Hi. Please can someone look at my bloods and give an opinion regarding medication. The blood tests date from February 23 (at the top of the picture) to June 22.
Currently I take 50 mcg Levothyroxine and 15 mcg Liothyronine - split 10 mcg in the morning and 5 mcg in the afternoon. My Endo says I am slightly over medicated but has agreed to continue with this prescription. My GP has advised that I need to go on statins. I’m reluctant to do this.
Can anyone help please? Thanks very much.
Simba53
My Endo says I am slightly over medicated
Then your endo is ignorant of how to interpret thyroid test results when T3 is added into the mix. Adding T3 lowers TSH, often to the point of suppression, your endo should know this. Also, dose should not be determined by TSH, it's not a thyroid hormone, it's a pituitary hormone. The thyroid hormones are T4 and T3 and your T3 at 4 (2.4-6.0) is well within range, just 44.44% through range, so you definitely are not overmedicated and don't need a dose reduction. In fact you could probably do with an increase as most people on combo meds feel best when FT3 is over half way through range.
My GP has advised that I need to go on statins. I’m reluctant to do this.
Then refuse them, you don't have to take them just because your GP thinks you should. I expect if your FT3 (and possibly even FT4) were higher in range then there may not be a problem with your lipid results.
Hi. Thank you for your reply. While I feel better taking the meds I’m on now, I’m definitely still operating below par. Should I try increasing Levothyroxine to 75 mcg and continue with T3 at 15 mcg? My next blood test is in around 5 months - I think have enough Levothyroxine to cover the increase for a couple of months.
Thanks again. As ever the advice on here is invaluable.
If you increase your Levo this will have the effect of raising your FT4 and possibly your FT3 as well. When using Levo plus T3 it takes a lot of tweaking of each hormone individually (never changing both at the same time) to find the perfect balance which takes us to our sweet spot. Some people are fine with a low FT4 as long as FT3 is in the upper part of it's range, some people need FT4 and FT3 better balanced when on combo meds. It's trial and error and requires a lot of patience to reach the right doses. If only doctors were more understanding of this!
When changing dose it's a good idea to retest about 8 weeks later to see what effect it's having on your results and how you feel. You can do this yourself by using one of our recommended labs. Cheapest is Monitor My Health for the basic panel (TSH, FT4 and FT3) and it's an NHS lab at Exeter hospital so if you needed to you could show the results to your doctor and if he wont accept them you can always ask why as it's an NHS hospital lab. Details and discount code here:
thyroiduk.org/help-and-supp...
Other more comprehensive tests (eg thyroid plus vitamins) are available with them and also with Medichecks and Blue Horizon.
Thanks for that. I’m reluctant to pay for more private tests. I think I might wait until my next appointment with the Endo and ask him if he’ll increase Levothyroxine to 75 mcg and keep Liothyronine st 15 mcg. He’s very amenable - I’m hoping he’ll go along with my request as a trial. Thanks again.
Suggest you try splitting T3 as 3 x 5mcg doses
5mcg waking, 5mcg mid afternoon and 5mcg at bedtime
Day before test last dose T3 Approx 8-12 hours before test
Personally I would push for dose increase in levothyroxine. Perhaps initially increase to 75mcg and 50mcg on alternate days. Retest thyroid and cholesterol in 6-8 weeks
Meanwhile important to test vitamin D, folate , ferritin and B12 at least annually
Which brand of levothyroxine do you currently take
Do you always get same brand levothyroxine at each prescription
nhs.uk/conditions/statins/c...
If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.
Hi. Thanks for your reply. I would struggle to split T3 to 3 doses daily if I want to leave an hour before doses. Also taking T3 before bed keeps me awake. I definitely need to get folate, B12 and Vit D checked. I’m taking Accord Levothyroxine - same brand for around 9 months.
Thank you for the NHS piece on statins. I’ll use it when I speak to my GP - I really don’t want to take any more medication - i definitely think tweaking my Levothyroxine will help in many ways.
Thanks again.
Free T4 (fT4) 12 pmol/L (9 - 19) 30.0%
Free T3 (fT3) 4 pmol/L (2.4 - 6) 44.4%
How do you feel?
Did you do the test as per the protocol recommended here? Test at 9am, fasting, last levo dose 24hrs before the blood draw (if you’re taking Levo), last T3 dose 8-12 hours before blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process)?
Your Endo is dosing you according to your TSH and not symptoms or cholesterol level.
Looking back on your previous posts you were previously on a higher dose of levo which you do actually need. You are under replaced at the moment and no wonder your cholesterol is raised.
You are not over medicated at all. TSH is a pituaitary hormone and when taking T3 does usually result in a below range or suppressed TSH. This is normal but Endo's do not understand this. Can you find a new Endo?
What were your latest vitamin results for ferritin, folate, B12 & D3?
What are you supplementing with?
Thank you for your reply. Blood test was done following the protocols. I’m currently taking D3 with K2, Thorne Vit B complex, magnesium glycinate and Ashwaghanda. I also eat 3 Brazil nuts a day for selenium. The NHS don’t test folate B12 and D3. The Endo wants to reduce Liothyronine to 10 mcg daily and 75 mcg Levothyroxine. Do you think it would help if I increased Levothyroxine to 75 mcg and continue with 15 mcg Liothyronine?
Thanks again for your reply.
Vitamin supplements sound great.
If you want to avoid statins then you really do need to increase and levo would be a good option with staying on 15mcgs T3.
If your Endo doesn't like this tell him about the NICE guidelines that are not mandatory.
The first paragraph in the NICE (NHS) Thyroid Disease, Assessment and Management guidelines says :
nice.org.uk/guidance/ng145
"Your responsibility”
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. "
Hi. Thank you your reply. The NICE guidelines are really useful to use in my argument to increase Levothyroxine while maintaining Liothyronine level. I’m concerned about my cholesterol LDL. I travel quite a lot - not going on statins now that my GP has written to me saying I need to go on them affects my insurance premium! Also as I already have aching joints going on statins would be an absolute last resort. Feel like I’m going round in circles to be honest.
Once again you for your reply.
Hi Simba
Back in the day before doctors stopped treating the patients and just treated the labwork they knew elevated cholesterol was an indicator of potential hypothyroidism/under medication of hypothyroidism. It is still mentioned in the guidance but routinely 'not known' or ignored.
Hi. Thank you for your reply. That’s really interesting. Why don’t Endo’s join the dots!! My blood pressure is raised, I’m pre- diabetic and I have high cholesterol - all of which I believe indicate that I am under medicated. I’m going to try and get an appointment with my GP to discuss my blood test results and to see if he will speak to the Endo to increase my meds. It’s so frustrating!
Thanks again.
Your post inspired me to write a longer piece with my take on this. link at bottom. I have some stuff on self advocay on my bio and in posts. If you click on my face you will find it all. Our medication may differ but we all come across the same sticking problems with the medics.
Info in my profile may help form counter arguments ( that are more logic than actual arguments) to their rather limited understanding. The others are on point and it was the forum advice that literally saved my life. 🤗
healthunlocked.com/thyroidu...
Hi. Thank you for that. I’ll have a read of your link shortly. I agree about this forum - I would be lost without the advice and support here.
Thanks again.
New blood test results
Blood results and endocrinologist advice 
Self medicating and Blood Results...
Understanding blood results 
Blood test results - hypothyroid
