxine as well as 10mcg of T3. If I were to take only 75mcg of levo my FT4 levels would be extremely low and I'd be non functional. Levo is dosed based upon 1.6 mcg per kg of weight but keep in mind the bioavailability of these pills is 80% so if you take 100mcg you're not actually getting 100mcg. Thyroid hormone eventually shuts down your own thyroid and you need to dose based upon your weight.
So will have to increase! But also just came across the fact that I have not - how could I have not thought about that!!- taken into account to have a gap between thyroid hormones and the Bisoprolol that I have been prescribed recently. Such invaluable support from this site! Thank you !
When I weighed 9 kg less I only took 88 micrograms of levothyroxine per day and was surprised how much I had to increase it just by gaining 9kg. I'm not familiar with the other medicine you take but medicines can affect your thyroid hormone too. I have to take iron and make sure to give 4 hours between. Sounds like you do the same already. Take care!
How long have you been on 75mcg Levo and 10 liothyronine? That wouldn’t be enough for quite a lot of people, to be honest. Unless you are quite slight?
My weight is 58.5 kg and I am 70 years old, the present dose has been like that for about4-5 years. Usually T4 was at about 18 (12-22) and TSH was depressed at about 0.005 (0.27-4.2)
my test results in the last few years have all been more or less constant with a suppressed TSH and FT3 and FT4 in the middle or upper end of reference ranges.
This is a fairly vague description of your results
Small differences in labs can make a big difference to how you feel!
When did you last have a full thyroid test?I wonder if your levels have been slowly dropping without you being aware of the change....until now.
Your TSH seems low considering your low Frees.
You say you've been feeling ok .....or have you just become used to feeling under par?
It may be that your thyroid ( or pituitary) is struggling.... and you need more hormone
75mcg levo + 10mcg T3 is not a huge dose
I suspect you may have been under/ wrongly medicated for a very long time....having looked at your previous posts.
On what basis did they decide your conversion was poor?
FT4 should have been high with low FT3.
Do you have your diagnostic labs....your first thyroid test labs.?
You are legally entitled to ask your surgery for test results
Your FT4 is very low....despite likely being slightly reduced by the added 10mcg T3
I'd suggest you need to trial an increase of T4...at least another 50mcg.... in 2 x 25mcg increments
Treating by TSH is not accurate as the following will show
Thank you for your extensive reply and a lot of what you’ve mentioned gave me food for thought! Have been hypo for nearly 45 years and only since I added - suspecting that I am a poor convertor and subsequent test confirmed a DIO2 polymorphism- the additional T3 have I felt any better. Lost a lot of weight and am now 58.5 kg but it could well be that I have been very slowly getting under medicated and got used to feeling under par!It is difficult to see a GP or get in touch with Endo although he was the one who got me onto T3 but an annual telephone call seems to be the only monitoring he does now, still in pandemic mode somehow.
I had been wondering whether to increase T4, it seems to be the first step to try. Thanks again!
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