Recent blood test results query

[Turquoisenona]

Hi

My most recent blood test results (following protocol of early morning and before Levo dose).

TSH 2.59 (0.27-4.2). Was 2.97 two months ago

Free T4 18.9 (12-22) Was 21.6 two months ago

Free T3 4.4 (3.9-6.7) Was 4.1 two months ago

Am I right in thinking these results are slightly better? The doctor was predictably very happy with these results. I have decided to add to my dose myself and retest privately in 2 months time. Only adding 12.5 mcg Levo. Starting from today. I figure if, when I retest, my levels are okay and I feel better on the increase I will then have more ammunition to ask for an increase on my prescription. What do you guys think?

[greygoose]

The only real difference between the two set of results is the FT4 and that has come down. So, not really better at all.

But, it's not more levo you need, it's T3, and increasing your dose of levo is not going to help that because it's pretty much the same now as when your FT4 was higher. Just slightly higher now, but probably not enough to make a difference to how you feel.

[Turquoisenona in reply to greygoose]

The Ft4 may be lower this time because of following the testing protocol I guess.

[greygoose in reply to Turquoisenona]

Ah well, perhaps you'd better explain how you did both those tests. If they weren't both done in exactly the same conditions then you can't compare them.

[Turquoisenona in reply to greygoose]

1st one was after taking Levo that morning. 2nd one following advice given on this site of fasting and early morning test.

[greygoose in reply to Turquoisenona]

OK, so you can't compare them.

What time of day were they both done?

[Turquoisenona in reply to greygoose]

1st one around 7 in the morning but within around an hour of taking Levo. 2nd one at around 0900.

[greygoose in reply to Turquoisenona]

OK, so right time of day, but on the first one we can't really know what your level of circulating T4 would be because you took the levo beforehand. But, the odds are, your FT4 level is improving, but your FT3 was too low in both of them. And I'm pretty sure that increasing the levo is not going to take it high enough without the FT4 going over-range. Which is rarely a good idea. You are a poor converter and ideally would need some T3 added to your dose of levo.

[Turquoisenona in reply to greygoose]

Okay, thank you. That would make sense as a few years back the doctor had me on 125mcg Levo and changed his mind and lowered it to 100mcg once results came in.

[greygoose in reply to Turquoisenona]

You're welcome.

[Turquoisenona in reply to greygoose]

I sent an email to doctor detailing that I clearly wasn't converting T4 to T3 very well and was interested in trialing T4/T3combination treatment. Said I hadn't felt well since my total thyroidectomy 3 years ago and asked if I could have a referral to an NHS Endocrinologist or whether this was something I would have to follow up privately. I wasn't expecting them to do anything on the NHS to be honest but thought I would try them first. It is so annoying to have such a blunt reply and with no consideration to me not feeling well or even to acknowledge that this is what my results show!

Reply from doctor

[greygoose in reply to Turquoisenona]

I'm afraid this doesn't surprise me because they are all so ignorant. They don't understand the importance of T3, nor what it is, nor what it does. They just look at the TSH and the price of the treatment, and that's all that interests them. They don't even know about all the possible symptoms of being hypo. And, frankly, they just don't care. Sorry your attempt to get help has failed.

[SlowDragon Administrator]

FT4: 18.9 pmol/l (Range 12 - 22)

Ft4 is 69.00% through range

FT3: 4.4 pmol/l (Range 3.9 - 6.7)

Ft3 only 17.86% through range

So poor conversion of Ft4 to Ft3

Previous results

FT4: 21.6 pmol/l (Range 12 - 22)

Ft4 96.00% through range

FT3: 4.1 pmol/l (Range 3.9 - 6.7)

Ft3 only 7.14% through range

Currently Ft4 is about right level

Ft3 obviously low

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

[Turquoisenona in reply to SlowDragon]

So my conversion is slightly better than last time. My Vit d ferritin and b12 were measured a couple of months ago. No folate test results ATM.

Vit D 89 (75-175)

Ferritin 65 (13-150)

B12 412 (300-569)

I have purchased Selenium + ace oral spray and d3000+K2 as recommended from my last post and have been taking around a week.

[SlowDragon Administrator in reply to Turquoisenona]

Perhaps consider adding daily vitamin B complex

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) 

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid 

healthline.com/nutrition/fo...

B vitamins best taken after breakfast

Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) 

Thorne currently difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay 

Other options 

healthunlocked.com/thyroidu....

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg)

[SlowDragon Administrator]

Looking at previous post

You have had thyroidectomy

Getting vitamins tested and maintaining optimal vitamin levels can help improve conversion rate of Ft4 to Ft3

Worth trying strictly gluten free diet too

Only make one change at a time or you can’t tell what’s going on

Do you always get same brand levothyroxine at each prescription

List of thyroid specialists and endocrinologists who may prescribe T3 if not

healthunlocked.com/thyroidu...

[Turquoisenona]

Have been (mainly) gluten free for around 3 months now. Slipped up with a couple of pints of ale in the sunshine one day. Have also gone dairy free.

[SlowDragon Administrator in reply to Turquoisenona]

Loads of pubs offer GF larger ….a few stock GF ale …