Help with latest test results & suggestions on possible next steps 🙏

[J972]

I’d really appreciate your thoughts and personal insights into my latest test results, carried out using Randox on 9.10.23:

TSH 1.44 mU/l (0.35-5.5)

FT4 18.2 pmol/l (11.9-21.6)

65% through range

FT3 3.96 pmol/l (3.1-6.8)

23% through range

(Antibodies tested, both within range)

I started Levothyroxine at the end of July (self-sourced) and have slowly built up the dose to 62.5mcg which I’ve been on for at least 7 weeks. Attempts to increase the dose results in intolerable side effects.

I’m feeling worse than ever. Completely exhausted all the time. Levothyroxine has provided no relief whatsoever and throughout the summer I acquired awful gut problems, with associated pain and reflux. Sometimes my body feels so inflamed, everything hurts. I’m now on a very limited diet. Have eliminated gluten, dairy, soy, coffee. I’ve been to the drs about the gut issues and am scheduled to have an endoscopy next Monday. At the GP appointment, I pushed for testing for H.Pylori, I got the impression this was an unusual request but in the end he arranged for a stool sample test which has come back negative. I also asked about SIBO, he’d never heard of it but, to his credit has written to the gastroenterologist at my nearest hospital for advice on a clinical pathway for that. At the appointment I also asked him to examine my neck for any thyroid nodules, he didn’t detect anything but did offer the comment that I “seem particularly fixated on my thyroid” and has referred me for an ultrasound. I remain undiagnosed from an NHS point of view.

So in addition to my FT3 being very low in range, suggesting (I think) poor conversion, I also recently arranged for my cortisol and DHEA to be tested. I posted the results here but to be honest didn’t get a huge amount of feedback. Here’s the original post:

healthunlocked.com/thyroidu...

My cortisol is less than optimal and my DHEA is way below range. I’d really welcome thoughts and suggestions on these results, particularly in conjunction with my recent thyroid results.

Ferritin continues to be stubbornly difficult to raise, despite supplementing with Three Arrows and increasing my consumption of beef.

June 2023 - 42ug/L (23-300) NHS

July 2023 - 62.8ug/L (13-150) medichecks

August 2023 - 26ug/L (23-300) NHS

I had a FIT test in August and this was negative.

Previous thyroid test results, for reference/comparison:

April 2023 Randox

TSH 3.06 (0.35-5.5)

FT4 15.7 (11.9-21.6)

FT3 4.17 (2.8-6.5)

June 2023 NHS

TSH 1.89 (0.35-4.94)

FT4 10.1 (9-19.1)

FT3 not tested.

At the time of the above two tests I was trying to self treat with thyroid S plus a small amount of metavive (which I’d started out with earlier in the year but wanted to see how I felt on NDT). I struggled to increase the dose, again due to horrible side effects.

I’m becoming increasingly despondent and worried that I’ll never regain my health. Please help if you can. Thank you 🙏

[SlowDragon Administrator]

Your conversion is poor

As TSH has reduced Ft3 has reduced too

What are vitamin D, folate and B12 results

Have you done ultrasound scan of thyroid

Have you got any T3?

If yes what size tablet

Suggest you cautiously add 2.5mcg T3

Either waking or mid morning

If that’s ok

After 3-5 days add 2nd 2.5mcg dose T3 mid-late afternoon

Wait 6-8 weeks and retest

[J972 in reply to SlowDragon]

Thanks slowdragon, I was hoping you’d say that.

I don’t have really recent blood test results for B12/folate/vit D but this is what I’ve had done in the last few months. I supplement with vitamin B complex daily and vitamin D maybe 2-3 times a week:

Vitamin D 13 June 2023: 114nmol/L (50-120)

Folate 17 August 2023: 7.5ug/L (3.1-20.5)

B12 17 August 2023: >2000 ng/L (187-883). I was supplementing

Ultrasound appointment just came through, remarkably it’s for this Friday.

I don’t currently have T3 but am prepared to source. Probably best to create a separate post for that later, right?

Edit: do you suggest that I keep on the current dose of Levothyroxine when starting T3?

Thanks again 🙏

[SlowDragon Administrator in reply to J972]

Edit: do you suggest that I keep on the current dose of Levothyroxine when starting T3?

Yes …only 65% through range

Ft4 Likely to drop a little when adding T3

[J972]

Thanks very much.