Latest blood test, what to do next…: Six weeks... - Thyroid UK

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Latest blood test, what to do next…

Nath27 profile image
13 Replies

Six weeks ago, I increased my levo from 125 to 137 mcg. I was surprised to see such an improvement in my results: FT4, FT3 and my vitamins apart from ferritin which has gone down. The problem I’ve got is I feel so tired and weak. My dizziness is still present.

But the last week, I also started to have problems with my sleep… I feel jittery which is new for me.

I have the last six weeks increase my intake of vitamins as suggested on the forum.

I know that the weight / levo ratio is only a guideline… but I’m already on higher dosage of levo compare to my weight.

I have a appointment with my GP in a couple of months… she will reduce my dosage when she sees my TSH. She thinks that I take 125 mcg of levo.

What to do next? Thank you for any advice.

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Jaydee1507 profile image
Jaydee1507Administrator

Th dose by weight guide is just that, a guide. Some people will need more and some less than the result of the calculation suggests.

Have you tried any dietary changes? Did you ever have positive antibodies?

Many with autoimmune thyroid disease aka Hashimoto's benefit from a gluten free diet. A smaller percentage of those also need to remove dairy from their diet to feel well. These are intolerances and will not show up on any blood test. Thats something you should try possibly.

Nath27 profile image
Nath27 in reply toJaydee1507

Hello Jaydee

Thanks for the reply. I’m gluten free, I have Hashimoto’s. Being tired and weak makes me miserable. I hardly go out anymore. A magic pill will be nice😀

Jaydee1507 profile image
Jaydee1507Administrator in reply toNath27

Perhaps try dairy free also? You will need to be reading labels very carefully as milk products slip into the strangest of things. Its also labelled as caseine & whey.

What supplements are you taking?

Obviously it will take some months for the effects of getting better vitamin levels to work.

Sorry, no magic pills and if there was one I'm first in the queue. 😉

Nath27 profile image
Nath27 in reply toJaydee1507

I take iron, Thorne b complex, vit d k2, , magnesium, selenium… I’m not dairy free. My vitamins have increased by a fair amount in the last 6 weeks which is good.

I have some Tiromel. I’m thinking about adding a small dosage of T3 to see if it helps with the fatigue.

Jaydee1507 profile image
Jaydee1507Administrator in reply toNath27

Dairy free is something to try then. It certainly causes me a lot of fatigue.

Be sure to be taking iron 4 hours away from Levo. Magnesium is also another supplement that needs spacing 4 hours away from anything else.

Are you always getting the same brand of Levo and have you tried a lactose free levo brand?

Your FT3 is really not that bad, a level of around 70% is where to aim for and you're pretty much there.

Nath27 profile image
Nath27 in reply toJaydee1507

I take all my vitamins at least 4 hours from levo. I’ve had the same brand since I was diagnosed in 2021. My levo is lactose free. It’ s such a slow and complex journey.

Brightness14 profile image
Brightness14 in reply toNath27

I have sent you a PM about T3 which could help you.

SeasideSusie profile image
SeasideSusieRemembering

Nath27

I know that the weight / levo ratio is only a guideline… but I’m already on higher dosage of levo compare to my weight.

I think you can see from your results than dose by weight is irrelevent in your case. You are taking more than dose by weight suggests yet you have FT4 at 70.3% and FT3 at 66.7% so obviously you are not overmedicated, they are pretty good levels.

I have some Tiromel. I’m thinking about adding a small dosage of T3 to see if it helps with the fatigue.

Adding T3 is not indicated by your results, your FT4 and FT3 are nicely balanced and show excellent conversion, you do not need T3.

I would be looking at iron. Iron in complicated in that ferritin ranges vary so much and it's generally said that ferritin should be half way through range and some experts say that the optimal level for thyroid function is 90-110ug/L.

Ferritin can be raised when inflammation is present, you have Hashi's and this can cause inflammation, so your ferritin could be falsely raised and not a true figure.

You say you already take iron, in which case you should be monitoring regularly with a full iron panel. Do you have these results?

CRP (inflammation marker)

Serum iron

Total Iron Binding Capacity

Saturation percentage

Ferritin

Medichecks do this - Iron Blood Test:

medichecks.com/products/iro...

Discount code here:

thyroiduk.org/help-and-supp...

You may have just low ferritin, you may have iron deficiency, both of these can cause fatigue, so I would rule that out (or in) at this stage.

Nath27 profile image
Nath27 in reply toSeasideSusie

Hello SeasideSusie,

I don’t have my full iron test. It was last year and I can’t find it. But I have a blood test prescription from my GP to do in 2 months with full iron panel and TSH only.😠 My GP in France just needs the TSH for the thyroid. ( same old story).

I have a prescription for my iron ( by my GP).

I’m taking Iron but not regularly… I was focusing on vit D, b12 and folate. Those vitamins have gone up in the last six weeks. I haven’t been as good with my iron.

Charlie-Farley profile image
Charlie-Farley

Hi Nath 😊

As others have said dosing by weight is a GUIDE. It is useful to some (me included) to argue for a dose increase when under medicated.

So it is a good lever to use when TSH obsessed doctors want to under medicate to get the TSH where they think it should be to the exclusion of any other consideration eg symptoms and actual thyroid hormone levels. 🙄

Ultimately the best guide are symptoms and it is incredibly useful to keep a brief diary of response to changes - in anything . So changes with dose increases or decreases, changes vitamin levels, diet lifestyle etc. it’s important that it is not every day endless filling in, just as and when things are noticed. Because if things are noticed, they are significant.

For example, I made a note when a dose was increased and then a note a few days/weeks later when I noticed dose kicking in - very brief ‘more energy, not constipated’.

Filling in a log every day you would lose the significance in the ‘background noise’ of trying to make an observation daily. Less really can be more.

The only thing that is off is ferritin. SeasideSusie is hot on this stuff I would take her advice on this myself. We had a friend who had low iron and he was feeling weak my goodness the colour was back in his cheeks after an iron infusion. The obvious effect was profound.

You are at the stage of optimising. Looks like you are almost there.

Nath27 profile image
Nath27 in reply toCharlie-Farley

Hi Charlie,

Thank you for your reply. I’m going to do a full iron panel soon, I don’t really want to wait two months, it’s a long wait when you are not feeling good.

I started to log in my symptoms and/or dosage changes… I agree it’s very useful.😀

I hope that I’m almost there even if right now it’s doesn’t feel like it. My labs results are good on paper( apart from ferritin). My results are much better than 6 weeks ago but I haven’t felt the effets yet .

Thank you for the encouragement.😀

Charlie-Farley profile image
Charlie-Farley in reply toNath27

almost there Nath it takes a while to optimise 😊👍.

I was good after a year m, 6months mismanaged 6 months fighting for dose increases and juggling vitamins, BUT after tweaking another two years I have had a gradual improvement even in that.

It can be done🤗 just one thing at a time so you know what does what.

Nath27 profile image
Nath27 in reply toCharlie-Farley

Thank you. I’m glad that you feel better. 😀 I used to be so active and fit. I don’t recognise myself. What a rollercoaster. I used to run marathon… loved it. I don’t even walk my lovely dog’s nowadays. But thank you for being positive… and hopeful. It’s probably what I needed. 😀🙏

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