Hi, I have been hypothyroid for many years now, but I am really struggling with brain fog and fatigue.
I am currently taking 75mcg of Levothyroxine daily, but my doctor says I am overmedicated and wants to drop the dose to 50mcg . I have resisted this so far. She refuses to test T3 as she says if I am on Levothyroxine treatment then T3 levels are irrelevant!.
I supplement with VitD with K2, VitB12 and sometimes, Folate. Good quality Vits are expensive and I can't always afford them.
Any suggestions to improve my T3 would be welcome.
I have posted my last Medichecks results, taken early morning 24 hours after my last dose of Levothyroxine.
Thank you
Blood results 04/09/2023
TSH 0.98 RANGE 0.27 - 4.2
FT3 3.58 RANGE 3.1 - 6.8
FT4 18 RANGE 12 - 22
VIT D 61 RANGE 50 - 200
B12 115 RANGE 37.5 - 150 (active)
FOLATE 4.16 RANGE 3.89 - 19.45
IRON 18.7 RANGE 5.8 - 34.5
FERRITIN 49.2 RANGE 13- 150
SATURATION 30.7 RANGE 20 - 50
CHOLESTEROL 7.04 RANGE 0 - 5
CRP-HS 5.64 RANGE 0 - 5
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All your results are in the ranges - you are not over medicated -
When on T4 monotherapy we generally feel best when the T4 is up in the top quarant with the T3 coming in at around 1/4 ratio T3/T4 ;
So if I divide your T4 reading by your T3 reading you are coming it a little wide at a 1/5 ratio.
Conversion can be compromised by non optimal levels of core strength vitamins and minerals -
I now aim for a ferritin at around 100 - folate around 20 - active B12 75 ++ ( serum B12 500++ ) and vitamin D at around 100 :
Your ferritin, folate and vitamin D all need supplementing and building up - everywhere I researched suggested ferritin needed to be over 70 for any thyroid hormone replacement to work well :
Conversion can also be down regulated by inflammation, antibodies, any physiological stress ( emitional or physical ) depression, dieting and ageing.
Your inflammation is over range - and your cholesterol rising - another sign of too low a T3 for you :
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)
Post discussing how biotin can affect test results
Hi, I have never had high readings for antibodies, my last test results wereThyroglobulin 14 Range 0-115
Thyroid peroxide antibodies
9 range 0-34
My doctor tested my kidney function twice, but just told me it is low and I should drink more. She will not test T3 as she says it's irrelevant if I am taking Levothyroxine.
No real help and I'm not sure where to go from here.
You will not be overmedicated unless your FT3 is over range....
and your FT3 is low at only 12.7% through ref range
FT4 is 60% ditto
Both Frees should roughly be approaching 75%
High ( ish) FT4 with low FT3 indicates poor T4 to T3 conversion
Your T4 to T3 conversion is poor....more levo may help or you may need to add a little T3 at a later date
For good health every cell in the body needs to be saturated with T3 by way of a constant and adequate supply.....
75mcg levo is not adequate for your needs.
The brain needs a lot of T3!
If this medic reduces your Levo dose to 50mcg you will be even more undermedicated.
She is probably looking at TSH, which is on the low side, and once medicated TSH is NOT a reliable marker
Improving your FT3 should reduce your cholesterol level too. Avoid statins.
Raised CRP indicates slight inflammation.
Have you had thyroid antibodies TPO and Tg tested to check for Hashimoto's disease. It is an autoimmune condition and a common cause of hypothyroidism. Immune system cells attack the thyroid gland, causing inflammation and, in most cases, eventual destruction of the gland.
A gluten free diet helps many with Hashi's.
How do you feel? I hope your doctor asked that important question because clinical evaluation is an important part of diagnosis
Any decision about treatment should be decided with both doctor and patient. So, if you feel a reduced dose is going to have a negative effect build your case and refuse to agree.
I suggest you request a dose increase to 100mcg and work to optimise your nutrient levels.
If GP won’t increase or insists on dose reduction in Levo
Refuse to reduce dose
If GP says " I have to reduce your dose because the guidelines say i can't let you have a below range TSH" .....
The first paragraph in the NICE (NHS) Thyroid Disease, Assessment and Management guidelines says :
nice.org.uk/guidance/ng145
"Your responsibility
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with themand their families and carers or guardian. "
Here’s link for how to request Thyroid U.K.list of private Doctors but also they will email list of recommended thyroid specialist endocrinologists who will prescribe T3
Ideally choose an endocrinologist to see privately initially and who also does NHS consultations
T3 is not irrelevant it is highly relevant. Your GP obviously doesn’t understand.
Can you go private only? There is a brilliant private only endocrinologist in Oxford that does telephone consultations so no need to travel. He is pro T3 if your blood results suggest you need it.
I was told exactly the same thing by my GP. “You don’t need T3 tested now you’re on Levothyroxine”. I’m afraid they have little to no knowledge about treating hypothyroidism. It makes you wonder how many of their patients believe that to be true and just live with debilitating symptoms.
Thanks for your comment Gingernut44. I just don't know where to go next. As a pensioner I can't afford to pay private, my options are very limited. I will up my vitamins and see how I go on. It's quite depressing really, my GP is very blinkered and not much help.
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