I have recently tested my thyroid function through medichecks as the drs won’t test for T3 or antibodys.
my TSH is is high T3 and T4 normal both antibodies are high. The drs blood test showed I am low in Ferritin and folate.
what do I do now?
I am exhausted all the time I have no energy, no enthusiasm to do anything. I spend all day sweating profusely .
TSH 6.7 mlU/L
T3 4.6 pmol/L
T4 15.4 pmol/L
Thyroglobulin antibody 432.7 klu/L
Thyroid perioxidase antibody 292.9 klu/L
people need to see the actual results - with ranges to make comments. You can edit your post. 🙂
hi Talulah75
Take your results with ranges in brackets and either type them manually or take a good photo BUT obscure your personal data (name etc).
Then add medication you are on (including brand) also tell us if there have been any recent changes AND (if you know them) vitamin levels - pop them on too with ranges. And the iron and ferritin.
Then people will be able to give advice.
😊👍
Please don’t get sucked into the ‘normal’ terminology guff. Doctors everywhere use the non-term ‘normal’. You can be anywhere in range and ‘they will call you ‘normal’. What you want Talulah is optimal (feeling well) and don’t settle for anything less. I’ve posted on this in the past - my content is accessible though my icon (cheeky pic).
I look forward to seeing your results. 🤗
As others have said, we need to see your levels to offer better advice re thyroid.
When I started to sweat more I suspected peri menopause. It may be useful to have a look at Dr Louise Newson’s free Balance App for information on this. There is also an ability to post questions.healthunlocked.com/redirect...
I’m on HRT patches
I take levothyroxine 25 mg.
Serum ferritin 16ug/L range is (15-200)
Serum folate 3.2ug/L (3-20)
B12 766 my/L ( 180-640)
I take levothyroxine 25 mg.
Following on from my post below, you are undermedicated to be on just 25mcg Levo.
When were you diagnosed?
How long have you been on 25mcg? Normal starter dose is 50mcg unless a child, elderly or have a heart condition.
Serum ferritin 16ug/L range is (15-200)
This is a dire result and according to NICE suggests iron deficiency:
From: cks.nice.org.uk/topics/anae...
In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.
Your GP should do an iron panel to include serum iron, transferrin saturation percentage, total iron binding capacity plus ferritin. This will show if you have iron deficiency. You can have low ferritin without iron deficiency.
He should also do a full blood count to see if you have anaemia. You can have iron deficiency with or without anaemia.
Serum folate 3.2ug/L (3-20)
This is very low and possibly suggestive of folate deficiency - see
cks.nice.org.uk/anaemia-b12...
Folate level
◦Serum folate of less than 7 nanomol/L (3 micrograms/L) is used as a guide to indicate folate deficiency.
◦However, there is an indeterminate zone with folate levels of 7–10 nanomol/L (3–4.5 micrograms/L), so low folate should be interpreted as suggestive of deficiency and not diagnostic.
You should discuss this result with your GP who may prescribe folic acid.
B12 766 my/L ( 180-640)
This appears to be a good result. Are you supplementing?
Was Vit D tested?
Oh my god Talulah75,
How long have they had you on 25 µg? That’s what they started me on and left me on it for six months and made me very ill! 25 µg is the starter dose for a child.
Do they think they are topping you up? In which case - oh my God you’ve got one as well a complete numpty. Read my profile story - it’s the record my mismanagement, but also how I argued for my full replacement dose. It won’t take long and it may resonate.
Welcome to the forum Talulah75
As others have said, we always need reference ranges that come with results. Ranges vary from lab to lab so to be able to interpret results we need the range that comes with it. However, I know Medichecks ranges so I can comment but it's important to know if you did your test as we advise:
* No later than 9am
* No food and drink other than water before the test
* Last dose of Levo 24 hours before the test
* No biotin, B Complex or any other supplement containing biotin for 3-7 days before the test
If you did your test like this then:
TSH 6.7 mlU/L (0.27-4.20)
This is too high.
The aim of a treated hypo patient on Levo only, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges, if that is where you feel well.
Your TSH seems too high for your FT4 and FT3 results which makes me think something has interfered with this and it's not a true measure.
T3 4.6 pmol/L (3.1-6.8)
This FT3 result is 40.54% through range which is probably too low to feel well. Low FT3 causes symptoms.
T4 15.4 pmol/L (12-22)
This FT4 result is 34% through range which is low and would be better over half way through range.
I think possibly that these results might not be reliable, can you please clarify whether you did the test as outlined above?
Thyroglobulin antibody 432.7 klu/L
Thyroid perioxidase antibody 292.9 klu/L
Your raised antibodies confirm autoimmune thyroid disease, known to patients as Hashimoto's. This was probably referred to in your results report if you had doctor's comments.
Did you already know that you had Hashi's?
Hashi's is where the immune system attacks and gradually destroys the thyroid. It is the most common cause of hypothyroidism. Hashi's causes fluctuations in symptoms and test results, you can swing into a "false hyper" episode where you may experience hyper type symptoms and then swing back to stable or a hypo period.
Some members have found that adopting a strict gluten free diet can help, although there is no guarantee.
Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.
You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.
Gluten/thyroid connection: chriskresser.com/the-gluten...
stopthethyroidmadness.com/h...
stopthethyroidmadness.com/h...
hypothyroidmom.com/hashimot...
thyroiduk.org.uk/tuk/about_...
Supplementing with selenium l-selenomethionine 200mcg daily is said to help reduce the antibodies, as can keeping TSH suppressed.
Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies. It's essential to test Vit D, B12, Folate and Ferritin and address any problems. You are welcome to post these results, including reference ranges (plus units of measurement for Vit D and B12), for comment and suggestions for supplementing where necessary.
No I didn’t know I had Hashimoto’s. I tested at 9.30 I hadn’t or drink anything apart from water. I actually haven’t taken levothyroxine for 48 hours. When you speak to the drs they are not interested in testing T3
Talulah75
I actually haven’t taken levothyroxine for 48 hours.
Do you mean you hadn't taken it for 48 hours before this test? That is too long and gives a false low FT4 result. You should leave 24 hours between last dose and test to avoid a false low or false high result.
When you speak to the drs they are not interested in testing T3
Most don't understand the importance of testing FT3 and probably don't know how to interpret the results anyway. Even if GP requests FT3 test often the lab doesn't do it if TSH is within range, the lab has the final say. This is why so many of us here do private testing to get the full thyroid picture.
ferritin is terribly low 😱 and folate. SeasideSusie SlowDragon we need the cavalry 😘
The forum can give some good Advice on supplements and nutrition. All important to underpin the body’s use of the levo.
one thing I can say straight away is autoimmune (Hashimoto’s) both antibodies are high - as was mine when private tests were done.
how long have you been left on just 25mcg levothyroxine
Which brand of levothyroxine are you currently taking
Make an appointment with GP
Request/insist on 25mcg dose increase in levothyroxine
Bloods should be retested 6-8 weeks after EACH dose change or brand change in levothyroxine
Standard starter dose levothyroxine is 50mcg
So you were started on too low a dose
Vitamin levels
No vitamin D result?
B12
Are you currently taking any B12 supplements or B12 injections?
Folate is deficient
GP must prescribe folic acid
Ferritin is deficient
GP must do full iron panel test for anaemia
Highly likely you need iron supplements
What’s your diet like
Are you vegetarian or vegan
Request/insist on coeliac blood test too
vitamin D 74.4 ( 71-200)
I’m not vegetarian
I had a B12 injection 3 months ago
Been on 25 mg since February 2020 the brand of levothyroxine depends on what the pharmacy give me
Good grief
Levothyroxine doesn’t top up failing thyroid….it replaces it
Standard starter dose of levothyroxine is 50mcg
Typically dose is increased slowly upwards over 6-12 months until on approx 1.6mcg levothyroxine per kilo of your weight per day
Being left too long on inadequate dose levothyroxine results in low vitamins
Low vitamins tend to lower TSH
ESSENTIAL to maintain OPTIMAL vitamin levels
Vitamin D at least around 80nmol and around 100nmol maybe better
Serum B12 at least over 500
Active B12 at least over 70
Folate and ferritin at least half way through range
How low was vitamin B12 BEFORE you had B12 injection
Did GP test for pernicious anaemia before giving injection
If very low B12 you should have several injections over 2-3 weeks, known as loading injections
Has GP organised ongoing B12 injections every 2-3 months?
Which other brands have you had
Northstar 25mcg is Teva brand
Teva brand upsets many people
Northstar 50mcg and 100mcg are Accord brand
Accord don’t make 25mcg tablets
Many people find Levothyroxine brands are not interchangeable.
Many patients do NOT get on well with Teva brand of Levothyroxine.
Teva contains mannitol as a filler, which seems to be possible cause of problems.
Teva is the only brand that makes 75mcg tablet.
So when you get up to 75mcg per day ……if wanting to avoid Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half
But for some people (usually if lactose intolerant, Teva is by far the best option)
Glenmark or Aristo (100mcg only) are lactose free and mannitol free. May be difficult to track down Glenmark, not been available very long
Most easily available (and often most easily tolerated) are Mercury Pharma or Accord
Mercury Pharma make 25mcg, 50mcg and 100mcg tablets
Accord only make 50mcg and 100mcg tablets
Accord is also boxed as Almus via Boots, and Northstar 50mcg and 100mcg via Lloyds ....but Accord doesn’t make 25mcg tablets
beware 25mcg Northstar is Teva
List of different brands available in U.K.
thyroiduk.org/if-you-are-hy...
Posts that mention Teva
healthunlocked.com/search/p...
Teva poll
healthunlocked.com/thyroidu...
Once you find a brand that suits you, best to make sure to only get that one at each prescription.
Watch out for brand change when dose is increased or at repeat prescription.
New guidelines for GP if you find it difficult/impossible to change brands
gov.uk/drug-safety-update/l...
If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient.
academic.oup.com/jcem/artic...
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
verywellhealth.com/best-tim...
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
REMEMBER.....very important....stop taking any supplements that contain biotin a week before ALL BLOOD TESTS as biotin can falsely affect test results - eg vitamin B complex
approx how much do you weigh in kilo
Likely to need at least 2 further increases in levothyroxine over coming months
pathlabs.rlbuht.nhs.uk/tft_...
Guiding Treatment with Thyroxine:
In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.
The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).
The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.
……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.
The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.
Vitamin levels are terrible BECAUSE you have been left on grossly inadequate dose levothyroxine
it’s exactly what happened to me but luckily found this forum sooner. Disgraceful treatment.
Talulah the working out of a guideline dose is in the NHS guidelines- you can see them online yourself- easy Google and you can use them to push for a dose increase. If they dare say any rubbish about being normal and your in range say - yes but I need a dose increase and the range will accommodate this.
SlowDragon gave me a lot of advice when I joined. I remain here testament to how much one can improve by acting on good advice.
looks like you need to increase your Thyroxine but best to always say what meds your on and the ranges for blood tests.
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