Advice on results please

[MiniMum97]

(All my blood tests were taken fasting and early morning. I stop biotin a week before and all other supplements 5 days before (to be safe!). I take T4 and T3 - currently 100mcg T4 and 20mcg T3). I generally take my last dose of T3 24hrs then 12 hrs before my blood test, but this time it was about 22 hrs and 10hrs before. My last T4 was taken 22 hrs before. (I woke up late)).

So to my question:

I last felt most well in the few months before Christmas. My blood test before then was:

15 Sep 2022:

TSH - 0.46 (0.3-4.2)

FT4 - 15.6 (12-22)

FT3 - 5.39 (3.1-6.8)

I was taking 75mcg of T4 and 15mcg T3 at the time.

My HRT was increased to 3 pumps just before Christmas and then in early Jan I started feeling really run down, and by Feb thyroid symptoms were starting to return.

My next blood test was:

09 Feb 2023:

TSH - 1.32 (0.3-4.2)

FT4 - 13.2 (12-22)

FT3 - 4.3 (3.1-6.8)

Endo agreed that HRT was likely affecting absorption and increased both T4 and T3 to the current 100mcg and 20mcg respectively.

Symptoms improved and had another test in May:

15 May 2023:

TSH - 0.04 (0.3-4.2)

FT4 - 13.5 (12-22)

FT3 - 5.7 (3.1-6.8)

I felt OKish on this, but not quite as good as before Christmas - it's hard to pinpoint exactly why - I just didn't feel as "robust and perky" if that makes sense. So anyhow, endo left meds as is, and introduced LDN as I wanted to try taking that for some of my inflammatory symptoms such as chronic tendinopathy that started during my first period of underactivity but has not gotten any better regardless of where my thyroid hormones are at (I have Grave's disease (positive TSI) but have both periods of under and over activity.

I started the LDN end June during my annual leave (as I didn't know how it would affect me). I had some initial mild side effects but those wore off and have noticed a slight improvement in my eczema, and also my tendinopathy became much less painful.

At the end of my 2 weeks annual leave, I caught a bug and have not been able to shake it since. I have cold like symptoms, bit chesty, was very fatigued (but that has improved in last few weeks), constant headaches, sneezing, diarrhea etc etc. It's been two months now - it keeps seeming like it's going and then it comes back again. One of the symptoms I get when underactive is feeling run down, or like i constantly have a bug that drags on and on and I can't get rid of it, or am continually catching bugs.

So I have just retested and these are my results now:

18 Aug 2023:

TSH - 0.02 (0.3-4.2)

FT4 - 14.8 (12-22)

FT3 - 6.1 (3.1-6.8)

So slightly better than in May!

So I have a few thoughts:

1. I just have a tricky bug that won't go it's unrelated to my thyroid.

2. Does my balance between T4 and T3 need tweaking slightly - was wondering whether to ask for a slight increase to my T4 and decrease to my T3? I did feel better when my T4 was slightly higher at about 15.8.....

3. This started just after I started the LDN - however, I can't find anything suggesting that it could have this effect even anecdotally, and it seems that it might be having a positive effect on some of my inflammatory conditions so I'm struggling to see that it might also be having a negative effect on my immune system?

Any thoughts?

Thank you!

[Hedgeree]

Hi MiniMum97,

Do you have any vitamin D results?

When I've been very deficient I was continually ran down and seemed to get any bugs about. It would take forever to get rid of any colds I got. Also daily continuous headaches, worse in the mornings but they wouldn't really go completely.

Best wishes.

[SlowDragon Administrator]

Perhaps try small increase in levothyroxine…… try 12.5mcg 3 days a week and retest in 6-8 weeks see how much Ft4 increases

Do you split your T3 as 2 or 3 doses through the day

Might eventually need small reduction in T3 to 3 x 5mcg per day