Hi, I would like some help with interpreting my latest results please with a view to understanding where I go from here. You will see from my profile that I upped my dose of Levo from 25mg to 50mg 2 months ago after advice from this group. Here are my last 3 sets of results which show some but no substantial movement.
All ranges are TSH 0.27-4.2 MU/L T4 12-22pmol/L. T3 3.1-6.8 pmol/L
13th Mar - TSH 4.71 T4 15.8 T 3 4.5 12th July - TSH 4.5 T4 16.6 T3 4.0 22nd Sept - TSH 3.11 T4 16.2 T3 4.3
All tests were taken before 9am, with only water before and more than 24 hrs since last Levo dose and any supplements.
My iron & vitamin levels are all ‘normal’ except for D3 which is now high (102 nmol/L) However, folate (10.6 Ug/L) & Vit B12 (62 pmol/L) are lower than they were in March.
I still feel low energy/tired, have some joint pain, my hair has been shedding a lot in the last few weeks and my nails lift from the nail bed (had this issue for a few years). So not optimal.
My question is, should I look to increase my dose again or stay where I am and see what the results look like in another couple of months? Interesting that my T3 levels are lower than they were in March when I was only on 25mg 🤔
Will be grateful for any guidance you can give.
n.b. My tests for antibodies show they are very low in the normal range
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Flamingo60
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Those symptoms you mention(joint pain,thinning hair and splitting/lifting nails)are common when under medicated.Some of the admins will hopefully be on soon to advise better but 50mcg is still a very low dose.They will probably advise increase to 75mcg daily then retest in two months.Its also recommended on here that tsh ideally be around 1 and defo no higher than 2.We are all different but I’m just getting back to myself now with tsh of 0.27.
Once hypothyroid we generally feel best when our T4 is towards/in in the top quadrant of it's range at around 70/80 % as this then should convert to a decent level of T3 tracking behind the T4 at around 60/70 % :
Currently your T4 is at 16.20 with a T3 at 4.30 with a TSH at 3.11 :
Your T4 is at just 42% through the range so suggest you need a dose increase of 25mcg daily T4 and retest in6-8 weeks again.
When T4 is not high enough in the range the body preserves the the T3 reading at the expense of T4 - so the T3/T4 readings can look inverted.
There is little point tracking or looking at T3 / T4 ratios until your T4 is up in the top quadrant and you have enough circulating T4 to readily convert to T3 without causing your body undue stress.
When taking T4 monotherapy the TSH needs to be under 2 and when optimally medicated the TSH will likely be under 1 and towards the bottom end of the TSH range and this will happen as you slowly increase your dose of Levothyroxine.
No thyroid hormone replacement works well until your core strength vitamins and minerals are maintained at optimal -
I now know i need to aim for a ferritin at around 100 : folate around 20 : active B12 75 ++ ( serum B12 500 ++ ) and vitamin D at around 100 :
What was your original diagnosis - sorry - I should have looked back before I started writing and if I do now - I'll loose what I have written.
Good morning pennyannie thanks for your help. My initial diagnosis was TSH 9.91 T4 15.3 and T3 1.6 in Sept 21. I was taking 25mg every other day for a while, then upped to 25mg daily until mid July when I increased to 50mg.
Yes antibodies were checked at that time and NAD. Had them rechecked in July and the results were Thyroglobulin 32.7 klU/L (0-115) Thyroid Peroxidase <9 klU/L (0-34)
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement and a week later add a separate vitamin B Complex
Then once your serum B12 is over 500 (or Active B12 level has reached 70), you should be able to reduce then stop the B12 and just carry on with the B Complex.
If Vegetarian or vegan likely to need ongoing separate B12 few times a week
Igennus B complex popular option too. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12 until Active B12 is at least over 70
Post discussing how biotin can affect test results
Good morning SlowDragon thanks for your help. I am currently taking Accord Levo. Have previously been on other brands. My iron & ferritin results are: HB 145 g/L ferritin 67 ug/L and TSat 36%.
Just been reading your responses to a number of questions from different people - thankyou so much for sharing your wealth if knowledge! You're more informed than GPs+even the Endi I saw once before she discharged me!! So very grateful to what I am learning from such knowledgeable Admins.❤️
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