As advised on this forum I stopped Meds 24hrs before test, it was at 9.20 in the morning.
The only supplement I take is Colecalciferol 800unit capsules prescribed by GP as at one point I had extremely low vitamin D.
I’m on Levothyroxine 100mcg daily (Accord). I was diagnosed with Graves 2007 and had RAI 2009. Many ups and downs over the years!.. I have never felt great since RAI.. and regret agreeing to it but was given no choice really. I felt good on Carbimazole.
Wondering if some of my ongoing symptoms are due to low Vitamins and minerals?.
My results have all come back normal!!.. I have intermittent burning and tingling, pins and needles in my feet and hands. Though sometimes freezing cold?. Aching muscles and joints. Poor memory, especially short term memory!. Little energy, often feeling exhausted. Poor sleep. Ocular migraines. I function but have to work on any enthusiasm. Any advice much appreciated, thanks
CRP HS 0.64
Ferritin 215 (30-650)
Folate Serum 14.5 (8.83-60.80)
Vitamin B12 Active 74 (37.5-188)
Vitamin D 87 (50-250)
TSH 1.02 (0.27-4.2)
Free T3 3.9 (3.1-6.8)
Free Thyroxine 19.1 (12-22)
Thyroglobulin 41 (0-115)
Thyroid Peroxidase 10 (0-34)
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Grizzermum
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So you have poor conversion rate and probably have room for dose increase in levothyroxine
Improving low folate likely to help
Approx how much do you weigh in kilo
You could push GP for dose increase in levothyroxine
Perhaps 12.5mcg per day on average
Accord don’t make 25mcg tablets
Request 50mcg tablet and cut into half to take 25mcg alternate days…or cut into 1/4’s to take 12.5mcg daily
Retest in 6-8 weeks
Meanwhile working on improving low folate with daily vitamin B complex
supplementing a good quality daily vitamin B complex, one with folate in (not folic acid). This can help keep all B vitamins in balance and will help improve B12 levels too
Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule)
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
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.
Just to add T4 - Levothyroxine is a storge hormone and needs to be converted by your body into T3 the active hormone that runs the body and your physical, mental, emotional, psychological and spiritual well being, your inner central heating system and your metabolism.
Your own ability to convert T4 into T3 can be compromised by non optimal levels of vitamin and minerals, especially those of ferritin, folate, B12 and vitamin D and antibodies, inflammation, and any physiological stress ( emotional or physical ) depression, dieting and ageing can also down regulate T4 to T3 conversion.
We generally feel at our best when our T4 is up in the top quadrant of the range as this should in theory convert to a good level of T3 at around a 1/4 ratio T3/T4.
So when taking T4 only the accepted conversion ratio is said to be 1 / 3.50 - 4.50 - T3/T4 and we generally feel best when we come in this ratio at 4 or under.
So to find how well you are converting the T4 into T3 you simply divide your T4 by your T3 and I'm getting yours coming in at around 4.87 so wide of the range and showing very poor conversion.
I didn't see on first read that you had Graves and had RAI thyroid ablation - sorry I missed this most important fact as that explains so much and now it all makes more sense and why your T3 is so low as you have ' lost ' you're own natural production.
The NHS have guess estimated and restored a replacement dose of T4 for you - but not considered restoring and guess estimating a dose of T3 for you - it's not just you - generally the NHS start us all of on T4 and hope for the best and never explain anything.
I too have Graves Disease and went through RAI thyroid ablation back in 2005 and deeply regret this treatment as I too was well on the Carbimazole but told it was too dangerous to stay on long term and given a toxic substance to drink instead.
A fully functioning working thyroid would be supporting you on a daily basis with trace elements of T1,. T2 and calcitonin plus a measure of T3 at around 10 mcg plus a measure of T4 at around 100 mcg. with T3 being around 4 times more powerful than T4.
Some people can get by on T4 only :
Some people find that T4 seems to stop working as well as it once did and find by adding in a little T3 - their well-being is restored - and it just seems logical to restore that little bit of T3 that was lost when they ' lost ' their own natural thyroid hormone production.
Some people can't tolerate T4- Levothyroxine and need to take T3 - Liothyronine only and we need around 50 T3 daily just to function.
Whilst others find their health restored better by taking Natural Desiccated Thyroid which contains all the same known hormones as that of the human gland and derived from pig thyroid dried and ground down into tablets referred to as grains.
I became very unwell around 8 years after RAI thyroid ablation and thankfully found this forum while researching low ferritin, the only diagnosis I had after over 2 years going around various O/P departments and getting no answers as to my health issues.
I was refused both T3 and NDT through my surgery and hospital and so I decided to self -medicate and am much improved and now 5 years on still I come back on here to help others on this amazing patient to patient forum.
For all things Graves suggest you dip into the Elaine Moore Graves Disease Foundation as Elaine has Graves and went through RAI and finding no help with her continued ill health started researching this poorly understood and badly treated AI disease herself and now the leading researcher with a world wide following. elaine-moore.com
Barbra S Lougheed - another lady with Graves post RAI thyroid ablation whose book title says it all :- From Hypo to Hypo to Healing - Breaking the TSH rule.
Your Thyroid and How to Keep it Healthy written by a doctor to equip patients better to self advocate. Barry Durrant- Peatfield writes in an easy to understand manner and it is about how the body works, how everything is inter-related, basic body physiology and my go-to years later on my continuing learning curve.
A couple of research papers we now have though I accept a bit late for you and me :
Ok then - just be aware your doctor may not accept these blood test results or know how to read them but if it means you will get a TSH, T3 and T4 runs on the NHS that is the first step.
Step 2 : Your doctor can only prescribed T4 - Levothyroxine and you need to be referred to an endocrinologist to get T3 - Liothyronine prescribed and it is not a ' given ' but a post code lottery as to if your local CCG or ICB wish to accept a new patient request and longer term if your doctor is happy to pick up the ' tab' as it costs considerably more than T4 just as Natual Desiccated Thyroid costs more again.
Step 3 : Read up about all things thyroid on the Thyroid UK website - thyroiduk.org - including the T3 Petition we have had raised by Lord Hunt in Parliament and the House of Lords which has been going on for several years and probably why the numbers of patients looking for help on this forum have grown very rapidly.
Up until around 20 years ago all the three thyroid hormone treatment options were available through your primary care doctor, to be used as s/he and the patient restored health and well being but gradually these have been whittled away and now only T4 monotherapy and the second line option of anti depressants are available.
Step 4 : email ' admin ' at Thyroid UK and ask for a copy of the current patient to patient recommended thyroid specialist both NHS and private and see who is around where ever you are that you would prefer to be referred to by your doctor.
Step 5 : have a look at openprscribing.net and then go into analyse where you can see by surgery and local CCG/ICB how supportive your surgery is, though if a group practice you can't see by name which primary care physician is writing the prescriptions for T3 and who is supportive and believes it is of value and a logical addition if the patient has lost their own thyroid.
So, that's a start and hope that makes some sense - my laptop keeps cutting out - it's probably me as I'm not tech savvy :
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Help with medichecks blood results please.
Thoughts on my blood test results please
Latest Medichecks Results.
Grateful for your advice on my test results please....
Advice on results please
