My blood results after 9 weeks on 100mcg

[ockerdoc]

Here are my results they were taken as per protocol nothing for 24hrs and I don’t take biotin. The Medichecks Doctor thinks I’m overactive.

TSH - 0.011 (0.27-4.2)

Free T4 - 21.6 (12-22) (96%)

Free T3 - 5.8 (3.1-6.8) ((73%)

On 75mcg my FT4 was 60% and my FT3 54%. I’m quite shocked it’s gone up so much. I definitely followed all the right protocol my last medication was about 26 hours prior to testing. I’m thinking of going back to 75mcg and then retest because if I carry on with 100mcg I’m going to go over range on my T4. I did have a few weeks of mild palpitations and high bp recently. I still don’t feel great though I’ve been back in the gym and recovery has improved but my cardio is still crap. Constipation has improved the last 3 weeks it’s the first time in 5 years that I haven’t taken any stool softeners. I’m 15 stone so I was thinking I may have to move up to 125mcg but looking at these results I don’t think that’s a good idea 🤷‍♀️

[SlowDragon Administrator]

suggest you stay on current dose and retest again in another 2-3 months…..

It’s too soon to increase dose yet

But likely to be ready eventually in perhaps 3-6 months

[ockerdoc in reply to SlowDragon]

Even with my T4 that high?

[SlowDragon Administrator in reply to ockerdoc]

If you feel you must reduce, perhaps just to 75mcg once a week

[ockerdoc in reply to SlowDragon]

Ok thank you 🙏

[RedApple Administrator]

'I’m 15 stone so I was thinking I may have to move up to 125mcg but looking at these results I don’t think that’s a good idea'

I agree. You may need that much further down the line, but apparently not yet. How do you feel? If you're feeling ok, maybe try alternate day dosing of 75mcg/100mcg to bring your FT4 down a little, then retest in say 8 weeks to see what difference that has made.

[ockerdoc in reply to RedApple]

I feel like I’ve improved but I don’t feel 100% like I did 5 years ago. I still don’t have loads of energy and my cardio isn’t great. I don’t think I could go climbing mountains like I used to and I’m only 51. These results have surprised me. Yes I think I’ll reign it back to 75mcg and 100mcg on alternate days then retest in a few months. Maybe I need to change other things in my life like my diet to improve my energy 🤷‍♀️ or maybe this is just how it is I really don’t know anymore.

[RedApple Administrator in reply to ockerdoc]

Some of us never return to feeling 100% unfortunately, despite all our best efforts. I have a suspicion that the longer you've been 'thyroidally challenged' before starting treatment, the harde (and possibly less likely) it is to get back to how you expect to be feeling once on a good thyroid medication regime.

But we keep trying, and stay hopeful 😊

[ockerdoc in reply to RedApple]

Yes thanks I’m beginning to think the same thing.. it’s a bit grim really but we keep fighting 👊🏻

[HealthStarDust in reply to RedApple]

This is my suspicion too.

[pennyannie in reply to ockerdoc]

Hey there Ockerdoc :

Can I just add that your weight will stabilise once you are optimally medicated and pushing yourself too much now can actually make matters worse - and back fire - as the more you exercise the more T3 your body will need.

Apart from maintaining optimal vitamins and minerals conversion of T4 into T3 can be down regulated by antibodies, inflammation, any physiological stress ( emotional or physical ) depression, dieting and ageing - it is a complex process - and punishing routines and pushing through are not conducive to good health when hypothyroid.

There is no quick fix with thyroid hormones and slow and steady generally suits the body better.

[ockerdoc in reply to pennyannie]

Yes thank you I get that but I’m already on an optimal dose and still not feeling 100%. I don’t think it’s just my thyroid at play here so I’m changing a few things to see if it helps. Hopefully it will ! 🤞😊

[HealthStarDust]

I am not sure it is wise to make a decision to reduce based on just one test result on the assumption that your FT4 will increase if you continue on a dose of 100mcg. It may have now reached its peak, and begin to come down again. I have found my FT4 drops after such a peak, signalling I need an increase when combined with symptoms.

