Blood test results

[Simba53]

I’d really appreciate your comments on my recent blood test results. I’m current taking 75 mcg Levothyroxine and Liothyronine at 10 mcg morning, 5mcg evening. TSH is very low - which I was expecting. Endo was very reluctant to increase Levo from 50 mcg to 75 mcg. However on the higher dose I’m practically symptom free and feel like I’ve got my old life back - plus I have lost a stone, which I’m delighted about. Any comments would be gratefully received. Thank you.

[SeasideSusie Remembering]

Simba53

Did you take last dose of Levo 24 hours before test and last dose of T3 8-12 hours before test?

Do you take any supplements?

If taking B Complex or Biotin in any supplement did you leave this off for 3-7 days before the test?

Folate: 16.2 (8.83-60.8)

Folate is recommended to be at least half way through range so that would be 35 plus with that range. Yours is low and could do with increasing.

Active B12 just into the range we suggest, ie 100 plus, so that's OK.

Vit D at 106 or 108 (image a bit blurred) is just into the range that's recommended, ie 100-150nmol/L, and as it's now summer you may be able to make Vit D naturally from the sun. It would be worth testing Vit D at the end of October to see if you need to supplement (or increase dose if already supplementing) during the winter months.

Ferritin looks OK but I can't take Inuvi's range seriously I'm afraid. Some say ferritin should be half way through range although some experts say that the optimal ferritin level for thyroid function is 90-110ug/L.

Your FT4 is quite high for someone on combination thyroid hormone replacement, but where we need our FT4 and FT3 is very individual so if that's right for you that's fine. I'm on combo meds and I need FT4 and FT3 better balanced at around 60-70% through range, others are fine with a low FT4 as long as FT3 is in the upper part of it's range.

If you're well and symptom free on these doses then resist any change.

Your antibodies confirm Hashi's which I expect you know.

[Simba53 in reply to SeasideSusie]

Hi. Thanks for your reply. I take Vit D with K2 as a spray. I sporadically take a B complex spray as well but unfortunately when I’m feeling well I tend to forget! I also did the usual protocol regarding my levo and Liothyronine meds prior to testing.

I’m expecting the Endo to try and reduce T3 at my next appointment. Do you think a reduction of 5 mcg Liothyronine would make a huge difference? I think I’ll struggle to get him to increase back up again once the dose is reduced if I start to be symptomatic again . Also I definitely don’t want to regain the weight I’ve just lost! Thanks again.

[SeasideSusie Remembering in reply to Simba53]

5mcg liothyronine can make a huge difference to some people. It is one third of your dose so I expect you would definitely notice a difference and your FT3 would drop and it's currently only 44.32% through it's range.

Calculator here: thyroid.dopiaza.org/

If endo wants to reduce your dose of T3 ask him why when your FT3 is less than half way through range.

With those results if any change is made I would expect to see Levo dose lowered to bring your FT4 down a bit, that will possibly have the effect of lowering your FT3 a bit as well depending on how much natural conversion you may have. If necessary your T3 could be increased if FT3 reduces. It's very much a balancing act, trial and error and much tweaking of doses when on combo meds, lots of time and patience is needed.

With your folate level you really need to take your B Complex regularly, it's way too low.

[Simba53 in reply to SeasideSusie]

Hi. Thank you for that. Your comments are really interesting. I’m not happy to reduce T3 particularly after reading your comment. I think I’ll argue to stay on the same dose of Levo and Lio. Also I will definitely take the Vit B complex regularly. I’ve got a bit sloppy with the supplements. Thank you again. Your help, as ever, is invaluable for when I do battle with the NHS!