Latest bloods - asking for your expert opinions before I see the GP :)

[Loopnova]

In February my TSH done by NHS was 0.19 but I'd been feeling increasingly worse again so my dose was increased to 100mg. The doc didn't really think that was the problem and thought it wouldn't help but I thought it was worth a try. I'd last felt really great at about 0.13ish, several months earlier, so thought it was on the up.

Anyway, two months on and I'm not better. In fact, I'm worse, so looks like I was wrong! Must be something else wrong with me. (I'm not having any typical symptoms of being overmedicated though).

Anyway I had NHS blood test which said 0.09. Interestingly, I did a private blood test on the same day, all same conditions except about two hours earlier, and that was 0.18.

I expect the doc will reduce my dose back down which I can't really argue against.

I'm interested in the T3 and T4 though so wondered what you make of these?

FT3 - 4.3 (range 3.1-6.9)

FT4 - 23.9 (range 12-22)

Last time (January) they were

FT3 - 3.9

FT4 - 21.2

So they've both changed and I wonder if that meant anything? Since then I've gone gluten free (about three months I think) and dairy free for 3 weeks. Been taking Vit B, D and Magnesium, and following all the usual rules re taking meds.

[SeasideSusie Remembering]

Loopnova

Both sets of results show high ft4 and low ft3.

Did you do both tests as we advise - last dose of Levo 24 hours before the test and no biotin or B Complex or any other supplement containing biotin for 3-7 days before the test ? If so then your results show poor conversion of T4 to T3 .

Do you have current results for keu nutrients? If they are optimal then it looks like you would benefit from adding some T3 to your Levo.

[Loopnova in reply to SeasideSusie]

yes I did them as per that advice. I’m quite strict with it 😀

Haven’t had the other test results through yet

Last time I showed the doctor the T3 and T4 and they just looked briefly and said they looked normal. Not sure they’re up on the whole conversion thing.

I’m beginning to think maybe I am over medicated though now. Just been reading more. I was mainly looking out for anxiety and heart palpitations which I don’t have at all. HR is as low as ever! But I do have bad fatigue, trouble sleeping, and a few times something that I thought was a minor hot flush (thought perhaps perimenopause was coming) but even that can be a hyper symptom apparently.

I now kinda regret going gluten free at the same time roughly as the dose increase what if that has helped me absorb more so it’s like a double whammy.

[Loopnova in reply to Loopnova]

I also wanted to ask how this works as I was fine at the end of last year. I felt great, fully normal, no symptoms of any kind… so if I had a problem with conversion or diet or vitamins etc, how come I felt great then and then got worse even though nothing changed? That’s why I thought it was just my condition worsening and needing a higher dose.

[pennyannie]

Hello Loopnova :

Once on any form of thyroid hormone replacement we must be dosed and monitored on our Free T3 and Free T4 readings and ranges and not a TSH seen in isolation though I am well aware that in primary care a TSH reading is sometimes all you get with an occasional Free T4 and very rarely a Free T3 reading.

T4 is a storage hormone and a prohormone and in itself pretty much inert and your body needs to convert the T4 into T3 as it is T3 that runs the body - you can live without T4 but you can't live without T3.

We generally feel at our best when our T4 is in the top quadrant of its range as this should then convert to a good level of T3 at around a 1/4 ratio T3/T4.

The accepted conversion ratio is said to be :- 1 / 3.50 - 4.50 - T3/T4 with most people feeling at their best when they come in this ratio at 4 or under.

So if I divide your T4 result 23.90 by your T3 result 4.30 I'm getting 5.50 so this shows that your conversion is way out from centre and you are struggling to convert the T4 into T3 and have very poor conversion and a struggling thyroid.

No thyroid hormone replacement works well until core strength vitamins and minerals are up and maintained at optimal -

I now aim for a ferritin at around 100 : folate at 20 : active B12 75 ++ ( serum B12 500 ++ ) and vitamin D up at around 100:

Looking back I see you are dealing with Hashimoto's auto immune thyroid disease and healing one's gut is the first step into being able to absorb and convert T4 thyroid hormone well - have you been checked for celiac as this is another AI health issue that tends to run alongside :

You might like to read around on Dr Izabella Wentz research and suggestions - thyroidpharmacist.com

[Loopnova in reply to pennyannie]

that’s really helpful, thanks.

I need to understand this conversion thing to properly speak to my doctor about it so this is useful.

Got some other results back.

Ferritin 245 (range 13-150)

Magnesium 0.91 (range 0.7-1)

Vit B - just says over 150. (Range 37.5-150)

Vit D - 83 ( range 50-200)

If I mention of this to the doctor they just say that it all looks fine. Whereas on here, people say we need more than normal due to not absorbing as well.

[pennyannie in reply to Loopnova]

Probably because doctors do not have any other treatment ptions to ofer you.

20 odd years ago doctors could prescribe T3 and also Natural Desiccated Thyroid which contains all the same known hormones as that of the human thyroid gland and derived from pig thyroids dried and ground down into tablets referred to as grains.

Currently you need a referral to an endocrinologist for any treatment option other than T4 - Levothyroxine and unfortunately CCG/ICB NHS financial constraints rather then medical need seem to be applied throughout the country.

Ferritin looks a but high but this could be due to inflammation which is common with Hashimoto's AI disease ?

Can't see a folate reading ?

[Loopnova in reply to pennyannie]

Is it serum folate? That’s 12.6 ug/l (range 5.4-24)

Yeah maybe inflammation. I do have a very mild case of psoriatic arthritis too.

[pennyannie in reply to Loopnova]

Might be worth asking the doctor just to put your mind at rest :

[McPammy]

Your T4 is above the highest point in the level. Once you take your t4 med after the blood draw it’ll go even higher. I can’t tolerate over range T4. In fact I need it pretty low. 8.5 (7.5- 14.4) that’s without taking levo before my blood draw. Once taken it’ll go higher. I take t3 medication also and my level ‘with taking’ the T3 before a blood draw is 5.6(3.7-6.0). My TSH last time was 0.89(0.35-5.5). I feel much better when my levels are within range and my TSH also. When out of range I feel pretty awful. We are all different I guess. I just try to mimic a healthy persons thyroid result.