Thyroid Blood test results. Very symptomatic. Please help.

[JBL312]

I need help please. I'm extremely symptomatic, which has been worsening over the last few months. Hair loss, extreme exhaustion, brain fog, depression etc. I am currently taking 125mg levothyroxine and 25mcg of t3. When diagnosed 5 years ago, my antibodies were around 900. They are now showing that they are in range. I have attached my blood results. Please help, I feel like giving up.

[SeasideSusie Remembering]

JBLOVELL

To help us interpret your results accurately, please tell us when you took your last dose of Levo and last dose of T3 before the test. Last dose of Levo should be 24 hours before and last dose of T3 should be 8-12 hours before (splitting T3 dose into 2 or 3 - whatever is possible - and adjusting time the day before if necessary).

Have you got current results for Vit D, B12, Folate and Ferritin? These need to be optimal for thyroid hormone to work properly and low levels can give symptoms which overlap with symptoms of hypothyroidism.

[JBL312 in reply to SeasideSusie]

Hi. It was 24 hours after levo dose and 11 hours after t3. My b12 was over range, due to monthly jabs. My vit d was around 200 so I'm not taking such a high dose and folate and ferritin was a little bit low, so am taking folic acid.

[SeasideSusie Remembering in reply to JBL312]

JBLOVELL

How low is ferritin? Have you done a full iron panel? Hair loss can be linked to low ferritin/low iron. Optimising ferritin and folate might help.

Perfect timing of last doses for your test so we can say with FT4 at 53% through range and FT3 at 18.92% through range then your results are showing that you could do with more T3.

BUT

Looking back at previous posts

November 2022

125mcg Levo plus 25mcg T3

FT4: 16.5 (12-22)

FT3: 6.4 (3.1-6.8)

So given that you were on the same dose as now, if test was done under the same conditions then your FT3 result is vastly different.

August 2022

125mcg Levo plus 50mcg T3

FT4: 15.6 (12-22)

FT3: 4.6 (3.1-6.8)

Amazing that such a high dose of T3 produced a much lower FT3 level than when on 25mcg T3. You didn't respond to the replies you had when you posted those results.

I can't understand why your FT3 is fluctuating so much. Your Hashi's might be playing a part, I can't say.

[JBL312 in reply to SeasideSusie]

Sorry the 50mcg was a mistake. I was on 25mcg. I will call the doctor for a full blood panel.

[JBL312 in reply to JBL312]

As my antibodies are now in range, what does this mean in terms of hashimotos?

[SeasideSusie Remembering in reply to JBL312]

Antibodies fluctuate and when they are low you still have Hashi's.

[JBL312 in reply to SeasideSusie]

Oh I see. Thank you so much.

[SlowDragon Administrator in reply to JBL312]

folate and ferritin was a little bit low, so am taking folic acid.

how low exactly were folate and ferritin ?

Is folic acid prescribed?

Rather than folic acid

As you have B12 injections it’s recommended also to supplement a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial.

This can help keep all B vitamins in balance and will help maintain B12 levels between injections

Difference between folate and folic acid 

chriskresser.com/folate-vs-...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

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) 

Thorne currently difficult to find at reasonable price, should be around £20 

If you want to try a different brand in the meantime, one with virtually identical doses of the ingredients, and bioavailable too, then take a look at Vitablossom Liposomal B Complex. Amazon sometimes has it branded Vitablossom but it's also available there branded as Yipmai, it's the same supplement

amazon.co.uk/Yipmai-Liposom...

or available as Vitablossom brand here

hempoutlet.co.uk/vitablosso... &description=true

Or 

Igennus Vitamin B complex. Nice small tablets. Full dose is 2 tablets per day. Most people are fine with just single tablet 

igennus.com/products/super-...

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

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate methyl folate supplement

[JBL312 in reply to SeasideSusie]

I'm going to call my GP tomorrow and ask for full blood panel. I will show them my private blood results, but they always panic about my tsh. Could you tell me how to explain to them please?

[SeasideSusie Remembering in reply to JBL312]

JBLOVELL

I fear your doctor will not understand or accept the explanation about the fact that taking T3 lowers, often suppresses, TSH. It's just what it does.

TSH is not a thyroid hormone, it's a signal from the pituitary to tell the thyroid to make thyroid hormone when it detects there's not enough. When we take synthetic T4 and T3 and we're taking enough then the pituitary is satisfied so it doesn't have to send the signal so TSH remains low. The actual thyroid hormones are T4 and T3 and are measured by the FT4 and FT3 tests. These are the results that are important and tell us our actual thyroid status.

TSHs is useful for diagnosis but once on replacement thyroid hormone it's not much use, we need FT4 and more importantly FT3 testing, it's T3 that is the active hormone which every cell in our bodies need. Most doctors don't know this because they're not taught it and haven't caught up with the science!

If GP mentions that a suppressed TSH will lead to atrial fibrilation and osteoporosis then we have links to dispute this.

Check out the following which I have made a note of from a thread a few years ago, the quote is from Diogenes who is Dr John Midgley who is a scientist, inventor of thyroid tests and an advisor to ThyroidUK:

LEVO DOSE SHOULD NOT BE DETERMINED BY TSH

Diogenes/Toft paper:

bmcendocrdisord.biomedcentr...

healthunlocked.com/thyroidu...

The link between TSH, FT4 and FT3 in hyperthyroidism is very different from taking thyroid hormone (T4) in therapy. In hyperthyroidism, FT4 and FT3 are usually well above range and TSH is very low or undetectable. In therapy, FT4 can be high-normal or just above normal, TSH can be suppressed but FT3 (the important hormone that controls your health) will usually be in the normal range. FT4 and TSH are of little use in controlling therapy and FT3 is the defining measure. A recent paper has shown this graphically:

Heterogenous Biochemical Expression of Hormone Activity in Subclinical/Overt Hyperthyroidism and Exogenous Thyrotoxicosis

February 2020 Journal of Clinical and Translational Endocrinology 19:100219

DOI: 10.1016/j.jcte.2020.100219

LicenseCC BY-NC-ND 4.0

Rudolf Hoermann, John Edward M Midgley, Rolf Larisch, Johannes W. Dietrich

LlINK TO PAPER:

ncbi.nlm.nih.gov/pubmed/320...

sciencedirect.com/science/a...

[JBL312 in reply to SeasideSusie]

Thank you so much. You're incredible.

[JBL312 in reply to SeasideSusie]

Could you take a look at my most recent post please? I don't understand why they haven't done a folate test. Although all she put on my notes after I told her all my symptoms were 'tired'.

[SeasideSusie Remembering in reply to JBL312]

Done.

[JBL312 in reply to SeasideSusie]

Thank you.

[SlowDragon Administrator]

Do you always get same brand levothyroxine and same brand T3

Are you on strictly gluten free diet or dairy free diet

[JBL312 in reply to SlowDragon]

Same brands, but I eat a small amount of both dairy and gluten.