New Results just in

[mary18]

These are my latest results from Med checks. My Levels have been falling for a year now and my GP despite this has wanted to decrease my 100 mcg Levothyroxine to 75mcg, well you can guess what i said to her... I have stayed on the 100mcg of Levo all the way through this last year and gained over two stone in weight and all the usual symptoms with that. I suspected maybe the Pituitary gland but now my T4 is on its way back up, can anyone help with what has gone on here and what's the best way forward please. I also have constant sweating its unbearable .

New results 5th December 2022

TSH 0.06 0-27 - 4-2 miu/L

T3 4-7 3-1 - 6-8 pmol/L

T4 17.6 12 - 22 pmoi/L

Last Results 12 October 2022

TSH 0.04 0-27 - 4.2 miu/L

T3 4.4 3-1 -6-8 pmoi/L

T4 15.4 12- 22 pmoi/L

Over the last year my T4 fell from 22 pmoi/L to 15.4.

Thank you

[pennyannie]

Hello Mary :

The accepted conversion ratio when on T4 monotherapy is said to be 1 / 3.50 - 4.30 T3/T4 with most people feeling at their best when they come in this ratio at 4 or under.

So to find your conversion ratio when on T4 only you simply divide your T4 by or T3 and I'm getting yours coming in at 3.5 in October and 3.7 in December - so your metabolism is, maybe, running a little fast for you :

Am I right in thinking you have Graves and had RAI thyroid ablation at some point in time ?

If so it is imperative that you are not dosed by the TSH reading but on your T3 and T4 levels which need to be balanced within the ranges and we generally seem to feel improved when at around a 1/4 ratio T3/T4.

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.

I too have Graves Disease and had RAI thyroid ablation and find myself most improved on Natural Desiccated Thyroid which contains all the same known hormones as the human gland and derived from pig thyroids dried and ground down into tablets referred to as grains and contains all the same known hormones as that of the human gland.

Just realised I wrote to you before !!

[mary18 in reply to pennyannie]

Thank you pennyannie

[pennyannie in reply to mary18]

Just looked back at October Medichecks and your inflammation was over range at around 7 with a top end range of 3 - do you remember what that was about and do you have a current inflammation reading ?

and now finished reading SeasideSusie excellent reply to you on all those non thyroidal, though related results.

You have had RAI thyroid ablation and your HPT axis - the Hypothalamus - Pituitary - Thyroid feedback loop - on which the TSH relies , does not work anymore as your thyroid has been burnt out by the RAI and disabled.

The HPT axis - and this circuit is broken as you don't have a fully functioning thyroid to complete this feedback loop.

So as to the comments about problems with your pituitary - I think it's more the fact that the RAI has burnt through and cancelled out any thyroid function - which was the intention of this treatment, rather than the issue being one of the pituitary gland.

[mary18 in reply to pennyannie]

Thank you pennyannie. Can you recommend what I should do now,vas the GP is only interested in the TSH. No idea what the inflammation was about and didn't retest that. I did have gestational O A T that persisted until I made the mistake of having RAI the purpose for rai I was told was to rebalance my thyroid back to normal but that's not what happened. I just don't know what I can do at this stage why my levels fell for so long and why they are now increasing while I'm still on 100mcg levo.

[pennyannie in reply to mary18]

Well from what I've read the dose of RAI is not that specific but ultimately the thyroid will become fully disabled:

I've also read that the thyroid gland can regrow :

If your T4 is rising for no apparent reason I wonder if the Graves antibodies are still active and driving up your T3 and T4 ?

I wonder if you could arrange a thyroid scan to check if your thyroid has any function.

You could also ask that your Grave's antibodies be run again ?

There is no cure for Graves - it is an auto immune disease and the thyroid is the victim in all this and not the cause as the cause is one of your immune system having been triggered to attack your body.

For all things Grave's Disease - elaine-moore.com

I'm still thinking - Medichecks run the Grave's antibody if your doctor says ' no ' :

I think you can also arrange a private thyroid scan but it shouldn't be up to you anyway - your doctor should be thinking why is this happening :

Am still thinking but need to turn off now otherwise I'll not be able to sleep at all ;

[mary18 in reply to pennyannie]

Thank you do much peñyannie. I hope you sleep well.

[pennyannie in reply to mary18]

Good morning :

Well, I'm not sure I can think of anything else.

You appear to have classic hypothyroid symptoms but you T4 level is not consistent while on the same dose of T4 - and your metabolism running a little fast :

You had RAI thyroid ablation some 22 years ago for Grave's Disease.

I wonder if this hiccup with high inflammation some months ago needs further consideration - did you discuss those results with your doctor as suggested by Seaside Susie ?

i think you need a referral to an specialist endocrinologist from the Thyroid UK list as suggested by Slow Dragon as you are clearly not well and going around in circles with your doctor.

Just as an aside - without a thyroid I find NDT a more balanced complete replacement as it contains all the same known hormones as that of the human gland :

In 2018 I was refused both T3 and NDT by my surgery and the one and only endo I had ever seen since having RAI in 2005 and I decided then to self medicate - I tried T3 with my T4 and felt turbo charged - I then tried NDT and it was/is like wearing a pair of slippers as opposed to shoes too sizes too small ?

[mary18 in reply to pennyannie]

Thank you pennyannie that has been very kind of you i appreciate your help.

[FAB-jellybean]

Hi mary18 , your first results show you are 34% through the range in your fT4 and 35% for your fT3. second results show 56% for ft4 and 43% for fT3. When we don't have any issues with conversion, you would expect to see them relatively balanced. So first lot are good and second lot conversion has dropped a bit. That can happen when we don't have optimal vitamins and minerals. Your recent vitamin test results look ok, vit D perhaps could be a bit higher but your ferritin looks a bit low. It would be worth asking your GP to run a complete iron panel to see what's happening there.

Everyone is different with their own set points where they feel best but it's usually in the top quarter of the T3 range and at least mid way through the T4 range. Your results show you would probably benefit from a increase in your levothyroxine but given your fluctuations, I would go low and slow. No more than 12.5.mcg daily to start with.

Your sweating isn't necessarily caused by the thyroid hormones, it could be your sex hormones to blame, I see you had them tested recently too.

Hope this helps a little.

[mary18 in reply to FAB-jellybean]

Thank you fab jellybean