Help with new blood test results

[efm2022]

Following on from my previous messages I have the results from my private blood test. My endo has requested my medication be reduced to 100 and 75 on alternate days which I’ve refused as you suggested. I will be looking into privately sourced T3 as I am failing to get the doctors to see past the TSH results and my endo has refused my request.

Let me know what you think about the below results. They were done first thing in the morning, no levo for 24hrs, no vitamins for a week prior.

Many thanks for all the help you’re giving me on my hashimoto’s journey.

[pennyannie]

Hey there again :

Yes - I'm afraid it looks like its down to you to get yourself better -

Your TSH is the only result these ' professionals ' are looking at - as when you look at all 2 in context it is obvious that both your T3 and T4 need to be higher in the range to have half a chance of restoring health and well being.

Your T4 is at just around 46% and your T3 at around 22% -

We generally feel at our best when our T4 is in the top quadrant of its range as this then, should, convert to a decent level of T3 tracking slightly behind at around 60% :

Once your T4 is in the top quadrant and when taking T4 monotherapy the accepted conversion ratio is said to be 1 / 3.50 - 4.50 with most people feeling t their best when they come in this ratio at under 4.

To find your conversion you simply divide your T4 reading by your T3 reading - currently you are coming in at 4.26 but this may well improve once your dose is built up a bit more.

No thyroid hormone woks well until your core strength vitamins and minerals are up and maintained at optimal levels -

I now aim for ferritin at around 100: folate around 20 : active B12 around 75 ++ and vitamin D around 100:

Having Hashimoto's dose throw a further spanner in the works as you are liable to auto immune attacks and ' swings ' in symptoms and erratic own thyroid hormone production as this disease systematically disables your thyroid gland with you requiring more, not less, thyroid hormone replacement support.

Healing the gut seems to be a common first step - testing for celiac and then looking towards food intolerances to try and calm down your immune system response and reduce the severity of the AI attacks.

I read many find the work and research of Dr Izabella Wentz helpful -

thyroidpharmacist.com

[efm2022 in reply to pennyannie]

wow, thank you so much for all the great advice. I think I will print this to help me when I have my next blood test review when the doctor will no doubt try to reduce me again!

[pennyannie in reply to efm2022]

I'm not sure it will help you as most NHS doctors just look at the TSH and believe it needs to be ' in range ' as per the guidelines they work to:

Basically - the guidelines ae not fit for purpose but most doctors do not know enough about Thyroid or Hashimoto's AI disease to know how to treat and so just follow the rules so they do not risk a disciplinary.

The TSH was originally introduced as a diagnostic tool to help identify a person suffering with hypothyroidism and once on any form of thyroid hormone replacement the TSH is just one of 3 readings that should be run - with the most important readings being the Free T3 followed by the Free T4 and lastly the TSH.

A low below range TSH when not on any thyroid hormone replacement is usually seen in cases of hyperthyroidism with a fast resting pulse, shakiness, weight loss, loose bowel. insomnia and a trembling middle finger - and hyperthyroidism is seen as life threatening if not medicated with an Anti Thyroid drug.

But once diagnosed hypothyroid and on thyroid hormone replacement - you can't become hyperthyroid - but you could become over medicated - but seeing that neither your T3 and T4 are even 50% through the range -

This just goes to show how ridiculous the current guidelines are interpreted by most in mainstream medical.

Thyroid UK hold a patient to patient list of sympathetic thyroid specialist and endocrinologists - both NHS and private.

Maybe get the list and see if you can get a referral to someone who understands thyroid AI disease. There could be someone in your area but also now, many offer video consults.

I think you need to email admin @ thyroiduk.org

You can also ask forum members for feedback first - on any doctor / specialist you think you might like to see - and your replies will be by Private Message - and the Chat light above ( paper plane ) lights up if you receive back replies as we are not allowed to openly discuss any person on the open forum.

P.S. If you want to reread all your previous posts and replies - just press on your face icon alongside your comments here - and this goes direct to your Profile Page.

