Please can anyone help with my latest blood results

[Piglet1956]

Ranges TSH 0.35-5 mu/l

Free T4 9-21 pmol/l

Free T3 pmol/l

This is so weird - just had results back - endo reduced my dose from 100/75 Levo and 2 x 5 Lio following on from the April blood results. Now my T4 and T3 have gone through the floor! I'd been having some symptoms and had hoped to persuade endo to increase Levo back to 100/75mcg, but hadn't expected this level of reduction.

The usual protocol was followed - blood taken at 9am, Levo 24hours before and T3 10.5 hours before. Vitamins are all good. Only change since April bloods is I stopped taking selenium as I was taking far too much and started taking zinc. Also started Amino Acids at the same time.

I have been on T3 since August 2022. My bloods haven't been this bad since I was on 50mcg Levo only in February 2021.

All comments gratefully received.

[SlowDragon Administrator]

Get dose increase in levothyroxine back to 100mcg and 75mcg alternate days

Are both tablets the same brand?

[Piglet1956 in reply to SlowDragon]

Hello SlowDragon. Do you mean the same as I always had before or the 75 (50 and 25) and 100 all the same. Not sure. I'll check it out. Would 87.5mcg of Levo a week really make that much difference?

[SlowDragon Administrator in reply to Piglet1956]

I suspect you might need to go to 100mcg daily after next test

But endocrinologist will only be looking at low TSH

[SlowDragon Administrator]

4 months ago you were discussing reducing T3 to 7.5mcg in total per day

Did you do that or did you actually stay at 2 x 5mcg per day

[Piglet1956 in reply to SlowDragon]

I reduced for just one week then I realised that it was carbs and sugar that were causing my heart to thump. All stopped when I changed my diet. I just can’t process sugar the way I used too. Do you think that could have had an impact?

[SlowDragon Administrator in reply to Piglet1956]

No …too long ago

But if you have significantly reduced carbs very low this might have changed conversion rates of Ft4 to Ft3

[Piglet1956 in reply to SlowDragon]

I’m not sure how the endo will respond to these levels. Got a call from GP next week. TSH still suppressed so wouldn’t surprised me if he wants to reduce further. But I think there’s possibly a delay in TSH rising when T4 is reduced.

[SlowDragon Administrator in reply to Piglet1956]

Many many people find when T3 added that TSH becomes suppressed or extremely low

Ft3 followed by Ft4 are always most important results

[Piglet1956 in reply to SlowDragon]

Thank you. Just not sure which way to go next.

[SlowDragon Administrator in reply to Piglet1956]

Well you very likely need dose increase in levothyroxine - making sure all levothyroxine is same brand

Wait 6-8 weeks and retest

Then reassess

[Piglet1956]

thank you - increase even though my TSH will be negligible?

[SlowDragon Administrator in reply to Piglet1956]

Are your symptoms are worse on these results ?

Which brand of levothyroxine do you use

Perhaps try SMALL increase

75mcg 4 days and 87.5mcg 3 days

Are you on gluten free/dairy free diet?

[Piglet1956]

Yes symptoms are worse as well as some new ones. I am given Mercury Pharma for 25mcg and Almus for the 50mcg and this has been consistent. I have been gluten free since diagnosis in 2020. I tried dairy free for a few weeks in 2021 but noticed no difference so stopped.

[Picketywitch]

Endocrinologist I saw said T3 is permanently suppressed. No matter how much reduction in T3 it won’t recover. When will the medical professionals get uptodate with combination treatment. As I’ve commented before I had to give up work because a gp chose to reduce both my T4/T3 dose based on a comment from the path lab. Never mind my TSH has been very low for years.

Good luck. I know what it’s like to feel like you’re not being listened to. I’ve had a total thyroidectomy looking back if I could have managed without that being done knowing what I know now I wouldn’t have had it done. But it was a necessity.

[Piglet1956 in reply to Picketywitch]

Thank you for your comments Picketywitch. I hope you’re feeling better now. They do seem to make it up as they go along.