blood results

[Alicereg]

hi there, hoping for some helpful advice. My bloods have come back that I have low tsh - 0.23. It used to be within range when I was just taking t4. I am now taking t3 as well. Upon google it tells me that I am now hyper but my endo says it’s a ‘normal’ result! Both t4 and t3 are within range. Endo says to carry on as I am but I’m not sure there is any point. Can anyone help

[Jaydee1507 Administrator]

How do you mean there's no point carrying on? Sometimes Dr Google can be misleading. When taking T3 the TSH frequently becomes what's called suppressed and can go very low to 00.1 sometimes. This is completely normal, so your result is fine as your Endo has said.

Your last post had some advice and comments you didn't respond to? healthunlocked.com/thyroidu...

[Charlie-Farley]

Hi Alicereg

God bless your endo!

Wow! So they know that TSH is lowered further and may even end up suppressed when on combo - brilliant 🤩 .

The most important thing is you getting to a point where you feel well. The purpose of blood tests is to guide along with symptoms - which are in fact the most important diagnostic tool.

In the event of a blood test not agreeing with your wellbeing, your health should come first. If ever it isn’t, then the doctor treating you won’t be treating you at all - they will be treating your lab work- a very common mistake unfortunately.

If your FT3 and FT4 are not out of range you shouldn’t worry.

Not sure how up you are on all this but TSH - thyroid stimulating hormone is made to stimulate the thyroid to produce T3 and T4 by the pituitary- so not even a direct measure.

FT3 and FT4 are thyroid hormone measures for a blood test and of course importantly, symptoms.

So right now I’d say how long have you been on combo?

What dose of T3 and T4?

And what are your blood results? (Ranges in brackets after each result)

And last but definitely not least - how do you feel Alicereg? 🤗 most important

Got to go to bed - early start tomorrow, but others may come along to give their opinion. I’ll Bob back tomorrow too. I find it very useful reading others lived experience helps to learn about our condition.

[Alicereg in reply to Charlie-Farley]

thank you so much for taking the time to respond. I am very untechy so find this forum very difficult to navigate! Only just mastered Facebook! I have been on this combination since August last year. I had been feeling generally horrendous - fatigue, achey, pre diabetic, depressed … I could go on! Probably worst of all was the brain fog! I will post a photo of my results. I have had a high levels of stress and also gone through menopause so that doesn’t help anything. Also been told I have hashimotos. I take 50/75 mg Levothyroxine and was on 1/2 to 1 20 mg liothyroxine but I now actually have half that. Brain fog is still horrific but I wonder if that is to do with low levels of oestrogen. Thank you for being so kind and helpful.

Photo of results

[Charlie-Farley in reply to Alicereg]

Ah so a lot going on!

So do not underestimate the draining effects of stress- I had ten years caring for both parents with help, but still running business with hubby - he took a fair amount of the burden for that, but I still burnt out and was diagnosed with hypothyroidism whilst going through menopause. I think with life, everything seems to converge around this time. It has taken me a while to get on track, but it is a course of slow progress, but it is progress, so don’t despair.

So you really need to be your own health advocate. The forum is here with a wealth of advice and knowledge. Get genned up it will make such a difference Do as I do and read others lived experience- wow it is amazing. Initially you feel like it’s all a foreign language, but with time it sticks. 🤗

So  SlowDragon has some advice on testing and vitamins with links to useful info (this where where my journey began). I’ve tagged her in.

Few questions

What do you weigh? (From symptoms sounds like under medication)

What are your vitamins and minerals like? Essential to have good levels to convert thyroid hormones, but also to feel well (Multivitamins are not good, poor quality) Low iron or any of the vitamins can make you feel rough and affect mental health.

What dose of T4 were you initially on?

If you read NICE Guidelines it I will give a guideline dose of 1.6ug Kg of Levothyroxine when on mono therapy. So I’m about 15 stone. I converted to kilograms then multiplied by 1.6 and came out with a guide dose of about 150ug of levo. I’m feeling well on that but TSH is well below range. There are scientific studies showing that TSH is unreliable anyway and if it is a toss up between feeling well or having ‘in range’ bloods I’ll go for well. Sadly doctors in the main have been given low quality guidance, out of date and erroneous. Good your endo is not too concerned because so may doctors stick to duff guidelines and are making us ill treating the lab work- not us 😱

Now you are on combo that will obviously change, but important to have a little background.

