Help with test results

[sunbee]

I am feeling a bit better, not so spaced out, no depression or dizziness.

I stopped HRT in July.

However, I do still get tired, have weight problems, have a swollen scalloped tongue, high cholesterol, goitre, tinnitus, joint stiffness. I am on 100mg Levothyroxine.

I take B complex, B1, selenium, zinc, 3 x 1,500mg vitamin C, digestive enzyme with meals, Co-enzyme 10, Probiotic, magnesium.

Please can somebody help me with thyroid test results?

I weigh 11 stone 7

For my weight I should be on a higher dose?

Do I have T4 to T3 conversion problem?

Would I benefit from a small T3 trial?

I have attached my last 4 Thyroid function tests.

Thank you.

[Jaydee1507 Administrator]

Free T4 (fT4) 19.8 pmol/L (12 - 22) 78.0%

Free T3 (fT3) 4.1 pmol/L (3.9 - 6.7) 7.1%

What time of day was your last test & did you remember to leave 24hrs between last Levo dose & blood test?

Your conversion really isn't the best.

You do have room for a Levo increase although not likely to improve your FT3 hugely.

Do you also take vit D & K2?

What were your last results for ferritin, folate, B12 & D3?

Its best to optimise all vitamins before thinking about adding T3 as otherwise it might be difficult to tolerate.

You could email [e-mail] for a list of T3 friendly Endo's. Pick one or two then make a post asking for feedback on them ,which will be locked and people can send you info by personal message.

[sunbee in reply to Jaydee1507]

Apologies Jaydee1507! yes, I do take 4,000 vitamin D with Vitamin K2 together with magnesium but not with the other vitamins.

Blood taken 9am in the morning, on empty stomach, 24 hours after previous dose.

23 Jan 2023

Serum ferritin 38 ug/L 30 - 148ug/L

Serum folate 20 ug/L > 3.9 - 26.8ug/L

Serum vitamin B12 919 ng/L Abnormal result 197 - 771ng/L

Serum total 25-OH vit D level 145 nmol/L

Thanks for advice re. finding an Endo.. I will also see which Endo is nearest to me, we live in mid-Wales! *gulp*

[Gingernut44 in reply to sunbee]

What ICB do you come under. You could look on the Open Prescribing website to see if there are any T3 prescribed in your area.

[sunbee in reply to Gingernut44]

We live in Wales and our surgery doesn't feature on the Open Prescribing website. I'll dig around further maybe NHS Wales does have something similar?

Thank you Gingernut44

[helvella Administrator in reply to sunbee]

Open Prescribing replied (when I asked) that the information is not available for them to include Wales, Scotland and Northern Ireland.

They want to include all the UK - but can't.

[sunbee in reply to helvella]

Oh helvella, thank your checking!

[helvella Administrator in reply to sunbee]

You could contact your health board and see if they can supply local information.

Probably better all round if you don't need to do this, but you could put in a Freedom Of Information request.

[Gingernut44 in reply to sunbee]

See if you can find any prescriptions for the whole ICB area. Perhaps the Open Prescribing doesn’t cover Wales, I really don’t know. Good luck in your search.

[Jaydee1507 Administrator in reply to sunbee]

Depending if you could go to a private Endo, there are more options as some offer virtual appointments or theres always Roseway pharmacy prescribing service.

[sunbee in reply to Jaydee1507]

Thank you Jaydee1507! Does Roseway require a doctor's prescription or do they prescribe using blood results?

[Lalatoot]

Sunbee, on 100mcg levothyroxine my results were similar to yours. My TSH was under range, my ft4 was 60% and my ft3 17%. Because I had years of similar results I was able to show that I had a conversion problem and I was prescribed t3 liothyronine to add to my levo.I only need 7.5mcg liothyronine daily.

Because I was already a patient of an NHS endocrinologist I was able to get t3 liothyronine prescribed on the NHS in Scotland.

[sunbee in reply to Lalatoot]

thank you Lalatoot!

[DippyDame]

High FT4 with low FT3 ( your results) signals poor T4 to T3 conversion and that results in health issues

Your symptoms indicate under/wrong medication

It looks as if you correctly followed testing protocols so labs should be accurate.

I wouldn't want to raise the levo dose much higher and I doubt the amount you have room to add would produce enough T3 to raise your miserably low T3 level in any meaningful way

You could ask your GP to refer you to an endo in the hope they prescribe T3.

They may, or may not....althought you have a good case for a prescription.

Or you could consult a private endocrinologist

Or you could self source T3 to add to your levo.

Whichever way, you need to raise that FT3 level....we aim to have both Frees roughly approaching 75%through their respective ref ranges

[sunbee in reply to DippyDame]

Thank you DippyDame!

[Nollig]

You have been “ reading my mail”I have had similar issues for some time. TSH is spot on but still have lots of hypo. symptoms( itchy all over. foggy brain,tired.sore joints and muscles etc.)My G.P. would not believe me so I changed to a Doctor recommended by a friend and was best thing I did.He discovered I dad early stages of Hashimottos . Have you been tested for same.?Don’t give up and keep your own council and “no” you are not going mad.Good luck and better health🤡

[sunbee]

Thank you for all the helpful comments, I've got a doctor's appointment on Thursday so I'll discuss this further. Hold thumbs!