Test results .. advice please

[MrsClanger]

Hi, this is an update to my previous post but i figured best to write a new one.

heres my last 3 thyroid tests ..

1st.. when id been on T3 for 7 months ..

TSH 0.01

T4 18.7 ( ref 12-22)

T3 4.6 ( ref 3.1 - 6.8 )

..

last test .. about 9 months ?? ago

TSH = 0.01 ( 0.27-4.20 )

T4 = 14 ( ref 11.10-22)

T3 = 3.7 ( ref 3.10 - 6.80 )

...

MOST RECENT TEST

TSH 0.01

T4 =18.3 ( ref 11.10-22)

T3 = 4.2 ( ref 3.1 - 6.8 )

Ive done the tyroid calculator, but dont really understand it. bearing in mind if the t3 is falsely low because i did not split the dose..

> Can anyone tell me if im ok to top up my T3 a bit more ?

I think i felt better on 12.5 mcg t3 , and so im considering scorcing T3 again to add to what im getting on nhs.

T4:T3 Ratio 4.357

I do realise i messed up ( again ..blame brain fog ) with how to take meds before testing, but i do the same every time .

I am currently on 75 mcg levo and 10 mcg of T3

This was prescribed by nhs who made me reduce my dose from 12.5 T3 i was scorcing myself, to thier 10 mcg , and reducing from 75/100 mcg levo alternate days to 75 per day, they wanted me to reduce to 50 mcg, but when i did i felt so awful i just stuck to 75 mcg.

I normally just miss my meds dose at 8am and get a blood test around 9 am so there is a 24 hr gap between last dose and blood test , By not splitting the t3 i understand this is giving a false low.

also forgot to stop b vits biotin, but the hospital told me that does not affect the test ( ?!)

So i have done this every time, so the comparison between this test and last is accurate, even if the t3 is falsely low.

They also do a bone profile, all normal except my serum alkaline phosphatase is still raised, but slightly lower, it is always raised,..

It is now 114 , It was 127 october 2022 .

what annoys me is the surpressed tsh is constantly an issue to them, and theyre not looking into my symptoms or the alkaline phosphatase.

ive just hit a slump, very tired and gaining weight again, also quite bloated , but i dont know if this is to do with they thyroid meds or something else.

im taking all my vitamins ( full list on other posts ) .. easy iron, b vits , calcium zinc magnesium, vit d and k2 mk7 ..

Im waiting to get more blood tests to check liver and vit D iron etc in about a month. Doc agreed to test liver again regarding the alkaline phosphatase

Info / convo with gp and endo ..

Both the doc and endo dont like my tsh being surpressed ..

So i spoke to Endo after these tests , he said the alkaline phosphatase could be lack of vit D and to speak to doctor. I asked to increase my t3 back up to 12.5 mcg as im exhaused and gaining weight since reducing it.. he said that i should contact my gp to look into my vit d levels, that hes not happy to increase my thyroid meds as my tsh still surpressed, but i can stay on the same dose i am on, then discuss again in august when i have my check up with them. no time to discuss hrt ( as advised on other post ) but dont feel thats for me really.. im post menopause for so long now dont see the point. (ive just turned 55 , menopause at 37 /done and dusted by 40 )

Next day i had a call from gp , i was told it was about the alkaline phospahatase , but instead he said it was my tsh hes concerned about and wants me to reduce my levo and t3, i just told him theres no way my tsh is going to change now, and he got v annoyed saying hes the doctor and knows better , and it will go down if i reduce my dose. I explained i would get very sick if i lower the dose as ive done that before , and that is why i scorced t3 myself, and if he cuts my levo prescription id simply buy online and take more T3 instead. So he said my heart could be at risk.. to which i explained that it will be if i reduce my dose as i kept fainting from bradycardia before, and im not getting bradycardia anymore and to me that says the t3 is doing me good, as that was a clear sign i was under medicated. He clearly didnt like me telling him i feel better on t3 so said he will write to my endo. I explained i had actually spoke to the endo the day before, So i told him go ahead as id already spoken to him and he said i can stay on the dose im on.

so.. should i wait it out, test vits first, focus on diet and drinking mire water etc.. or top up the T3 a bit, Tell doc to send me to get my heart checked and if thats all ok, just tell them that i know what im doing best !