[Charlie-Farley in reply to Charlie-Farley]

A post with good info on a superb example of our Admins providing lived experience advice- as far as my experience goes - the best ! 🤗❤️

Just click on the link and follow instructions 😊👍

healthunlocked.com/thyroidu...

[Charlie-Farley]

also if they try and stuff you on statins you need to know optimal treatment for your hypothyroidism can lower cholesterol and there is a risk of tissue damage from statins- doctors don’t always read the guidelines… often people are stuffed on statins and pressured to persevere when they feel unwell on them. Had a fiasco with them trying to push my mum onto statins for two years. She was passive and was scared to speak up for ages but even she eventually had enough. Never diagnosed with Hashimoto’s, but I have my suspicions as it runs in her side of the family I have lately discovered.

[Charlie-Farley]

AND re navigating the site- yes it takes a while but here is something to try - if you click on my face it will take you to my profile and there you can read my bio and you can also access past posts. Same goes for everyone.

There are pinned posts for easy access and you can search the site. Below posts you will see subject tags that you can click on to read more related stuff.

Depending on whether you are on a phone or laptop the screen will differ, but you will get there. 😊👍

[SlowDragon Administrator]

So next steps to consider

A) If not had vitamin D, folate, ferritin and B12 levels tested, get these tested now

Are you currently taking any vitamin supplements

If yes….what exactly

Please add most recent vitamin results if you any

Or come back with new post once you get results

B) which brand of levothyroxine are you currently taking

Do you always get same brand levothyroxine at each prescription

How much levothyroxine were you taking BEFORE adding T3

C) T3.

Are you taking as 10mcg once a day. Suggest you cut 20mcg tablets into 1/4’s (5mcg)

Experiment with taking 5mcg waking and 5mcg late afternoon

You may eventually need 3 x 5mcg at roughly equal 8 hour intervals- waking, mid afternoon and bedtime

Get weekly pill dispenser for spare 1/4’s

Cutting tablets with pill cutter or a sharp craft scalpel

D) you have Hashimoto’s. So you need coeliac blood test if not tested yet

Then trialling strictly gluten free diet is always worth doing 

Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential 

Similarly few months later try dairy free too.

Approx 50-60% find dairy free beneficial 

Hashimoto’s and leaky gut often occur together 

Both dairy and gluten are inflammatory foods

Testing

Test vitamin levels at least once year

all thyroid blood tests early morning, ideally just before 9am and last dose levothyroxine 24 hours before test 

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Day before test ALWAYS split T3 and take last 5mcg dose approximately 8-12 hours before test

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Currently on offer at £68

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65 

(Doesn’t include thyroid antibodies) 

monitormyhealth.org.uk/full...

10% off code here 

thyroiduk.org/getting-a-dia...

Only do private testing early Monday or Tuesday morning. 

Watch out for postal strikes, probably want to pay for guaranteed 24 hours delivery 

[Alicereg in reply to SlowDragon]

thank you so much for taking the time to respond. I have taken all the tests you suggest and after tweaking supplements here and there all are now in range. I’ve done some with medichecks and some with gp. Weirdly I had very high b12 and creatine a couple of years ago but both now within range. Ferritin on the lower side but still within range. Yes, I have been checked for coeliac disease and don’t have it. I do believe I have leaky gut and have been strictly gluten free but do have a little on occasion now. I also love to intermittent fast which I believe may not be idea for me. I was on the same dose of levo before taking t3. I only take wockhardt brand as did have teva and reacted to that. Annoyingly I started taking t3 at the same time as I started magnesium and I do feel less fatigued but omg the brain fog is still as debilitating. I wonder if that’s due to low oestrogen. Thanks again

[SlowDragon Administrator in reply to Alicereg]

please add actual vitamin results and ran

We need OPTIMAL vitamin levels, not just within range

Exactly what vitamin supplements are you currently taking

magnesium must be at least 4 hours away from levothyroxine

Many people react badly to Teva

Gluten is often cause of brain fog

Keeping Ft3 levels steady by 3 smaller doses spread through the day may help with brain function too

Intermittent fasting probably impairs conversion of Ft4 to Ft3

Approx how much do you weigh in kilo

50/75mcg is VERY low dose levothyroxine

On levothyroxine ALONE majority of people eventually need approx 1.6mcg levothyroxine per kilo of your weight per day. So you were likely not on high enough dose levothyroxine before T3 was added

When adding T3…..dose of levothyroxine is sometimes reduced slightly (perhaps 12.5mcg or 25mcg per day) …..but if Ft4 not right at top of range …dose levothyroxine might not be reduced at all

[TiggerMe]

Your thyroid results look good and it sounds like you have a switched on Endo, I would certainly recommend investigating your sex hormone levels, as you mentioned low estrogen = foggy and a whole lot of other debilitating effects all very similar to Hypo 🤗 getting all your hormones in balance is the key.

