Can I have your thoughts on my latest bloods please?

I have just had bloods back after 14 weeks on 50mcg T4, 60mg NDT, and 10mcg T3. They are:

TSH: 1.1 (0.27 - 4.2)

FT4: 12.3 (12 - 22)

FT3: 5.8 (3.1 - 6.8)

4 weeks ago I had the following results:

TSH: 0.39 (0.27 - 4.2)

FT4: 11.3 (12 - 22)

FT3: 5.6 (3.1 - 6.8)

I have an appointment with my consultant in a week or so and I'm not sure what to ask for in terms of dose adjustment and I'm terrified he'll leave me as I am because my results look pretty perfect on paper.

I'm symptomatic again. I'm struggling to stay awake past 8:30. I don't have the energy to eat well which is making me feel worse. Just back to that heaviness where it feels like I'm wading through treacle all the time.

The addition of T3 made my life so much better, for the very first time I actually felt hopeful that I could get back to being 'normal', and indeed, when my bloods were taken 4 weeks ago I felt very much back to normal... Even seriously considered going for a run!

My initial thoughts are to add 25mcg levo but I'm nervous of my T3 going too high.

I don't know whether to suggest moving away from NDT entirely and trialling just T4/T3.

I'd be grateful for some thoughts!

[Jaydee1507 Administrator]

What makes you say your results are perfect?

Free T4 (fT4) 12.3 pmol/L (12 - 22) 3.0%

Free T3 (fT3) 5.8 pmol/L (3.1 - 6.8) 73.0%

Most people on T3/NDT and feeling well would have a suppressed TSH which yours is not.

How are the vitamins looking? What are you taking?

[Hidden in reply to Jaydee1507]

I should've been clearer - they probably look pretty perfect to an endo. 😂

He was happy with my previous results because I felt well but now I don't feel well again.

I've had over range FT3 and felt rotten so I'm hesitant to adjust anything for fear of going over again.

Vitamins are a bit shoddy so I've started re-taking them. Got them up to a good level and experimented to see if/how long I could hold onto them.

17/01/2023 - Monitor my health - ranges are funny because it was the anaemia panel so only checks deficiency.

B12: 81 (40 - ?)

Ferritin: 75 (15 - 300)

Folate: 4.9 (3 - ?)

Vit D: 53 - Adequate

[Jaydee1507 Administrator in reply to Hidden]

I'm assuming that this is a private Endo. Have they been twitchy about your TSH? If so then perhaps a different private Endo might work better?

For myself I know by now that my own body is not going to retain vitamins so I just plod on and take them continuously. You have some work to do with all of them there to get them more optimal as you already know.

It's a strange combination for sure taking Levo, T3 and NDT but I'm sure there's a good background story. Would be a lot neater to go t4/t3 combo but it's an upheaval with symptoms to be expected.

[Hidden in reply to Jaydee1507]

He is a private endo. He doesn't seem to be fussed about my TSH and is led by symptoms in the main.

I had a pretty rough ride adding T3 so the thought of going through that again doesn't exactly spark joy!

I'm just so fed up of the constant adjustments. I just don't seem to be able to find my sweet spot. I always felt best when T4 was high in range before I added T3.

I felt the best I ever had when I had those results 4 weeks ago and my FT4 was below range so I don't even have that certainty anymore!

[Jaydee1507 Administrator]

Perhaps dropping some T3 and adding Levo?

Keeping on top of vitamins is going to be a good buffer for symptoms and being able to find your sweet spot.

[silverbelle51]

My situation is I believe I was incorrectly diagnosed/ prematurely diagnosed whatever for me Levo was like being on "speed" , but I had no clue cause I trusted the doctor who kept telling me I had to adjust 4 3/4 years later I weaned myself and told a very unhappy doctor who was busy building a "Problem List" . My advice to you is if the lab numbers look OK, then maybe your problem isn't your thyroid. Maybe your doctor is treating symptoms and not very well and not what is causing your symptoms. I get people angry when I say this, but I am now a firm believer that very many people especially women don't have a thyroid issue, but doctors who are poor diagnosticians. In fact I think doctors are deficient across all of healthcare. God Bless you and you will be in my thoughts and prayers.

[Hidden in reply to silverbelle51]

At diagnosis my TSH was 8.9 and I was symptomatic to the point where all I could do was lay on the sofa all day, without even the strength to stand to make a cup of tea. I am almost back to health now I'm on thyroid hormone replacement.

You probably get people angry because we're all sick of being told 'its not your thyroid' when it very definitely is.

Thanks for taking the time to comment though, it's always helpful to see other perspectives.

[silverbelle51 in reply to Hidden]

Thank you for your thoughtful response. Sounds like you are satisfied and all is well ! You responded to treatment , so your dx was correct! My point is if you are placed on a medication , your # are OK, but you still don't feel better, then maybe you have been incorrectly dx, clearly not your situation . God Bless You !