latest results

[Milkyway88]

Morning All

My latest results from MMH.

TSH - 28.6 (0.27-4.2)

T4 - 14.6 (12-22)

T3 - 2.9 (3.1-6.8)

Previous Jan 23

TSH - 0.09 (0.27-4.5)

T4 - 21.5 (11-23)

T3 - 4.54 (3.1-6.8)

No vitamins this time, previously deficient in Vit D, but was coming up nicely last time after following advice on here. In range but Low in B, self-treating for that.

GP appointment last week - he has asked for NHS blood test (admitted I should’ve been recalled earlier) and further appointment. Could do with an iron panel, and will ask the nurse nicely next week at blood test. (Previous ferritin 40, 20-260)

Last appointment was March (no testing) when dosage of Levo was reduced to 75! That GP agreed I need to see an endo, but he has since left.

25 years of yo-yoing Levo post RAI.

Latest GP refused to refer and asked what an endo can do for me. He laughed when I suggested a trial of T3. (I’m splitting my sides here, mate). Cut me dead when I tried to list the physical symptoms and only wanted to take me through a mental health questionnaire. Really don’t know what to say at the next appointment.

Happy to find my own endo and have scoured the list on here. If anyone has their own recommendation/suggestion of a competent and sympathetic endo please private message me. Would be great if there’s one in the Humberside/Lincs/Yorkshire area, but I will travel. Have family in Oxford and very impressed with JR hospital if there’s one there.

I’m not following a special diet other than being vegetarian. I did try cooking liver, but couldn’t face it - the dog had a beano that day.

Finally, is it possible to purchase T3 over the counter in Germany or Holland, and if so is there an issue at customs?

Thanks, lovelies.

[SlowDragon Administrator]

What dose levothyroxine were you on BEFORE dose was reduced in January

There was absolutely NOTHING wrong with January results

Clearly been reduced completely inappropriately

Essential to test vitamin D, folate, B12 and full iron panel test for anaemia including ferritin

[Milkyway88 in reply to SlowDragon]

I was on 100 Levo, but still symptomatic. Before that it was 150 as TSH had crept to 13.5 (April 21). Has been gradually reduced from then. My symptoms tend to present more as hyper, which confuses me to be honest, but gps don’t take it on board. Similar pattern in the 2 previous years too. Generally, over the years, T4 has been in the upper range, but I only started private testing recently so can’t track T3 for long.

[SlowDragon Administrator in reply to Milkyway88]

I was on 100 Levo, but still symptomatic

FT4: 21.5 pmol/l (Range 12 - 22)

Ft4 was 95.00% through range

But

FT3: 4.54 pmol/l (Range 3.1 - 6.8)

Ft3 only 38.92% through range

So poor conversion rate

So next step would be to test vitamin levels

For good conversion on Ft4 to Ft3 we need optimal vitamin levels

Essential to maintain GOOD vitamin D, folate, ferritin and B12

When were these last tested

What vitamin supplements are you taking

As a vegetarian you will need to take daily B12

Likely to need iron supplements…..but must get full iron panel test BEFORE considering any iron supplements

And trialing gluten free/dairy free always worth considering

[Milkyway88 in reply to SlowDragon]

yes I wonder about conversion, given that T3 is low this time.

I’m on Vit D +k2 (4000), vit B Complex with biotin and folic acid and magnesium taurate. (1000).

Given that my diet is quite restricted, I’ve put off giving up dairy and gluten, but will remain open to trialling it when vitamins are better and I’ve more energy to think about it.

If not for this forum, I wouldn’t have considered testing vitamins and so would still be D deficient. Sad that GPs don’t consider it.

Thanks SD. Hoping for some endo messages. 😀

[SlowDragon Administrator in reply to Milkyway88]

You shouldn’t need vitamin B complex and folic acid

But you might need separate B12 as well as vitamin B complex as you are vegetarian …..perhaps 3-4 days week

Obviously essential to test full iron panel including ferritin

[SlowDragon Administrator]

If GP says " I have to reduce your dose because the guidelines say i can't let you have a below range TSH" .....

The first paragraph in the NICE (NHS) Thyroid Disease, Assessment and Management guidelines says :

nice.org.uk/guidance/ng145

"Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. "

TSH should be under 2 as an absolute maximum when on levothyroxine

gponline.com/endocrinology-...

Graph showing median TSH in healthy population is 1-1.5

web.archive.org/web/2004060...

Comprehensive list of references for needing LOW TSH on levothyroxine

healthunlocked.com/thyroidu....

T4 therapy

ncbi.nlm.nih.gov/labs/pmc/a...

In a study evaluating tissue function tests before total thyroidectomy and at 1 year postoperatively when using LT4, it was found that peripheral tissue function tests indicated mild hyperthyroidism at TSH <0.03 mU/L and mild hypothyroidism at TSH 0.3 to 5.0 mU/L; the tissues were closest to euthyroidism at TSH 0.03 to 0.3 mU/L [48]. A normal serum TSH level consequently does not necessarily indicate a euthyroid state at the tissue level.