I am no expert, but I think it may be worth continuing with 100mcg for a full 12-14 weeks for good measure and then retest, as those numbers look good for now.

Previously, you mentioned that you didn’t feel a difference on 75/100 on alternative days, but perhaps you didn’t give it long enough? And, if you feel you must reduce based on symptoms, I think as has been mentioned by  SlowDragon you could drop 100mcg to 75mcg for one day a week.

Personally, my suspicion is yo-yoing too quickly on different doses is not a good idea either. But, only you can decide what feels too soon for you.

Good luck.

[ockerdoc in reply to HealthStarDust]

Thank you 🙏 yes it’s not just the levels that I’m concerned about it’s how I feel. Looking at those numbers I should have boundless energy but I really don’t. I think I felt better on 75mcg all in all. I’m going to make some dietary changes to see if I can improve my energy levels by doing keto/carnivore for 6 months. Lose weight and get lean so I think going back to 75mcg is probably going to be the best for me in the long run. I have psoriatic arthritis so I wonder whether that is the main cause of my lack of energy not the thyroid hormones. I think an anti inflammatory diet like keto/carnivore may just be my best bet to improve my overall symptoms.

[SlowDragon Administrator in reply to ockerdoc]

Very low carb diet will badly reduce conversion of Ft4 to Ft3

Suggest you wait at least 6 weeks and retest before ditching higher dose levothyroxine

[ockerdoc in reply to SlowDragon]

Apparently it changes your metabolism so you actually need or use less T3 to compensate. That’s the theory anyway.

[HealthStarDust in reply to ockerdoc]

Looking at those numbers I should have boundless energy but I really don’t.

Symptoms lag behind numbers often. And, remember symptoms do resolve, and symptoms of under and over medication can look the same. These will most likely be unique to you, and as you become more experienced with your symptoms combined with levels and dose, you will have a fairer idea of what may need doing.

The problem with testing is everyone is different. Your numbers may look the same in a few weeks time, though I very much doubt it based on what you’ve shared re weight, although I accept weight is just a guide but even then most people and up on a dose of 100mcg or over.

I think SlowDragon is right. You need to give this dose a bit longer especially as those numbers suggest you may be already at or reaching your optimum dose. Acting prematurely now, as I believe you have done previously when alternative on 75/100 I think, could set you back.

Anyway, I hope that helps. Take care.

[ockerdoc in reply to HealthStarDust]

Thank you 🙏 I’ll let you know how I get on.

[HealthStarDust in reply to ockerdoc]

If it helps, these are my peaks and troughs of one dose (I believe it was 75mcg actually. I rested about 6 weeks later and it had already dropped. I think it’s possible your decision is being lead by fear based on an assumption that your FT4 will keep climbing. Although, it is not clear to me why you have assumed this.

Anyway, I thought I would also add that in case it helps.

🫶🏽

FT4 progress chart.

[ockerdoc in reply to HealthStarDust]

That’s great thank you yes very interesting. It’s mainly due to the weight loss I’m hoping to lose at least a stone or more so realistically my body will need less T4. Hopefully should be about right but I’ll play it by ear as we go along. I can’t carry on like this I have to make some big changes.

[HealthStarDust in reply to ockerdoc]

I honestly think at the time of your test you have reached your peak plasma levels , so you should stick to your correct dose for 12 weeks at least, by which time I think in most likelihood your FT4 will have dropped.

We mention a lot about of 6-8 weeks of reach in a stable dose in terms of blood levels with regards to increasing dose, but as you are reaching the optimum dose it is wise to give it longer up to 12 weeks.

[HealthStarDust in reply to HealthStarDust]

P.S. weights and Levi those are just a guide. Not an exact science.

[helvella Administrator Thyroid UK in reply to ockerdoc]

The thyroid hormone requirement depends on many things.

And if you try to factor weight in, you need to consider that the requirements of a kilogram of muscle, fat, bone or retained liquid will be very different to each other.

Activity level is also important.