( adding link so i have it saved ..thyroid.chingkerrs.online/ )

[SeasideSusie Remembering]

Mrs Clanger

T4:T3 Ratio 4.357

You can't use the ratio when using T3 or NDT. It's simply to show how well you convert T4 to T3 when taking Levo only, and if you take T3 in any form it's not possible to know because your result reflects that you're taking T3.

TSH 0.01

T4 =18.3 ( ref 11.10-22)

T3 = 4.2 ( ref 3.1 - 6.8 )

Ive done the tyroid calculator, but dont really understand it. bearing in mind if the t3 is falsely low because i did not split the dose..

Your FT4 is 66.06% through range and your FT3 is 29.73% through range. Your FT3 will be lower than normal but we can only guess by how much but it would still be very low for someone on combination thyroid hormone replacement. Optimally medicated and your FT3 would probably be over half way through range. Perhaps try to remember to split dose and take last part of dose of T3 8-12 hours before test next time.

also forgot to stop b vits biotin, but the hospital told me that does not affect the test ( ?!)

Considering there is a warning on many print outs of results I'm surprised at this. There will only be a lowish amount of biotin in a B complex, maybe 400-500mcg, and this amount would only need to be left off for a couple of days, but it may have made a difference to your results otherwise why would they add a warning about it?

what annoys me is the surpressed tsh is constantly an issue to them,

It will be, they just don't understand about T3 lowering TSH.

ive just hot a slump, very tired and gaining weight again, bloated and dont know if this is to do with they thyroid meds or something else.

Well, you are undermedicated to have such a low FT3 that this could be the cause.

[MrsClanger in reply to SeasideSusie]

Hi Susie, Thank you for the info, ill get a re test and then re post. much appreciated

[SlowDragon Administrator]

Have you tried splitting T3 every day

5mcg waking and 5mcg mid-late afternoon

It might (possibly) increase TSH a little

Suggest you get TSH, Ft4 and Ft3 retested, making sure you split day before and that last 5mcg dose is 9pm day before test

And stop vitamin B complex 3-5 days before test

[MrsClanger]

hi slow dragon, thank you , i will try that, and also get a re test following the advice, and then re post. much appreciated

[SlowDragon Administrator in reply to MrsClanger]

ideally if changing how you take your T3/Levo

Wait 6-8 weeks before retesting

Personally I split my levothyroxine too. Half dose 6.30am and half dose at 11pm.

I also take T3 as 3 x 5mcg doses…..6.30am, 2.30pm and 11pm

If you get 2.5mcg dose increase in T3 …..try splitting as 3 doses. 5mcg waking and 5mcg mid afternoon and 2.5mcg at bedtime

[MrsClanger in reply to SlowDragon]

Isn't it tricky to fit in food and suppliments i thought thyroid meds need to be taken an hour away from food and 4 hrs from suppliments?

[SlowDragon Administrator in reply to MrsClanger]

Levothyroxine needs to be at 2 hours from most supplements

Some four hours - eg Magnesium, iron, vitamin D tablets

I find it easy. Admittedly I don’t have to fit in iron supplements (my ferritin is way over range……due to inflammation)

Daily

levothyroxine and T3 at 6.20am (alarm then go back to sleep)

Daily Vitamin D mouth spray and vitamin B complex after breakfast about 8.45-9am. Once week also selenium and zinc supplements

T3 mid afternoon

Magnesium supplement immediately after dinner about 7pm

Levothyroxine and T3 at 11pm

[MrsClanger in reply to SlowDragon]

Ah OK.. I'll try figure out a plan