Alternatively press the icon top right which reads More and there are several options there and you go to Your Profile :

Likewise if you want to read further about anyone who writes anything just press the icon alongside their comments and you can then read their bio and all they have ever written on this forum.

[pennyannie in reply to pennyannie]

Sorry my maths was out a bit last night - but I've amended the T4 reading accordingly and everything still stands - you need a dose increase in T4 - Levothyroxine :

I don't have a calculator as I think i need to keep my maths mental - !!

Use it or loose it - but it was well after my best before time of day for mental arithmetic =aplogies !!

[SlowDragon Administrator]

When were vitamin D, folate, ferritin and B12 last tested

What vitamin supplements are you currently taking

Are you on strictly gluten free diet or dairy free diet

Which brand of levothyroxine are you currently taking

Do you always get same brand at each prescription

Your results suggest you need dose INCREASE….not decreased

and essential to get vitamins tested and optimal for good conversion of Ft4 to Ft3

Email Thyroid U.K. for list of thyroid specialist endocrinologists and doctors who will prescribe T3 if necessary

[e-mail]

[efm2022 in reply to SlowDragon]

thank you so much for replying.

My last vitamin panel test was in Dec which I’ve attached but I have added vitamins to try to be more optimal. It won’t let me attach another image so the ones I take are:-

Calcium, magnesium and zinc

VIT d3 & k2

Bio cultures complex

VIT b complex

VIT b12 oral spray

I wish I could say I was completely gluten and dairy free. I try so hard and then I have a moment of weakness and I’m back to square one. I do not have celiac as I did a private test for that.

As per your advice I am only on accord brand levo now.

I did look into endocrinologists a while ago and they were a long way away but I think I need to take time off work to travel for better support.

Thank you all so much for your help in this forum. It is truly life changing advice.

.

[SlowDragon Administrator in reply to efm2022]

So these old results

FT4: 17.2 pmol/l (Range 11 - 23)

Ft4 only 51.67% through range

FT3: 4.2 pmol/l (Range 3.9 - 6.8)

Ft3 terrible at only 10.34% through range

Helpful calculator for working out percentage through range

thyroid.dopiaza.org/

Most people when adequately treated will have Ft4 at 60-80% through range and Ft3 at least 50-60% through range

Do you take levothyroxine waking or bedtime

Or have you tried splitting as half dose waking and half dose at bedtime

Approx how much do you weigh in kilo

Week before test when you stop vitamin B complex, recommend you take a separate methyl folate supplement…..eg Jarrow methyl folate 400mcg

most recent results

FT4: 16.6 pmol/l (Range 12 - 22)

Ft4 now only 46.00% through range

FT3: 3.9 pmol/l (Range 3.1 - 6.8)

Improving at 21.62%

Conversion is improving

You need next dose increase in levothyroxine

[pennyannie in reply to SlowDragon]

Hello Speedy Dragon:

The above result is from 2022 - we have April 23 results at the very top of the post :

Best wishes as always :

[SlowDragon Administrator in reply to pennyannie]

Thanks

just edited to clarify

[pennyannie in reply to SlowDragon]

Just as well as I always check my mental arithmetic against someone who comes along with a calculator -

and you caught me out - but it was well past my best before time of day !!

I 've now amended my T4 percentage to yours !!

Thank you

[efm2022 in reply to SlowDragon]

thanks for the updated comments. I take my levo around 6am each morning. Never tried splitting them as I take my hrt in the evening. Weigh around 76kilos

Is my conversion improvement down to the supplements I now take?

[SlowDragon Administrator in reply to efm2022]

so guidelines suggest likely eventual daily dose levothyroxine is 1.6mcg per kilo of your weight per day

76kg x 1.6mcg = 121.6mcg per day

850mcg per week

That’s 125mcg per day 6 days per week and one day 100mcg per week

But if on HRT it’s common to need slightly higher dose levothyroxine than this

HRT needs to be at least 4 hours away from levothyroxine