Further advice, please!

[UKmale_hypo]

Hi. Asking for advice again.

I've attached a table I created of my Levo dose and test results since last August, just before I started any thyroid treatment. I have also attached the three pages of all my results from test on 10th May.

I have a long history of coronary artery disease since 2010 when I had a small heart attack aged 39, with several quite serious recurrences of this CAD: I now have 6 coronary stents. I was diagnosed with Growth Hormone Deficiency in Nov 2020 and have been on treatment for that with Somatropin since then. It improved things enormously, but still symptoms remained, and I finally figured out that I have Central Hypothyroidism, largely thanks to this group.

You can see that I titrated my dose of Levo up, though perhaps a little quickly towards the end, and my recent results are too high. I did also get Vit D, Vit B12, Folate, and Ferritin tested this time: I'd appreciate thoughts on these results. I have already asked my GP for vitamin D supplements, and have reduced my Levo dose to 125mcg. (I realise that the general advice is to test these vitamins etc before starting Levo, but I am where I am now).

Over the last couple of months I have been experiencing some angina pain again, and initially thought this was a recurrence of CAD, though I now wonder if it is to do with overmedication of Levo, at least in part. Apart from that, I generally don't feel well.

Apart from Somatropin and Levo, I am also on Aspirin, Clopidogrel, Bisoprolol, Amlodipine, and Lansoprazole.

Any and all advice on what to do next gratefully received.

TIA

[UKmale_hypo]

Blood test results, page 1

Blood results page 1

[UKmale_hypo in reply to UKmale_hypo]

Blood results page 2

Blood results page 2

[UKmale_hypo in reply to UKmale_hypo]

Blood results page 3

Blood results page 3

[UKmale_hypo]

Also, just to confirm, I have always taken bloods BEFORE Levo dose for that day, and I leave an hour after taking Levo in the morning, on empty stomach, before food or caffeine.

[shaws Administrator in reply to UKmale_hypo]

That's the method recommended and you are following it correctly.

[arTistapple]

I don’t know enough to comment sorry but I would like to congratulate you on your spreadsheet. I really like how clear it is and lots of good info on it. The additional column showing how many days on particular dosage is great for contributing to a very full picture. Brilliant.

[UKmale_hypo]

I don't seem to have got all that much response to this post in terms of where to go next - I know I've had many replies to previous posts. I'm wondering if I've posted too often, or if people feel I've had enough information in previous posts, or if this one has just fallen through the racks a little?

[pennyannie in reply to UKmale_hypo]

I can bump you up the screen a little by answering the post -

Had you not offered such detail on other health issues I'm sure i would have replied in due time as would many others.

My knowledge is limited but it seems obvious that you are now over medicated on T4 thyroid hormone replacement, as both T3 and T4 are over range:

We don't have a T3 reading at the reduced dose of 125mcg T4 - but a T4 at around 15 is only around 46% through the range and we generally feel at our best when T4 is in the top quadrant.

So maybe try 137.50 mcg T4 daily - adjusting down by just 12.50 mcg daily and see if these symptoms are relieved.

i do not know what the interaction of your other drugs may have on each other and T4 - Levothyroxine - but do know thyroid hormones are very fussy and generally need to be taken well away from anything else , including food.

Your vitamin D is very low - we need this up and maintained at around 100 :

[PurpleNails Administrator in reply to pennyannie]

think you have a typo there.

[pennyannie in reply to PurpleNails]

Was it just the one !!

d to b - thank you -

[PurpleNails Administrator in reply to pennyannie]

spotted another - w/hen.

[pennyannie in reply to PurpleNails]

Oh dear - this is not good :

I'm jumping around this morning over a couple of different websites - which does not suit me ;

I usually reread once I've posted and spot the obvious and my dyslexia also comes to the fore when I'm not fully focused -

Thank you for proof reading !!

[UKmale_hypo in reply to pennyannie]

Hi and thanks for the reply.

I think what might have happened with the Levo dosing is that I tested on the 125mcg dose a little early, and perhaps my levels were still building up, so the results on 125mcg were not reflective, and might have been higher a few weeks later. I've reduced to 125mcg again and will get tested again in due course. I guess at least I know I don't have a conversion problem!

I am very careful to take Levo in the morning 1 full hour before any other meds and any food or drink. Originally I'd only been leaving 30 mins, but I changed in light of advice.

I have asked my GP for vitamin D pills but not heard back yet. Do you think that just this low result could be causing my continuing hypo symptoms? I can't say I feel any better than when I wasn't on any thyroid meds. I really could do with feeling normal!

[pennyannie in reply to UKmale_hypo]

Your low vitamin D will likely to be part of your overall well being -

All I know is that since getting my vitamins and minerals to optimal and then maintaining them there my overall health has much improved.

I just accept the fact that I need to supplement for myself as the NHS will only prescribe to get you into a range and we need optimal levels in order to be well.

[UKmale_hypo in reply to pennyannie]

So by 'vitamins and minerals' do you mean vit D, B12, Folate, and Ferritin, or is there anything else that I need to look at?

Thanks again

[pennyannie in reply to UKmale_hypo]

Yes, those are the 4 main core strength itamins and minerals that we need maintained at optimal levels.

[Wetsuiter]

I don't know enough to offer advice other than reduce levo and start on vit D which you already know.I just came on here to say that you haven't done anything wrong with posting. The lack of useful replies is just one of those things sometimes.

Keep going