Here we go again reduction of levothyrixine following blood tests

[Seabird4]

Scenario just to make everyone aware of my mistake in being honest with GPLast year I was in seeing the nurse for my regular B12 injection I have PA & hashimotos. This was an afternoon appointment. The nurse pointed out I needed my thyroid bloods checked as they hadn't been done for some time ( well covid is about and you can't get appointments) she would do it at the same time as my injection. I explained that my preference was to have it first thing in the morning as I was able to monitor my levels more accurately with bloods taken this way. I didn't mention a thing about the TSH levels being higher at this time. I went on to point out that the readings would be skewed. I reluctantly agreed a big mistake on my part as I had taken my thyroxine that morning . As always I asked for my T3 to reported too.

Results

Range TSH T4 T3

0.55-4.7 10-25 4-7

Sep 21 0.01 23.3 5.3

Dec 21 0.01 18.7 4.8

Dec 22 0.03 17.00 4.4

On the first result they reduced my thyroxine from 175 to 150 I requested a retest taken first thing in the morning after 3 months which they reluctantly agreed to, see results above. I immediately got constipated and felt tired, weight increase. I've been stable for years as I try to look after my health in other ways too. As I was away abroad on holiday & had a supply of thyroxine I went back to my original dose & thankfully things went back to normal. As I needed 25 thyroxine tablets & I had not had my routine recall for thyroid blood test at GP surgery I decided to make an appointment to see the GP to discuss my prescription being returned to 175. I explained that my results had been skewed on the first test and the last result in Dec 21 was at 175. GP requested blood test see results above. Again ensuring T3 was tested too. I'm aware of this be cause of all the invaluable advice I've had on this forum. At no point were my levels showing over medicated GP has not as yet inncreased my thyroxine again but has arranged a telephone appointment to discuss...watch this space

[SlowDragon Administrator]

FT4: 17 pmol/l (Range 10 - 25)

Ft4 only 46.67% Through range

FT3: 4.4 pmol/l (Range 4 - 7)

Ft3 only 13.33% through range

Assuming test done early morning and last dose levothyroxine 24 hours before test

Results show poor conversion of Ft4 to Ft3

ESSENTIAL To test vitamin D, folate, ferritin and B12 too

What vitamin supplements are you currently taking

Most people when adequately treated will have Ft3 at least 50-60% through range

And Ft4 often needs to be bit higher

[Seabird4 in reply to SlowDragon]

Thank you for your reply Slowdragon. Had a good discussion with GP this afternoon and she has reinstated my 25 thyroxine back to 175 again which I've felt good on for years. She raised the subject of introducing T3 to raise my TSH I presume by reducing my thyroxine at the same time? But I always thought T3 suppressed your TSH too? GP will consult with endo on this matter. I don't know much about combination therapy. My results have been higher in the past with the same dose 175. I usually have all the same brand of tabs but recently chemist cannot supply Mercury pharma as requested and noted on my file. I am taking vitD & calcium as prescribed by the GP as I have a bit of osteoporosis in my knee & my B12. GP reported that my recent other blood tests are ok but I didn't get a copy this time. These were sugar, cholesterol etc.

[SlowDragon Administrator in reply to Seabird4]

So which brand of levothyroxine are you currently taking

Teva especially upsets many people

You can take prescription to different pharmacies if your local can’t/won’t prescribe necessary brand

Suggest you register for online access to your blood test results

Saves the faff of trying to get copies each time

Yes adding T3 likely to LOWER TSH

But reducing levothyroxine a LITTLE and having slightly lower Ft4 is possible better long term

Adding small split doses of T3 through the day prescribed alongside levothyroxine is increasing being recognised as giving better quality of life

But it’s a post code lottery, depending on where you live and wether endocrinologist is pro or anti T3

Over 60,000 prescriptions in England last year

Typically 6 prescriptions per person per year

openprescribing.net/analyse...

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

[Seabird4]

Teva really made me unwell & that is on my record too. The brand I've been given now is accord & almus. Di t ever remember having them before. I've still mercury pharma left so hopefully next prescription will be that too. So I was correct in my thinking that T3 suppressed TSH too. Must have read it on this forum oh well the brain is still working. Well I've never had T3 so if they agree to go ahead I may try it. I've felt good on 175 thyroxine so feeling even better going into older years is an comforting thought. Does it give you heart flutters?

No not on gluten free or dairy free. I was dairy free for a number of years when tests showed I was allergic to milk but then follow up tests indicated this was a false positive. Had no more issues since. Since getting 12 injections from GP I'm a different person altogether so must have had PA for years.