Latest thyroid bloods & iron panel…

[TiredMummy]

I’ve just got my latest bloods back and this confirms I need to reduce my Levothyroxine. It’s a similar result to last time and shows my T4 to be too high. I was on 150mcg T4 only:

TSH: 0.005

Free thyroxine: 33.5 (12-22)

Free T3: 5.88 (3.1-6.8]

Previous bloods from mid July tell the same story…

TSH: 0.005

Free thyroxine: 34.1 (12-22)

Free T3: 5.38 (3.1-6.8]

Both blood tests were done early in the morning, fasting, having not taken any thyroid medication for 24 hours or B vitamins for a week prior. I also stopped taken any iron supplements one week before the first test and didn’t resume taken them so I’ve been off iron supplementation since July.

I have now reduced my Levothyroxine to 125mcg (I’m now on the 3rd day of this 25mcg reduction). I personally feel my T3 conversion isn’t optimal and that I will start to feel more and more hypo. The last time I tried 125mcg T4 only (earlier this year) by day 20 I was needing to sleep during the day for example…

I have Thybon Henning T3 and thinking of trying a very small dose of T3 to see how I get on (5mcg daily, split into two 2.5mcg doses). Feedback on this would be appreciated but I think I ought to try it. If I start to feel too unwell (I don’t have a fantastic track record with T3), then I’ll have to try alternating 125mcg one day & 150mcg the next for 6-8 weeks & then re-test?

I think this proves the first result wasn’t a hyper swing……the question is what do I do to address this that doesn’t make me feel worse!

I’ve also just got my iron panel results back which I did after recommendation on this forum:

CRP HS: 0.65 (0-5)

iron: 26.8 (5.8-34.5)

TIBC: 51.8 (45-81)

UIBC: 25 (24.2-70.1)

Transferrin Saturation: 51.7 (20-50)

Ferritin: 143 (13-150)

The comments that came with the results said my transferrin saturation was high (which I can see) but at this level no concern but not to supplement with iron or reduce if already doing so (which I no longer am).

Thanks for any advice 🙂

[Jazzw]

Hmm. This is a bit of a puzzle, isn’t it? Why oh why isn’t your FT3 higher given how high your FT4 is?

You say:

I think this proves the first result wasn’t a hyper swing……the question is what do I do to address this that doesn’t make me feel worse!

but I’m not sure that’s necessarily the case. It could still be a Hashi’s flare. But it’s plain weird that it’s only making your FT4 too high.

Think you’re right about poor conversion being a possibility but I’d be cautious about changing too much at once.

I think I’d wait to see what the reduction in levothyroxine does first and only then consider whether to add T3. If you do too much at once you won’t know what it was you did that made the difference.

[TiredMummy in reply to Jazzw]

thanks Jazzw but I’ve already seen what happens when I’m on 125mcg only so will have to play by ear…..I know it makes sense what you have suggested, I’ll just have to see if I can do it or not & by that I mean not need to sleep for most of the day….

[Jazzw in reply to TiredMummy]

Oh, I know that feeling. I’m so sorry TiredMummy. Hugs x

I’m just mindful that you might get yourself into even more of a mess if you add T3 too soon (before your FT4 levels drop, I mean). When you add T3, it sometimes seems to stimulate additional conversation of T4 to T3, so you’d be risking getting yourself even more over medicated, which wouldn’t be good.

I know 125mcg didn’t work for you previously but things do change over time—it might be enough this time around,

[SlowDragon Administrator]

ideally you would reduce levothyroxine first …..wait 6-8 weeks and retest before adding T3

See how you get on

As you have Hashimoto’s are you on strictly gluten free diet or dairy free diet

Which brand of levothyroxine are you currently taking

Do you always get same brand levothyroxine at each prescription

[TiredMummy]

Thanks Slowdragon, yes I’m gluten and dairy free strictly. Always take TEVA. I know many people don’t get on with TEVA but I don’t think it would explain my strange results?! I’m not sure I can do ‘ideally’ by just being on 125mcg T4 to see, it depends on whether I can still function & hold down a job I will try 5mcg in two 2.5mcg doses if not.

