Just had a telephone consult with my Nuc Med Dr. over my latest results (See my latest update on previous post) for ease though here they are
TSH 0.44 Range 0.35-4.94 2.0% thru range
FT4 18.9 Range 9-19 99% thru range
FT3 3.7 Range 2.9-4.9 40% thru range
T4:T3 Ratio 5.11
Conversion T3/T4 0.2
These results are following me deciding to reduce Levo in January from 137.5 to 125mg daily, consequently my TSH has risen from 0.18 in January to 0.44 now. He will go along with this 125mg, but would 'prefer' me to go back 137.5 to keep my TSH suppressed in order to keep any remaining cancer cells down.
On the broader picture I suggested that I was not a good converter of T4 (as has been mentioned on here), but he refuted this and said I was converting T4 to T3 satisfactorily. I asked if I could go on a low dose trial of Liothyronine, but he said there was no need for that. I have averaged out my FT3% over the last 2 years and it is 51%, (which include a couple of spikes at around 80%). I do have a bar chart of all results over the last 2 years.
Obviously I don't want to increase the chances of any rogue cancer cells growing, but not sure what to do, if anything, regarding T3. My energy levels are currently just about OK, though I do 'empty the tank' quite quickly and would of course like to be better.
Any thoughts on how best to proceed and whether I am in fact low on FT3, or do I just go with Drs recommendation and try going back to 137.5mg and see what happens over the coming moths. My next NHS blood test is in 3 months and telephone consultation isn't for 6 months.
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Devonlad
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Many thanks for your reply. My vitamin levels, taken in Feb were Vit D 95 range 75- 200, Vit B12 457 range 145- 569, Folate 27.3 range 8.83-60.8, Ferritin 296 range 30-400, Mg 0.9 0 range 0.66-0.99
I do feel better in myself on 125mg
I do try to stay on the same brand of levo and pretty much achieved this over the last couple of months.
Yes my test was done as per your recommendations, no biotin, 24 hrs off levo and test before 0900.
Would he be willing to decrease t4 medication and add in a natural dessicated thyroid medication? I'm not sure how the NHS is in your area for paying for that, some do, some don't. (If willing, but the NHS doesn't cover it, you'd end up with a private prescription, which could be pricey). If your doctor is unwilling to change the overall amount of medicine, this could be a good way to have a better balanced supplementation programme. I know there has been at least one study that has shown that patients taking T4 only vs T4/T3 combination had basically the same test results, but the T4/T3 group reported feeling better.
If you're not happy with how you're feeling, I'd fight for either adding synthetic T3 or a natural dessicated medication. Different things work for different people. I recently switched from synthetic T3/T4 combination to NP Thyroid and am happier.
If after advocating for yourself , (for an earlier consult, for different medicine, a different doctor....) you're still not on the right medicine, Metavive could be a good option for testing the medicine you want. Just beware that it could impact your bloodwork.
Thanks EIRR for your reply, I'd never considered NDT before. I don't think this Dr is open to any suggestions, he was pretty dismissive when I asked about T3. I'm down in West Devon and even if I was allowed T3 they only allow up to 10mg. I've never heard of Metavive, so will google it to see what it is.
At the end of the day I think I'm going to have to go private, which obviously I've been reluctant to do.
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