I need to book next blood tests. I’ve always had my bloods done first thing, no food or hot drinks, no thyroid meds until after test etc. I’m not sure whether I need to do this any more. I’ve been on T3/T4 combo since November 2020. I have raised cholesterol, average results around 7, was 8 and has been 6. I should be taking statin as there is a family link. I have held off for now but think I should try, although considering I have Hashimotos I don’t want to risk the Atenolol the Gp has prescribed. I also take propranolol which seems to have slightly lowered my T3. Whenever I have my cholesterol test, which is usually at same time as having TFT’s, it now says not fasting. My husband was told a while ago that there’s now no need to fast for Lipids too. Should I still fast? I’m not sure how much this would effect TFT’s and Lipid results and therefore what I might be told to change etc, which might sound silly. Also I would like to know which statin would be more suitable with less or none of the usual awful side effects. Many thanks 😊
Blood test question: I need to book next blood... - Thyroid UK
Blood test question
I had lipids tested in April this year and there was a note on the report which said
LDL cholesterol may not be valid for non-fasting samples
I always do every pre-booked test fasting just in case they pop another one in that I wasn't told about.
Personally, for continuity and to be able to compare accurately, I would continue to test the way you have always done.
Also I would like to know which statin would be more suitable with less or none of the usual awful side effects.
None of us here are medically qualified and it would more appropriate to research this yourself and discuss with your GP. Not everyone reacts to a medication in the same way so however one member here reacts to something might not be the same as how you react to it.
Many thanks.
why are you taking propranolol
Propranolol slows uptake and conversion of levothyroxine
pubmed.ncbi.nlm.nih.gov/168...
labtestsonline.org.uk/tests...
Drugs that may decrease PTH include cimetidine and propranolol.
rejuvagencenter.com/hypothy...
how much propranolol are you currently taking
It’s important to never ever stop propranolol suddenly. Has to be reduced incredibly slowly
Propranolol may also lower magnesium levels
Essential to test vitamin D, folate, ferritin and B12
Always test thyroid levels early morning ideally at 9am, last dose levothyroxine 24 hours before test
Day before test split T3 into 2 or 3 smaller doses spread through the day and last dose approx 8-12 hours before test
What are your most recent thyroid and vitamin results
Taking propranolol for migraines as was getting 3 really nasty ones per week. Nothing else has worked well enough in over 40 years. Taking one a day 80mg sustained release capsules. Using magnesium spray and sometimes magnesium glycinate capsules.
Most recent tests:-
TSH 0.03 mu/L (0.35-4.9)
FT4 13.5 pmol/L (9.1-17.6)
FT3 3.5 pmol/L (2.4-6.0) - was 4.7 same time last year.
VITAMIN B12 Serum vitamin B12 level 830 ng/L [187.0 - 883.0]
Serum ferritin level 134 ug/L [5.0 - 204.0]
Serum folate level Serum folate level 8.4 ug/L [3.1 - 20.0]
VITAMIN D Serum total 25-hydroxy vitamin D level 73 nmol/L [50.0 - 200.0]
Thank you 😊
migraine is a common hypothyroid symptom
You might find you could (extremely slowly) reduce and eventually stop propranolol
Took me 6-8 months to reduce and stop from 4 x 10mg per day
Reducing by 5mg ….waiting 4-6 weeks….reducing again etc
Last 5mg ….cut to 2.5mg
Then reduce one day week…next week 2 days etc
Why would I stop propranolol to go back to being laid up half the time with crippling migraine, couldn’t plan anything or do very much. Tried everything else and to take more thyroid medication causes further problems.
Thank you.
migraine are frequently caused by being hypothyroid
you are now on levothyroxine and T3 as well, so you are no longer hypothyroid…..though your Ft3 is probably still too low
Ft3 is probably too low because propranolol is reducing conversion of levothyroxine (Ft4) to active hormone (Ft3)
You would probably no longer get migraines….because your hypothyroidism is being treated
it’s important to only ever reduce propranolol EXTREMELY slowly or can cause adrenal crisis
Obviously….if migraine can back….you would have to go back on propranolol
Thanks. Tried to cope with crippling migraines for so many years avoiding statins because of side effects, also trying increase in thyroid meds to reduce cholesterol which caused worse palpitations and tight chest. Endo did genetic test for familial hyperlipidemia and although the results do not identify an FH mutation, my lipoprotein(a) level was slightly elevated therefore there is a genetic component to my lipid profile which would put me at higher risk of premature cardiovascular disease/strokes etc. Along with my elevated cholesterol levels it is recommended that I take statins. My Mother had high cholesterol and had to take statins. The above result info is taken from the report.
high cholesterol linked to low Ft3
nhs.uk/conditions/statins/c...