[Noelnoel in reply to TiredMummy]

Hi tiredmummy

Am I to understand that you think to feel well you need FT3 higher than 75% through range

[TiredMummy in reply to Noelnoel]

erm….are my FT3 results 75% through the range? And what is optimal?

[greygoose in reply to TiredMummy]

Yes, it is 75% through the range - handy calculator here:

thyroid.dopiaza.org/

But, some people do need it higher to feel well. And, optimal is when you feel well. It is not a number.

I don't think this result proves that you're not having a Hashi's 'hyper' swing, at all. It doesn't prove - or even suggest - anything much. But, I just do not believe that taking 150 mcg levo can cause an FT4 that high. Plenty of people take 150 and much more, but their FT4 never goes that high. And, yes, I know we're all different, but not that different. And, as Jazzw says, it's weird that your FT3 isn't higher with that much T4 sloshing around. It just doesn't make sense.

I think, if it were me, I'd get labs done by a different lab, just out of curiosity, if nothing else. But, before doing that, go back a bit - right to the beginning of testing, if you can - and make a note of all you FT4 results and the doses you were on. That might give you a clearer picture of what could be going on.

[Noelnoel in reply to TiredMummy]

Calculator for working out where you are within the ref range

chorobytarczycy.herokuapp.c...

[Noelnoel in reply to Noelnoel]

Indeed it is, just over in fact at 75.14%

As I’m sure you’re aware, each and every one of us has a different optimal. Yours may be higher or lower but for many 75% would be a dream. I’m not qualified to comment further than that other that to say your FT4 does seem disproportionately high

With regard to nausea you could experiment with taking your levo with breakfast. It’s recommended on an empty stomach yes but to repeat that favoured maxim on here, we’re all different …

Or if you’re feeling rebellious, with lunch! Or just before if you want to try out the empty stomach thing at different t times

[tattybogle]

as you are understandably wary of 125mcg. then personally i'd just reduce to 137.5mcg for now and give it at least 2 months to see how it feels .. then re test to see where you are

unexplained high fT4 may come down by itself eventually with just a slight reduction , mine did :

125mcg ~June 2019 ~ 20.5 [7-14] ~ felt ok , but agreed to reduced dose.

112.5mcg ~Sept 2019 ~ 22 [7-14] ~ reduction felt rough for the first 5 weeks but then started to improve.... but fT4 gone up again despite reduction. so eventually i agreed to reduce again

100mcg ~ March 2020 ~ 19 [7-14] ~ gave it 6 weeks trial but had non functioning digestive system and brain on 100mcg, so i insisted on putting it back up despite T4 being so high.

112.5mcg ~Oct 2020 ~ 16 [7-14] 6 months later & fT4 had come down quite a lot, despite dose being increased.

Note * ...Don't be too quick to make your mind up about how a new dose feels.. for me the first 5 weeks were really rubbish when i reduced to both 112.5mcg and 100mcg .. but on 112.5mcg from week 6 onwards things gradually improved and now i'm actually functioning much better on that dose than when i was on 125mcg ,, but if you'd asked me at day 20 i'd have been adamant it was not enough.

[TiredMummy in reply to tattybogle]

Thats fascinating & extremely helpful of you to share a similar experience Tattybogle! Your suggestion makes sense to me perfectly on trying a lesser reduction down to 137.5mcg. I did try this after my first set of high T4 results and started to feel too hypo (very difficult to work, sleep, function etc) but I will try alternate dosing this time (150mcg one day, 125mcg the next) as this may suit me better. Really strange how your T4 came down even though your last dose was an increase?! I have no idea what this is all about……thank you again for sharing, it’s really helped 🙂