I am in need of help about my underactive thryoid

[charliepickle]

I had been a member a long time ago and got some fantastic help, so I'm back again but can't remember my old log in so joined again,

I am having trouble with my doctors. These are my results for the last few blood tests.

Aug 2022

Serum TSH level (XaELV) 0.01 miu/L [0.35 - 4.9] - Below low reference limit Information about this test

Serum free triiodothyronine level (XaERq) 5.7 pmol/L [2.4 - 6]

Doctor stopped me taking 25mcg of Levothyroxine so now only taking 50mcg.. Also taking 3/4 tablet of T3.

Jan 2023

FREE T3 AND TSH Report, Satisfactory, No Further Action. Review not applicable

Serum free triiodothyronine level (XaERq) 3.7 pmol/L [2.4 - 6] Information about this test Serum TSH level (XaELV) 0.56 miu/L [0.35 - 4.9] Information about this test

Aug 2023

Serum free triiodothyronine level (XaERq) 5 pmol/L [2.4 - 6] Information about this test

Serum TSH level (XaELV) 0.26 miu/L [0.35 - 4.9] - Below low reference limit Information about this test

Serum triglyceride levels (XE2q9) 0.72 mmol/L [0.4 - 1.5]

Sept 2023

FREE T4+FT3+TSH Report, Abnormal, No Further Action. Review not applicable

Serum free T4 level (XaERr) 10.6 pmol/L [9.1 - 17.6] Information about this test

Serum TSH level (XaELV) 0.22 miu/L [0.35 - 4.9] - Below low reference limit Information about this test

Serum free triiodothyronine level (XaERq) 4.3 pmol/L [2.4 - 6]

Since stopping the 25mcg my weight has increased by a stone and I can't shift it so I'm not happy.

I hope somebody can shed any light on this for me.

Thank you Carol

[Jaydee1507 Administrator]

Likely the issue is your doctor is trying to keep your TSH within the referene range which will result in free hormone numbers that are too low.

Free T4 (fT4) 10.6 pmol/L (9.1 - 17.6) 17.6%

Free T3 (fT3) 4.3 pmol/L (2.4 - 6) 52.8%

Many people on a combination dose need both FT4 & FT3 at around 70% to feel well.

What size T3 tablets do you have?

Do you spilt your dose?

Did you take this test as we recommend here? Last Levo 24hrs & T3 8-12hrs before the test?

This shows stable hormone levels as opposed to the peak after you take it.

What supplements are you taking?

What are you most reent results for ferritin, folate, B12 & D3?

Lots of questions but the more you can answer the better guidance we can give you.

[charliepickle in reply to Jaydee1507]

T3 - Tiromel 25mcg. I take 3/4 of a tablet. I take this with my Levothyroxine before bed.

Supplements- D3 4000iu, Chelated magnesium 4 times a day,

Selenium 200ug + Vits A-C-E, K2 100mcg. I take these in the morning

B12 -5000mcg with my dinner in the evening

I attach my blood test results:-

Differential white blood cell count;Urea and electrolytes;Liver function tests;Serum lipid levels;Serum ferritin level;Haemoglobin A1c level;EGFR (F) / 1.73M2;TOTAL PROTEIN ONLY Report, Abnormal, Need to speak to doctor. Review not applicable

Lymphocyte count (42M..) 1.32 10^9/L [1 - 4]

Monocyte count - observation (42N..) 0.37 10^9/L [0.2 - 1]

Differential white blood cell count (42I..) Information about this test

Neutrophil count (42J..) 2.11 10^9/L [2 - 7.5]

Eosinophil count - observation (42K..) 0.07 10^9/L [0 - 0.4]

Serum sodium level (XE2q0) 138 mmol/L [133 - 146] Information about this test

Serum potassium level (XE2pz) 4.7 mmol/L [3.5 - 5.3] Information about this test

Basophil count (42L..) 0.04 10^9/L [0.01 - 0.15]

Urea and electrolytes (X77Wi) Information about this test

Total white blood count (XaIdY) 3.91 10^9/L [4 - 11] - Below low reference limit Information about this test

Platelet count - observation (42P..) 341 10^9/L [150 - 450] Information about this test

Full blood count (424..) Information about this test

Haemoglobin concentration (Xa96v) 124 g/L [115 - 160] Information about this test

Red blood cell count (426..) 4.37 10^12/L [3.8 - 5.8] Information about this test

Mean cell haemoglobin level (XE2pb) 28.4 pg [27 - 38]

Mean cell haemoglobin concentration (429..) 32.5 g/dL [30 - 35] - This value has been converted from: 325.0 g/L

Haematocrit (X76tb) 0.381 [0.35 - 0.47] Information about this test

Mean cell volume (42A..) 87.2 fL [84 - 102]

Serum urea level (XM0lt) 5.5 mmol/L [3.5 - 7.2] Information about this test

Serum ferritin level (XE24r) 13 ng/ml [5 - 204] - Ferritin <15ug/L is indicative of iron deficiency Information about this test

eGFR using creatinine (CKD-EPI) per 1.73 square metres (XacUK) > 90 mL/min [60 - 200]

eGFR is not valid in AKI, dialysis and pregnancy.

