I Would Like Some Advice Please? Re: Blood Test After Levo Reduction.

[Ellie-Louise]

A while back after a blood test, the doctor (not my usual) rang me to tell me I was taking too high a dose and I was to go back to 75mcg daily instead of the 100mcg that I had been on. Some time previously it had been raised because of my tiredness. I’d been fine on 100mcg.

Anyway, I rang my doctor and we agreed that I would take 100mcg from Mon-Thurs., and 75mcg from Fri-Sun. These are the blood test results 8 weeks after starting the new doses. They also tested antibodies this time, and that had never been done before.

Do these results look fine, or does it look as if I really should go back down to only 75mcg Levo daily please? Thank you.

Serum free T4 level - 17.6 pmol/L [9.0 - 19.0]

Serum free T3 level - 4.5 pmol/L [2.6 - 5.7]

Serum TSH level - 0.03 mu/L [0.35 - 4.94] Below low reference limit.

Serum thyroid peroxidase antibody concentration - 9.29 iu/ml [0.0 - 5.9] Above high reference limit.

(The remarks for all tests were - Abnormal, but expected. No further action.)

[RedApple Administrator]

Ellie-Louise, How do you feel on this dosing?

[Ellie-Louise in reply to RedApple]

Well I still get tired in the early evening, I never used to on the higher dose because I could and did, easily stay up gaming until 2 am. Now I have to go to bed around midnight or earlier. Last night it was 11:30.

[RedApple Administrator in reply to Ellie-Louise]

If your only unwanted symptom is not being able to stay up gaming after midnight, I'd say your thyroid levels are spot on!

[Ellie-Louise in reply to RedApple]

Funny haahaa. I don’t really care about that and only did it because my friend is in Texas and 6 hours behind.

The yawning all afternoon gets to me and I wish I didn’t feel like that.

[RedApple Administrator in reply to Ellie-Louise]

'yawning all afternoon gets to me'

If you have a 'carb heavy' lunch, try changing to a low carb mid day meal for a while and see if that helps.

[Ellie-Louise in reply to RedApple]

I could try, but we have dinner at lunchtime. So it’s with cous cous or rice. A few chips on a Friday and only a couple of small roasties on Sundays in the way of carbs.

[RedApple Administrator in reply to Ellie-Louise]

Ellie-Louise 'take 100mcg from Mon-Thurs., and 75mcg from Fri-Sun. '

There doesn't seem to be much sense in being 'slightly over' for four days and 'slightly under' for three days. If it was me, I'd try alternating the doses, taking 75mcg one day and 100mcg the next day. That might even things out more and help stop the yawning.

[Ellie-Louise in reply to RedApple]

Thank you, then I’ll try that. It never occurred to me to do it that way. x

[SlowDragon Administrator]

looking at your age, request GP test B12, folate, ferritin and B12

Or test privately

Low vitamin levels are common on levothyroxine, an£ increasingly common as we get older

What vitamin supplements are you currently taking

Was thyroid test done early morning and last dose levothyroxine 24 hours before test

Which brand of levothyroxine are you currently taking

Is 75mcg same brand as 100mcg

[Ellie-Louise in reply to SlowDragon]

Serum vitamin B12 level 526 ng/L [180.0 - 640.0] and others were tested last time, I occasionally take D3 etc. and take Thorne Basic B, plus a B12 every morning. Eat lots of pate.

Yes, 24 hours exactly, and tested at 08:40

Always North Star Levo.

[Ellie-Louise]

I just don’t know if I should stay on the same dose or lower it as the other doctor said to do. I need to stop worrying about it.

[RedApple Administrator in reply to Ellie-Louise]

Your test results definitely don't indicate any need to lower your dose further.

[Ellie-Louise in reply to RedApple]

I had wondered if I needed to go back to 100 as it was before. I was fine then.

[greygoose in reply to Ellie-Louise]

If you were fine then, and not so fine now, I'd say you need to go back to that dose. That doctors is only looking at the TSH, which is the least important of the three results. Can you tell us what your results were on 100 mcg a day? I can't imagine they were that different, because you only had a slight reduction, but that slight reduction obviously had a noticable effect on how you feel. If your FT3 wasn't over-range on 100 mcg, I cannot see any reason to reduce your dose.

[Ellie-Louise in reply to greygoose]

They didn’t test much last time and certainly not T3 even though I had asked for it to be tested. I had mistakenly left more than 24 hrs before testing, but it was done early not long after 8am.

June 22 ‘22

Serum ferritin level 119 ug/L [15.0 - 200.0]; Consider iron studies in anaemic patients withnormal/high Ferritin and an inflammatory state.

Serum folate level 11.2 ug/L [3.0 - 20.0]

Serum TSH level 0.11 mu/L [0.35 - 4.94]; Below low reference limit

Serum vitamin B12 level 755 ng/L [180.0 - 640.0]; Above high reference limit.

Serum free T4 level 14.9 pmol/L [9.0 - 19.0]

Result - Borderline

What you need to do - Need to speak to doctor (doc called me).

[greygoose in reply to Ellie-Louise]

Yes, as I said, that doctor only looked at the TSH, and not having much knowledge of thyroid, thought it meant you were over-medicated. You weren't. Your FT4 was only about mid-range. So, highly unlikely your FT3 was over-range! Another useless doctor, I'm afraid! I think you should go back to 100 mcg a day, if you felt well on that.

[Ellie-Louise in reply to greygoose]

Thanks greygoose, I think I might do that, but first, do you think there might have been much difference if I had been tested nearer the 24 hours then as I had done properly this time?

As much as I try to learn everything thyroid, it just drops right out again. However, it is in my head about timespan ready for the next time.

I am so grateful to you for taking the trouble to set me right. x

[greygoose in reply to Ellie-Louise]

How much more than 24 hours did you leave?

[Ellie-Louise in reply to greygoose]

I just missed out the night before, so roughly 32ish hours.

[greygoose in reply to Ellie-Louise]

Ah, that's rather a long time. So, it would have been lower if you'd only left 24 hours, but impossible to say by how much. Even so, very unlikely your FT3 would have been over-range.

[Ellie-Louise in reply to greygoose]

Two days ago I had a call from a doctor, he was checking up on me about something else I had seen him about recently. Then he said he had looked at my blood tests and he wanted me to reduce down to 75mcg a day. I told him that the whole reason I had originally increased my dose was that I was feeling tired more. (Taking 100 long before they made me go to 75 had stopped that). I told him I didn’t want to to and would stay on the 100/75 alt. although I really would like to start taking 100 daily instead to get me back to where I felt fine.

Then he said that my T4 was 17 now and if I took a higher dose it would push me over 19 (top of range). Then the bright spark told me that I wasn’t hypo, but hyper because hyper’s get tired. I was too dumbstruck to tell him that I didn’t have any hyper symptoms! When I looked those up later on, I am the complete opposite.

I don’t think I could start taking 100mcg daily as I would prefer to do because my prescription only states 75 and I would run out of them too early.

[greygoose in reply to Ellie-Louise]

Buy your own. You're obviously never going to get anywhere with these clowns, they haven't a clue how it works! Start a new post asking people to give you their trusted links to reliable on-line sources of levo without prescription.

[Ellie-Louise in reply to greygoose]

Thank you, I might do that, but first I’ll just see how I go with my doses rearranged. x