Hypothyroid blood results advice.

[Mhaire]

I was diagnosed with hypothyroidism 3 years ago. I have never felt well on Levothyroxine. I have had severe fatigue, muscle pain, pin, and needles, low blood pressure etc, etc. GP only did TSH and T4. Started on 25mg increased to 50 , fatigue continued,increased 75-felt so ill I weaned down and came off altogether. 6 months off treatment before restarting due to bloods TSH raised.

So fed up feeling ill, got private bloods. Can anyone help me understand results please?

Cortisol 438 (166-507

TSH 2.64 (0.27-4.20)

T4 98.6 (66-181

FT4 14.4 (12-22)

FT3 3.99 (3.1-6.8)

rT3 15 (10-25)

rT3 ratio 17.32 (normal >15)borderline12- 15) low<12

TPO <9 (<34);TRAB 21 ( <115)

Vit d 83(75-200

b12 459 (145-568)

foliate 25.3 (8.83-60.8)

Thanks

[Lalatoot]

Mhaire When on levo we look to the tsh being around 1 with ft4 and ft3 being at least 50% through their ranges.Your TSH, low ft4 and ft3 plus symptoms show that you need and increase of 25mcg in you levo dose.

[Mhaire in reply to Lalatoot]

Thank you so much Lalatoot. That is really interesting. I've just been so fatigued for so long and now having palpitations and kidney symptoms. Trouble is that I have dose increase in levo makes me feel even worse. Wondering about conversion issues and T3 treatment but don't know enough about it.

[Lalatoot in reply to Mhaire]

There is nothing to suggest you need T3. Nothing to suggest that you have a conversion issue at this stage. Your RT3 result may have nothing to do with your thyroid.T3 is not an easy or quick fix - it can take years of adjusting doses till you find levels that suit. It is easier if you can feel well on levo alone.

Have you tried splitting your levo dose. I always have as I found it difficult to increase.

Taking 2 doses or 3 doses per day is gentler on the system.

[Mhaire in reply to Lalatoot]

Will try this and feel really informed now. Thank you.

[greygoose]

rT3 15 (10-25)

rT3 ratio 17.32 (normal >15)borderline12- 15) low<12

Pointless tests, waste of money, don't give you any useful information - especially the RT3 ratio - nothing that you can't see from the other tests. rT3 isn't a real issue, anyway.

TRAB 21 ( <115)

This is a test for Grave's hyperthyroidism, which you're hardly likely to have given that you were diagnosed with hypothyroidism. TPO ab is negative, but that doesn't prove you don't have Hashi's. There are two Hashi's antibodies, the other one is TgAB. And, antibodies fluctuate all the time, so should be tested at least three times before you can assume you don't have it. And, even then... With Hashi's, you can't prove a negative.

Your vit D is a bit low. No results for ferritin?

[Mhaire in reply to greygoose]

Thanks greygoose. Ferritin was 80.5 (13-150) I Just had a whole battery of tests done as part of a private bundle so the anti thyroglobulin was part of it anyway.

[greygoose in reply to Mhaire]

It might be a good idea if you could try and raise ferritin by eating liver, or liver paté or black pudding once a week. It is on the low-side.

[SlowDragon Administrator]

Request 25mcg dose increase in levothyroxine and retest in 6-8 weeks

Which brand of levothyroxine are you currently taking

Do you always get same brand

Have you had ultrasound scan of thyroid

20% of Hashimoto's patients never have raised antibodies

healthunlocked.com/thyroidu...

Paul Robson on atrophied thyroid - especially if no TPO antibodies

paulrobinsonthyroid.com/cou...

No ferritin result

What vitamin supplements are you currently taking

[Mhaire in reply to SlowDragon]

Thanks slowdragon. They keep giving me northstar which I feel awful on. Never had a scan. Requested endo referral but was told no, not needed. Only test Tsh and T4. Ferritin 80.5 (13-150) mg 1.05 slightly above ref range (0.7-1). Prob not significant. Take a goid quality vit D3 and k2 supplement so surprised not higher in ref range. No other supplement as they had iodine in any preparation.

[helvella in reply to Mhaire]

100 and 50 microgram Northstar is Accord product.

But 25 microgram Northstar is Teva.

All too many find they do not tolerate Teva levothyroxine well. (Others find it the best available in the UK.)

I can't work out what dosage tablets you are getting.

helvella - Thyroid Hormone Medicines

I have created, and try to maintain, a document containing details of all thyroid hormone medicines in the UK and, in less detail, many others around the world.

From Dropbox:

dropbox.com/s/wfhrlmb5983co...

From Google Drive:

drive.google.com/file/d/11z...

[Mhaire in reply to helvella]

Helvella I am on 25mcg levo northstar. Just spoke to pharmacist who will try me on Wockhardt UK. Thank you. This forum and your expertise is a revelation!

[apelila]

You are hypo. I would start with the 75mg of T4 again. Then retest in 4-6 week to see if you are converting it and if not add T3 at that time.