Measure urine ACR at least annually for

individuals with CKD. Use kfre.co.uk to

predict risk of future kidney replacement therapy.

Serum total protein level (XE2e9) 74 g/L [60 - 80] Information about this test

Haemoglobin A1c level (X772q) Information about this test

Haemoglobin A1c level - IFCC standardised (XaPbt) 39 mmol/mol [20 - 41]

Interpretation of HbA1c in screening for Diabetes

Serum alkaline phosphatase level (XE2px) 69 iu/L [40 - 150] Information about this test

Serum alanine aminotransferase level (XaLJx) 29 iu/L [0 - 40] Information about this test

Serum creatinine level (XE2q5) 47 umol/L [49 - 90] - Below low reference limit Information about this test

Liver function tests (X77WP) Information about this test

Serum total bilirubin level (XaERu) 8 umol/L [0 - 21] Information about this test

Serum cholesterol level (XE2eD) 6.8 mmol/L Information about this test

Serum triglyceride levels (XE2q9) 1.5 mmol/L [0.4 - 1.5] Information about this test

Serum albumin level (XE2eA) 41 g/L [35 - 52] Information about this test

This is all I found from my patient records

Thank you

Carol

[Jaydee1507 Administrator in reply to charliepickle]

I'm afraid I can't comment on cholesterol, liver, kidney or full blood count results.

200ug of selenium is quite a lot to be taking and its possible to take too much. It might be an idea to take a break from that for a month or two then restart on 100ug 5 days a week.

Magnesium needs to be taken well away from other supplements and meds to avoid absorption issues. I there a reason you split the dose?

We usually recommend a b complex as opposed to a stand alone B12 which would help keep all the B's in balance. It would also contain folate which you currently aren't supplementing and is important. I'll list 3 that are methyl form that you might want to choose from.

amazon.co.uk/Liposomal-Soft...

amazon.co.uk/Yipmai-Liposom...

hempoutlet.co.uk/vitablosso...

An increase in Levo would help.

[SlowDragon Administrator]

T3 - Tiromel 25mcg. I take 3/4 of a tablet. I take this with my Levothyroxine before bed.

Does your GP know you take T3

Ft4 is far too low

You need 25mcg dose increase in levothyroxine

Retest in 6-8 weeks

You may find it better to split T3 as 3 x 5mcg - 5mcg waking, 5mcg mid afternoon and 5mcg at bedtime

Why are you taking magnesium 4 x a day…..once a day should be sufficient (four hours before levothyroxine)

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

Essential to test folate, ferritin and B12 at least annually

Ideally test vitamin D twice year

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

On T3 - day before test split T3 as 2 or 3 smaller doses spread through the day with last dose 8-12 hours before test

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/wp-content/up...

Tips on how to do DIY finger prick test

healthunlocked.com/thyroidu...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

Just TSH, Ft4 and Ft3 test - £32

monitormyhealth.org.uk/thyr...

10% off code here

thyroiduk.org/getting-a-dia...

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65

(Doesn’t include thyroid antibodies)

monitormyhealth.org.uk/full...

10% off code here

thyroiduk.org/getting-a-dia...

On almost any dose of T3 your TSH is likely to be extremely low or suppressed when adequately treated

You will need an endocrinologist to ok this, or your GP will just keep lowering Levo dose making you even more hypothyroid

and get endocrinologist to prescribe T3

List of thyroid specialists and endocrinologists who will prescribe T3

healthunlocked.com/thyroidu...

[Chriskisby]

Doctors will not let go of the mania with TSH levels! I have had some fantastic support here because mine are always very low and they were desperate to reduce my levothyroxine. I paid for a full blood test as the NHS won’t test T3, and everything else was fine, except my TSH. I waited 6 weeks for a GP appointment and took all my evidence with me, including the private blood test (though, interestingly it was never added to my records!) and explained everything to him. He actually listened, and now says he wants to see my blood tests in future, and no need for another one for a year. Good luck with yours.