Thankfully after menopause it is much easier to balance your sex hormones 🙏

[Delgor in reply to TiggerMe]

Did you do a certain test Eeyore that you can recommend or was this something that your endo instigated?

[TiggerMe in reply to Delgor]

I started on HRT just based on symptoms but for my own records/knowledge I later took a Medichecks test, they have a range of options but it's often cheaper to go for one that covers more bases.... medichecks.com/products/wel...

Thinking I might make this one my annual check up 🤗 depending on what the GP will be coaxed into doing.....

Edit... this one doesn't test testosterone levels but now that it is prescribed they test me annually so maybe one of the specific female hormones would suit a non user 😉

Also this one can be just a finger prick test so less costly... but tricky to do if using transdermal already as it is too easy to contaminate the sample 🙃

medichecks.com/products/fem...

[Delgor in reply to TiggerMe]

Thanks so much for your detailed reply - much appreciated😀

[TiggerMe in reply to Delgor]

Welcome🤗... many edits required as I thought it through... 😀

T4 levels are rising and brain function improving again thankfully... though in fits and bursts it would seem 😏

[Delgor in reply to TiggerMe]

Slow but sure is the best way to go which is indicative of my birth sign (the goat)🐐

[TiggerMe in reply to Delgor]

This myopic donkey does everything sideways 🦀🤣

[tattybogle in reply to TiggerMe]

what 'sort' of goat are you Delgor ? wood/ earth/ water/ fire / metal... i'm a fire horse .. i run around fields jumping the hedges and accidentally setting stuff on fire on my way.. apparently if you marry me i'll refuse to be submissive enough , then i'll bring ruin to your business ..and then you'll die. In fear of this outcome the chinese tried very hard to avoid having girls in 1966 . The next lot of us will be along in 2026 .. watch out.

[TiggerMe in reply to tattybogle]

🤣🤣 (LMFAO) Oh my word!😳 the kids are threatening adding to the population crisis

[TiggerMe in reply to tattybogle]

Terrifyingly accurate the Chinese! Check me out...

travelchinaguide.com/intro/....

[tattybogle in reply to TiggerMe]

why am i not surprised to find out you're a monkey ... lol .. yep they are alarmingly accurate

[TiggerMe in reply to tattybogle]

🐵(monkey face as they didn't have a monkey bottom) I live with an Earth Pig.... true on every 🐽(snout) level!

[Alicereg in reply to TiggerMe]

thank you for taking the time to reply x

[Batty1]

Your taking T3 your TSH will drop and it doesn’t mean your hyper …. You need to give ranges with your results.

[Charlie-Farley]

Hi Alicereg

I had a quick peek at past posts - HRT too ?! Ooooo, this can have an effect on your bodies overall balance and there’s a lot going on at the same time. So you haven’t started yet, but if your brain fog stems from being under medicated for your thyroid it will make it all the more difficult to see where symptoms are stemming from. HRT is good but it is the latest ‘thing’ trending and there tends to be a presumption that all other conditions are already optimally treated. You’re still grappling with the thyroid issue. I’m not sure what others would suggest but in any scientific experiment you only get meaningful results from changing one variable at a time. Change too many things in one go and you end up with what-did-what???? Tagging in    tattybogle too for another perspective and    SlowDragon .

As     SlowDragon mentioned you might not have ever been on a therapeutic dose of Levothyroxine before being put on combo. This could be precisely because the doctor was treating your lab work not you. Worried about keeping the TSH in range over making you feel well and not genned up enough to realise this is erroneous.

What do/did you weigh? And what was your levo dose before when on just Levothyroxine? This might help us follow how you got to this point.

Let’s do the calculations 😊👍

[Ruby1]

Mine often comes back below normal but they never change my dose and I continue to feel well. (I'm on thyroxine only).

[Charlie-Farley in reply to Ruby1]

my TSH is very low too - but I feel very well 😂👍 there’s more of us confounding their theory than they would like to admit.