Latest results

[RoseF3]

Hi,

Could someone give me some advice as to my results? I’m feeling pretty good at the moment but still have a lot of water retention although this has improved slowly. I sometimes get that overwhelming tiredness in the afternoon. Should I carry on as I am or do you think it’s worth dropping some T3 and increasing the T4 to see if it helps the weight?

I currently take 50mcg T4 and 15mcg T3. I split the T3 so 10mcg in the morning and 5mcg in the afternoon.

[Jaydee1507 Administrator]

As you can see your FT4 is below range so barely doing anything at the moment. On a combination dose many people need FT4 at 70% of range.

Your FT3 is at 54% of its range and many people need it at 70% roughly to feel well.

So you are under replaced for both hormones but increasing Levo may be enough to bring both hormones back to where they may need to be.

There's no need to reduce T3 although an increase of Levo will bring your TSH below range. On a combination dose that works people will have a low if not suppressed TSH.

How are your vitamin levels looking?

What supplements are you taking?

[SlowDragon Administrator]

Ft4 is below range

Suggest you increase levothyroxine by 25mcg

Leave T3 at 10mcg at moment

Retest thyroid levels in another 6-8 weeks

essential to test vitamin D, folate, ferritin and B12 at least annually

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

On T3 - day before test split T3 as 2 or 3 smaller doses spread through the day with last dose 8-12 hours before test

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/wp-content/up...

Tips on how to do DIY finger prick test

healthunlocked.com/thyroidu...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

[RoseF3 in reply to SlowDragon]

Thank you, I think I just assumed if I increased the T4 then my T3 would go over range - I guess you don’t know unless you try! I’ve now upped to 75mcg of T4 and kept the T3 at 15mcg.

My vitamin levels were recently checked by the GP and after nearly 2 years are finally at very good levels! The GP was not very happy with my TSH and T4 being abnormal and have insisted I book an endocrinology appt.

[SlowDragon Administrator in reply to RoseF3]

Comprehensive list of references for needing LOW TSH on levothyroxine

healthunlocked.com/thyroidu....

onlinelibrary.wiley.com/doi...

If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).

on combination therapy it’s very common for TSH to be very low or suppressed

[RoseF3 in reply to SlowDragon]

Thank you, this is very helpful!