“If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.”
Was your mum hypothyroid/Hashimoto’s too
Mum didn’t have thyroid symptoms, no diagnosis, but she had high BP and Cholesterol. Yes NHS say the above, but I’ve tried for years to achieve ideal treatment for hypothyroidism. If I can’t tolerate higher doses of Levo or Lio then my cholesterol will not reduce. When I did increase there was very little reduction in cholesterol.
FT3 3.5 pmol/L (2.4-6.0)
That is why your cholesterol is high. You don't need statins, you need more T3.
I’ve tried more T3 but palpitations and tight chest became much worse.
OK, but statins are not the answer. The cholesterol is not causing you any problems. It doesn't cause heart attacks or strokes, as doctors claim. And it doesn't cause any symptoms. It is a symptom itself, not a disease. So why take a dangerous drug to get rid of something that isn't doing you any harm? And, they do say that those with higher cholesterol live longer.
By taking statins you have a greater risk of muscle damage. They will lower your sex hormones, removing your protection against breast cancer. You will run the risk of developing diabetes. And all sorts of other problems can be caused by statins. So, why bother? Just carry on as you are.
But, have you ever had your cortisol tested in any way?
how much levothyroxine and how much T3 are you currently taking
Do you split your dose T3 as 2 or 3 smaller doses spread through the day
Do you split your Levothyroxine
Presumably you always get same brand levothyroxine at each prescription (and T3)
Levo- 75 mcg 3 x per week
Lio- 50 mcg 4 x per week
I split 20mcg Lio into 4 (2 days)
Always same brand, never change.
T3 absolutely essential to take EXACTLY same dose T3 everyday
if got 25mcg tablets…..1/4 tablet twice a day
(at approx 12 hour intervals)
Or 1/4 tablet three times a day
(at approx 8 hour intervals)
That’s a tiny dose levothyroxine
Far better to take same or very similar dose levothyroxine everyday
Eg 50mcg per day …..perhaps as 2 x 25mcg split waking and bedtime
Retest after 6-8 weeks
I do take 1/4 20mcg Lio tablet twice per day. When I cut 20 mcg Lio into 4 they are not absolutely perfectly equal but there’s no way that I know of to achieve perfection, unless anyone knows how. I use a pill cutter but to be honest it’s not great, especially cutting in half.
I have tried Levo up to 75mcg per day. This caused awful worsening palpitations. I was on 25 mcg for years in beginning, eventually going up to 50, but 75 just didn’t feel good so reduced to 60.7. Endo said dose depends on weight, I am only 7.5 stones. If I was 15 stones I could probably take up to 125mcg. I have never seen on here about splitting Levo dose morning and night, only Lio. How could I take 60.7 mcg in two doses and how would this make a difference please?
Thank you
which brand of levothyroxine are you currently taking
Many people find different brands are not interchangeable
Teva is only brand that makes 75mcg tablets and Teva upsets many people
do you get 25mcg, 50mcg or 75mcg tablets levothyroxine
If you got 25mcg tablets…..
you could take 25mcg plus 1/4 of 25mcg waking and same again at bedtime
That would be 62.5mcg per day
If you get 50mcg tablets
Cut 50mcg in half to get 25mcg…..half waking and half at bedtime….plus 1/4 tablet either waking or bedtime
Wockhardt 25 mcg.
It would be very difficult cutting Levo into quarters as well. I tend to cut my Lio on mass as it’s so tedious to do every day, doing both Levo and Lio would be difficult to get perfect.
How did you calculate to 62.5?
The problems with splitting tablets ahead of need are:
You could end up taking all the "small quarters" one after the other, then all the "big quarters". This can be enough to make dosing rise and fall even more sharply than if you do each one as you need it. (It possibly also makes it more difficult to make sure you don't lose any crumbs.)
It also opens up the insides of the tablets to deterioration due to humidity, light and oxygen.
Yes - I do appreciate the tediousness!
I use a craft scalpel
philipharris.co.uk/product/...
You should only cut tablets one day at a time …..otherwise they start to degrade
62.5mcg = 50mcg plus 12.5mcg (half 25mcg tablet)
Weekly pill dispenser for levothyroxine
Daily pill dispenser for T3
Thank you. I’m not good with knives, very accident prone and bit shakey.
