My last bloods were in May where my TSH was 1.40 mU/L.
In April my TSH was 4.5.
I am on 150 mcg Levo. I seem to have settled around mid 1 TSH level. My question is, should we all be striving to get as close to 0 as we can? Or should I be content with where I am now? It’s took a long time to get to this position and I am finally feeling quite a bit better, not perfect but, better
Do I ask to trial yet another increase in Levo?
Bloods were taken 08:30 fasted with no Levo 24 hours prior FYI.
Thank you
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dexterholland91
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Can you pop the labs ranges on your post. Figures in brackets. They vary lab to lab.
You say you feel better but not perfect.... So that's an indicator that you are not quite there and would benifit from an increase but really need the lab ranges.
I had a full blood count drawn but they didn't do any vitamin stuff. I will have to wait until my next round of bloods.
Right now, I only take magnesium and Selenium. I was taking B12 everyday but as I've never shown low in B12 and the fact I didn't feel like they were doing anything, I dropped them. I do still have some though so can re-introduce if need be.
Yep, I know I have hashimoto's.
No, haven't tried gluten free. It's not an avenue I am willing to open up as of yet, I have too much going on elsewhere.
If we could just stick to my question about the TSH result if possible. If it's not that simple then that's fine
No, it’s not that simple. Your TSH level may be fine for you if your FT4 and FT3 were in a perfect place and you felt extremely well. The fact that “they” are not and you don’t feel on top of the world, then your TSH level is not fine. Once being treated with Levothyroxine, the important numbers are FT4 and FT3. Yours are not optimal regardless of where your TSH level is. I hope that answers your question.
If we could just stick to my question about the TSH result if possible. If it's not that simple then that's fine
Sorry but it's not that simple and if you focus on TSH then you are likely to continue to struggle I'm afraid....and that's not fine!!
But to start there...when medicated TSH should be 1 or less....so, for a start 1.83 suggests undermedication.
TSH is a pituitary, not a thyroid, hormone.
It reflects the overall hormone level ( FT4 + FT3) but not the level of each hormone which is the important point
Looking at your thyroid labs you need more than an increase in levo dose.
FT4 is 53% through the ref range
FT3 is 29.17% ditto
Both are too low...we aim to have each Free roughly approaching 75% through range....with the caveat that we are all different so this varies a little.
Your T4 to T3 conversion is poor..... indicated by high(ish) FT4 with comparitively low FT3
For good health almost every cell in the body needs to be flooded with T3 in a constant and adequate supply....your T3 supply is miserably low and symptoms will result.
Low cellular T3 = poor health.
Have you optimised vit D, vit B12, folate and ferritin in order to support thyroid function/ conversion....if not it's vital you do so.
Your current labs suggest you initially need to raise your T4 dose to 175mcg....you can do this because your FT4 lab leaves room for an increase. But...
(I'd be cautious of just ramping up T4/levo....there is a possible cancer risk( research) with high levels of T4....so we need to consider T3 medication as an alternative)
Test again after at least 6 weeks on a steady dose of Levo and while addressing nutrient levels
Those labs will point the way forward tho I suspect you may have to add some T3 at a later date....post new labs for advice.
Suggest you read the following which further explains my comments about focussing on TSH!!
Our aim is to recover so we need to address more than TSH which is not a reliable marker, it fluctuates throughout the day... and, more so if Hashi's is a factor. So you also need to consider a GF diet
Thyroid disease is not an easy road to travel, it is long and slow, but there is light at the end if correctly and adequately treated.
