Feeling woefully undermedicated……

[J972]

Hi everyone,

A friendly nurse practitioner agreed to run some blood tests for me this week. I remain undiagnosed. I’ve been using Metavive since January and have been trying to switch over to Thyroid S for a couple of months. I’m finding it very difficult to increase my dose (unpleasant side effects) so am currently on just 80mg of Metavive II & 0.5 of a thyroid S tablet.

Results from this week (13.6.23), blood drawn bang on 9am, stopped biotin a good 10 days prior and thyroid meds imbibed early the previous day.

TSH level 1.89 mu/L [0.35 - 4.94]

Serum free T4 level 10.1 pmol/L [9.0 - 19.1]

T4 is very low. Would this account for my symptoms, which include joint and muscle pain/weakness, exhaustion, inertia, brain fog, swollen tongue, puffy eyes?

Ferritin continues to be inadequate 42 ug/L [23.0 - 300.0] and I’ve ordered a full iron panel. I think I’ve read that low ferritin can be a factor poor tolerance of thyroid medication. Can anyone confirm or elaborate on this?

They didn’t test B12 I’m afraid so I’m also going to get that sorted privately; I’m supplementing this using sublingual drops. Also taking b-complex (liposomal).

Vitamin D was tested and is now optimal so I’ll reduce the rate with which I’ve been supplementing:

Vitamin D 114 nmol/L [50.0 - 120]

Serum thyroid peroxidase antibody concentration 16.3 ku/L [0.0 - 34.0]

I’ve previously tested positive, indicating Hashomotos.

Please can I hear from you if you have any suggestions as to what I can do to improve. I’m feeling very low and fed-up, to be honest.

Thanks.

[SlowDragon Administrator]

You need to test TSH, Ft4 and Ft3 together

Test early morning.

Day before test split your dose ….half waking and half 8-12 hours before test

Come back with new post once you get results

Yes Ferritin is still low

[greygoose]

Would this account for my symptoms

Probably, indirectly, yes. T4 is basically a storage hormone that doesn't do much until it is converted into the active hormone, T3.

The thyroid does make some T3, but not as much as it makes T4 because most T3 comes from conversion. But, if your FT4 is low, the odds are the FT3 will be low, too. And, it's low T3 that causes symptoms.

As SlowDragon says, you need both FT4 and FT3 tested - plus antibodies - to get a clearer picture of what is going on.

[J972 in reply to greygoose]

Thanks. Yes it’s frustrating that it wasn’t tested.