Not sure what you mean about weekly and daily dispensers and why different for Levo and Lio?
I think the idea is you need seven compartments for a full week of levothyroxine. And four for the split single tablet of liothyronine.
Fill up a weekly pill dispenser for levothyroxine
2 x 25mcg per day ….
plus an extra 25mcg every other day …..
then extra 25mcg in half on the day ….either with craft scalpel or pill cutter …..putting other half in next day’s compartment
Liothyronine
Store in another pill dispenser of your choice
Cut a 20mcg tablet in half….put half away for next day
Cut the half into 1/4’s
Personally I take 15mcg as 3 doses T3 per day ….so cut into 1/4’s and take 3 x 1/4 per day …..so every 3 days there’s 3 x 1/4’s stored safely for the next day
I use one dispenser for both and I take Levo and Lio at same time.
I don’t understand extra 25mcg every other day as would be complicated to arrange over 7 days. 25mcg in half on the day? Sorry I can’t seem to grasp what is meant.
Thank you 😊
you are wanting to take 62.5mcg levothyroxine per day
That would be 50mcg per day plus cutting a 25mcg in half to get 12.5mcg
If you don’t want to cut tablets…that’s 50mcg and 75mcg on alternate days…..obviously that only repeats nicely over 14 days
If you are fine with slightly higher dose ….you could do 4 days 75mcg and 3 days 50mcg every week
= 64mcg per day on average
Thank you.
I think the idea from the responses was to increase from 60.7 which I have currently, to a little more 62.5 because my results show a slight decline, also to level up my dose each day probably because not doing so may have affected results.
Current dosing has been:-
Levo- 75 mcg 3 x per week
Lio- 50 mcg 4 x per week
I split 20mcg Lio into 4 (2 days)
Also why do I need to keep Lio and Levo separate please ?
so try 75mcg 4 days and 50mcg 3 days
You don’t have to keep levothyroxine and T3 in separate dispensers it it doesn’t suit you
Oh so I don’t have to cut Levo and equal out doses then? I though I was being told to have same dose each day dividing up Levo as well as Lio? Reading back that’s what seems to be suggested:-
“how much levothyroxine and how much T3 are you currently taking Do you split your dose T3 as 2 or 3 smaller doses spread through the day Do you split your Levothyroxine Presumably you always get same brand levothyroxine at each prescription (and T3)”……..
“You should only cut tablets one day at a time …..otherwise they start to degrade 62.5mcg = 50mcg plus 12.5mcg (half 25mcg tablet) Weekly pill dispenser for levothyroxine Daily pill dispenser for T3”
“I think the idea is you need seven compartments for a full week of levothyroxine. And four for the split single tablet of liothyronine.”
“I got the impression you are dividing your liothyronine into four quarters. So one for each quarter.”
“Fill up a weekly pill dispenser for levothyroxine 2 x 25mcg per day ….plus an extra 25mcg every other day …..then extra 25mcg in half on the day ….either with craft scalpel or pill cutter …..putting other half in next day’s compartment Liothyronine Store in another pill dispenser of your choice Cut a 20mcg tablet in half….put half away for next day Cut the half into 1/4’s”
levothyroxine you can take slightly different dose every day as levothyroxine is a storage hormone
but many people find they prefer to cut tablets to take same dose levothyroxine every day …they find it smoother
If you find it difficult to cut levothyroxine tablets then alternate the dose
Liothyronine- it’s ESSENTIAL to take EXACTLY same dose every day. And only cut one tablet at a time
if taking 2 x 5mcg per day - cut one 20mcg in 1/4’s and save two 1/4’s for next day
Mop up any crumbs with damp finger, after cutting tablets
Thank you.
Is the mopping up to do with safety as it’s a hormone? I have been cutting Lio into 4 but they are not perfect which from the responses it sounds like they have to be perfect!
you need to make sure you get all the crumbs …lick any crumbs off your damp finger
Ideally we’d get prescribed 5mcg tablets….or capsules….but cost is an issue
healthunlocked.com/thyroidu...
Thank you. Yes I know cost is and issue.
The above report also says:-
The LDL-C 12 -SNP score may not accurately reflect the likelihood of polygenic hypercholesterolaemia, however it did show it is within the 10th decile, therefore, there is a high likelihood that the elevated LDL-C levels in this patient have a polygenic aetiology.
Help with blood test results.
Advice needed on blood test results
Advice on blood results please- why no improvement in T3?
T3 blood test result 
Latest blood test results are depressing 