I have been asked to contribute to this thread as I have " experience " with levothyroxine. Yes I have been taking it for over 40 years, many of them very successfully ,guided by a GP who listened and observed, knowing that my self monitoring was based on some knowledge( I was a practising veterinary surgeon for over 45 years). Blood tests were few and far between. Then she retired and the new regime were hell bent on getting my TSH up to top "normal" regardless of anything else. Meanwhile I had developed several other auto immune diseases and seen many consultants who blamed each other for any inadequate responses to treatments. I reached a nadir during lockdown when one trainee GP reduced my Levo by 40% overnight, when my stocks were low and I had to acquiesce, based on a single TSH result taken in imperfect conditions due to Covid. I begged for more without result and eventually after 12 months of hell,a kindly Rheumy consultant, seeing my distress, did an internal hospital referral to an Endo consultant who listened to me and blasted my GP out of the park. Things are not perfect now, too much reliance still on TSH, and an unexplained refusal to try T3 even though I obviously convert very poorly, but much better than before and I do feel listened-to. Sorry if this does not answer the question but I think it may express the feelings of many who struggle with an imperfect system, through no fault of our own.
Thank you so much for all the comments. It has been an eye opener.
When my blood results come back, all my Dr ever looks at is TSH and always just says it's normal and within range. It's been through this website and my own persistence that has got me to where I am in the first place!
I am going to take all this info and go see the Dr again. Luckily, he's a young lad like me and understands my frustrations and is generally willing to do whatever I suggest.
Firstly I am going to mention trialling 150 and 175 Levo alternate days. But I want to cautious as I dont want to just keep upping my Levo if that's not the real answer.
Could staying at 150 but trialling GF for a while make me be a better converter perhaps? Am I a poor converter because of me having hashimoto's and my gut acid levels being high?
I guess what I am asking is, what is the best way to get my FT3 and 4 levels optimum?
Thank you so much...I feel like I am back to drawing board where in fact I actually thought I was nearly there
I went to see the GP yesterday. I printed off this entire thread and my GP read through it word for word! She was so open and honest about knowing that GP's don't have enough knowledge on this subject matter. It was actually really refreshing to hear.
So, as expected, she couldn't prescribe me T3 right there and then. She has written to the ENDO with my latest TFT's plus my symptoms as well as all the vitamins I take. So I am hoping the endo actually looks into my results rather than just seeing they are in the "normal" range,
The GP literally asked me "so, what do you want to do now?" I said, I want to go up to 175 Levo and she didn't question it and wrote up my prescription.
I shall go back in 6 weeks and see what the TFT's are saying.
I shall update if I hear anything back from the Endo.
I am already on a B12 complex as well as a separate B12.
My ferritin was at the lower end of the scale last time I had it checked in april-ish. Just not sure what to do to bring it up. I'll get it re-tested soon and see if I am making any progress.
Extremely difficult/impossible to maintain goods ferritin with Hashimoto’s on vegetarian diet
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron
Medichecks iron panel test
Test early morning, fasting. If on iron supplements stop 5-7 days before test
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Just had my latest round of bloods after a 25mcg increase from 150 to 175 daily.
Pre increase: (still didnt feel right at all)
TSH - 1.83 mU/L (TSH range - 0.30 - 4.20)
T4 - 14.3 pmol/L (T4 range - 9.0 - 19.0)
T3 - 3.7 pmol/L (T3 range - 3 - 5.4)
New bloods:
TSH - 0.74 mU/L (TSH range - 0.30 - 4.20)
T4 - 17.6 pmol/L (T4 range - 9.0 - 19.0)
T3 - 4.0 pmol/L (T3 range - 3 - 5.4)
I also made 2 very tough decisions at around the same time of the medication increase..
After 4 years of not eating meat and VERY little dairy I started to eat meat again.
I am also 6 weeks into being gluten free - This is proving to be very difficult and a real life style changer BUT I am feeling the best I have in probably 2 years.
Also, my B12 is up and so is ferritin. But iron as a whole has slightly dropped.
In my last round of bloods the observation was made by you guys that I was a pore converter of T3, do we think this is still the case with my latest bloods?
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Latest Blood Results (Thyroid & Iron)... Thoughts On Levels Gratefully Appreciated 😊
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