[JoJoloveschocolate]

I’m in a similar position. My last tsh was 1.9 and t4 dropped had from 11.4 to 9.8 (range 7-17) after a few weeks on 50mcg so the gp agreed a trial of 75mcg. Just had my latest results which now show tsh slightly under range at 0.1 and t4 of 13. 8. I was really shocked to see those results as I felt great for a while on the 75, but recently started to feel a bit achy again in my back and thighs and thought I was heading for an increase up to 100mcg (I weight about 87kg). I went i to a bit of a panic because of my low tsh and I don’t want the tsh to go down even more because I know the gp will jump on that and decrease my levo. Generally I feel ok, but am not bouncing off the walls with energy like I thought I would be! I don’t feel overmedicated. That said, I did wonder if I’m aching a bit more because I’m actually doing a bit more walking…and also maybe it will just take longer for the symptoms to catch up to blood results as I think I’ve been hypo for years. I might carry on with my dose as it is and then do a medichecks in a few weeks to check my thyroid and ferritin etc again. I’m glad you posted your story. thanks! Hope you get on ok.

[ockerdoc in reply to JoJoloveschocolate]

Thanks for the reply your T4 is at 68% so you’ve got a bit more room than me but your right about your GP they will worry about the TSH 🙄 To be honest I think my T4 is too high at 96% I’ve had some palpitations lately so I think I’m heading down the overmedicated road if I carry on. But I still don’t feel particularly great so I’m now wondering if the lack of energy is linked to my psoriatic arthritis which is very common. If this is the case I need to look at an anti inflammatory diet like keto/carnivore and losing as much body fat as I can. That’s my next step now so we’ll see how it goes! 🤞 hope you keep improving good luck 😆

[JoJoloveschocolate in reply to ockerdoc]

Thank you, Ockerdoc. 68% is not too bad is it. I think it might drop off again in a few weeks as that’s what happened before. That said, the tsh is a law unto itself!! I’ve never been able to guess correctly what it might do! I’ve seen my Gp’s comment on my nhs app - the results were seen by the original gp who started the levo trial and thankfully she has put “tsh only slightly under range no action required” I have a feeling that she might be on thyroxine herself because she had no issue with starting me on levo even though my results were classed as subclinical, but I had severe symptoms which I originally thought were worsening chronic fatigue that I diagnosed with in 2019 (probably hashimotos all along!). Have you had all your vitamins and iron levels checked too? My ferritin level was low last time so i’ve been trying to address that through dietary measures too. Good luck to you too with it all too! It’s all a bit nuts isn’t it 🤣

[ockerdoc in reply to JoJoloveschocolate]

🤣 it certainly is! Yes vitamins all good thanks the only issue was my folate but I’ve been supplementing so everything is optimum at the moment 👍

[HealthStarDust in reply to JoJoloveschocolate]

I think on lower doses you can expect the ft4 to peak then drop. Don’t forget that initially Levothyroxine tops up the thyroid briefly before replacing it.

Ultimately, I have found the longer I leave the tests, the less likely the results will remain the same or higher on low doses.

TSH move all the time for various reasons, and chances are in another few weeks it will raise again.

In one week on two NHS test via GP my TSH went from 1.5 ish to 2.5ish on the same dose. There in lies a big clue how much the tests results can change!

I guess in a way I’ve been lucky as I’ve had multiple tests in quick successions via NHS and can see the TSH and other numbers move around a lot.

So, my take home message is when your still trying to reach your right dose, focus much more on symptoms and somewhat on level and especially time in weeks before testing.

[JoJoloveschocolate in reply to HealthStarDust]

Thank you HealthStarDust, yes that makes sense. When I saw my results yesterday I went into a a bit of a panic with the tsh being below the range low! I posted my results/questions up on the forum but I think my post got lost as it was busy so I’m glad I found Ockerdoc’s post and all the helpful replies because it helped me to calm down a bit! I think I’ll stay on 75mcg for now and re-test with medichecks later.How long do you think I should leave it. I was thinking maybe another 6-8 weeks or so, unless things change/get worse in symptoms.