I would appreciate an interpretation of my latest Medichecks. Tests done early morning without Levo for 24 hours. Both T3 and T4 seem lower end and TSH just over. Medichecks doctor suggests an increase in Levo. Perhaps trial 100mgs or alternating 75/100mgs.
My next clinic appointment is 17th May.
I had a thnyroidectomy in May 2022 after struggles with an overactive thyroid/enlarged goitre and on Carbimazole for years and juggling the dosage. I have been on Levo (Accord) since the surgery starting 50/75 alternating over 6 days as prescribed by the surgeon. This was increased to 75 for February. Getting the balance correct seems tricky and also a brand that suits me. Teva was not great.
Symptoms - weight gain - now up to 72kgs (10kgs heavier since surgery). Endless sensitivities to foods/scents. Sluggish, sad, poor gut health. I am having some help with complementary therapy and restoring gut health. Diet is avoiding gluten and dairy and being on a low histamine diet.
I stopped the B12 as I am now on a multivitamin. I take an oral Vitamin D but will increase this to two sprays a day.
Many thanks. ck
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JemBron
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Very low free levels + high TSH so a 25mcg increase would be OK.
Hypo people get low vitamin levels due to poor absorption from food due to low stomach acid. We need OPTIMAL vitamin levels for our thyroid hormone to work well.
I stopped the B12 as I am now on a multivitamin.
Take a look at the quantity of B12 in the multi and you will see it is a lot lower. Multivitamins are not recommended here as they contain poor quality vits, low in quantity, not enough to bring levels to optimal which is where we need them to be. Often they contain iron which prevents most of the rest of the content from being absorbed.
Far better to test levels and supplement with good quality, high content specific vitamins.
A B complex is recommended to keep all the B's in balance. Thorne Basic B is a good one.
Folate - people report feeling well with a folate at 20. Look at methylfolate which is the active vitamin, also contained in a B complex.
Ferritin ideal level is 90-100 for best thyroid hormone use by the body. Focus on eating chicken livers, pate and red meat.
Thank You! For years tried to stabilise with Carbimazole and the overactive thyroid and tiny increase/decrease in meds and weight loss up/down! The multi was recommended but I do have Bs recommended here from an earlier post. I will see how the 25mgs increase works. My gp/consultants at the clinic are supportive - asking me to be patient to get meds/balance correct with the body swinging the other way!
Jem I'd ditch the multivitamin. You could be knocking your system out of balance with it. You may not be getting enough of what you lack and too much of things you have enough of already. And some vitamins work against others. For example Vitamin C should be taken 2 hours away from B12 as the C interferes with the B.
Multi vits can also contain iodine at 100% daily dose. I took a multivitamin like that for many years. My thyroid went haywire. It was the start of my trouble and the endo thought that the iodine played a part.
You do need an increase in levo. Adequately treated TSH would be under 2 and likely 1 or lower with ft4 and ft3 at least at the halfway point through range - but this is a rough guide as we individually need to find which levels suit us in the end.
Thank You for the info. I will certainly take on board the comments, especially about the multi. I have sent the Medichecks results to my gp asking for my prescription to be increased, in line with what the Medichecks doctor is also recommending.
Looking back at your previous posts you certainly qualify for several stamina badges and see you already know of Elaine Moore and Dr Eric in the States - two websites I found too late for me as I only started my research post RAI thyroid ablation for Graves Disease in 2005.
Just for reference a fully functioning working thyroid would be supporting you on a daily basis with trace elements of T1. T2 and calcitonin + a measure of T3 at around 10 mcg + a measure of T4 at around 100 mcg - with T3 said to be around 4 times as powerful thanT4.
T4- Levothyroxine is basically inert and a storage hormone that needs to be converted by your body into T3 the active hormone that runs all your bodily functions including your physical, mental, emotional, psychological and spiritual well being , your inner central heating system and your metabolism.
In order for T4 - Levothyroxine to work well we do need to maintain optimal levels of ferritin, folate, B12 and vitamin D and I now know I need my ferritin up at around 100 - folate at around 20 - active B12 at around 75++ and vitamin D up at around 100 to feel well.
It is essential that you are dosed and monitored on your Free T3 and Free T4 readings and generally speaking we feel at our best when our T4 is in the top quadrant of the range as this should, in theory, convert to a good level of T3 at around a 1/4 ratio - T3/T4 :
In primary care your doctor may just be looking at your TSH reading -
This is highlighted as being too high for someone on thyroid hormone replacement and suggesting to your doctor that you need a dose increase as we generally feel best when our TSH is at last under 2 and more likely at the lower end of the reference range.
As your dose of Levothyroxine is slowly increased up in 25mcg increases every 6-8 weeks you should start to feel better
As the TSH goes down your T3 and T4 should start to slowly build up into the ranges and once your T3 and T4 are up and over 50% through their ranges you should start to feel some relief of the hypothyroid symptoms.
Some people can get by on T4 - Levothyroxine only :
Some people find that T4 seems to stop working as well as it once did, at some point in time, and need the addition of a little T3 - probably to replace that little natural bit lost when they lost their thyroid.
Some people can't tolerate T4 and need to take T3 only - Liothyronine.
Whilst others find their health restored better taking Natural Desiccated Thyroid which contains all the same known hormones as that of the human gland and derived from pig thyroids dried and ground down into tablets referred to as grains.
I am now self medicating as in early 2018 I was refused both T3 and NDT by my surgery and hospital and I am much improved taking full spectrum thyroid hormone replacemnt.
Details on my profile page if interested - just press the icon alongside my name and go to my Profile page :
Many thanks for your detailed reply. I know it will take time and slowly does it! But they (medical) said you will feel so much better with the thyroid gone!! Well, not yet! It was a long-term struggle being overactive but I do know how important getting the numbers within ideal range helped me. So…onwards - it is what it is and one day all will be well.
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Test results advise please
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Thyroid Test Results 
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Thyroid test results
