Help with blood test results, please

[Partiallythere]

Just received my blood test results as have been feeling really rubbish lately and cannot lose a single 1lb - in fact it just keeps creeping on. I am exhausted from trying and getting nowhere. And also just generally exhausted!

Could do with your expertise please:

TSH 5.13 miu/L (0.27-4.2)

FT4 14.5 pmol/L (10.5-22.0)

FT3 3.8 pmol/L (3.1-6.8)

Also had iron, vits B12 and D3 checked - all in normal range, but look to be on the lower end of each 'normal' range.

GP said nothing about these, just said he is raising my levothyroxine from 75mg to 100mg and retesting after 8 weeks.

Thanks very much!

[DippyDame]

You have been undermedicated so increase to 100mcg should help.....GP's action sounds fine meantime.

Test at 9am, 24 hours after last dose of levo and at least an hour away from food and drinks, except water,

Your result shows low FT3 this results in low metabolic rate and if this is low fatigue and weight gain follow... as FT3 rises these issues should resolve

Your T4 to T3 conversion is low but this may improve with improved nutrient levels and more levo.

Your new lab results in 8 weeks will show if further dose change is required

Nutrients must be optimised to support thyroid function/ conversion.

Lower end of range isn'tenough.

Vit D: 100-150nmol/L

Total B12....top of range

Active vit B12.....100+

Folate: at least half way through range

Optimal ferritin level for thyroid function is 90-110ug/L

Suggest you post the next set of results and meantime work on improving nutrient levels

Good luck

[Partiallythere in reply to DippyDame]

Thanks so much DippyDame! So helpful to see the optimal ranges for iron and vits, which differ from my results:

Vit D was 55 (50.0-140.0) and you say it should be 100-150.

Serum vitamin B12 was 273 (197-771.0) and you say it should be the top of the range, so in the 700s, ideally.

Active folate level was 4.7 (3.0-26.8) and you say it should be at least halfway through range - so in the teens, ideally.

Ferritin was 150 (13-150) and you say it should be at least 110 - so that's looking good.

So am I right in thinking that iron isn't an issue (I wrongly through folate was iron, but just googled ) but vits B12 and D3 need increasing?

[DippyDame in reply to Partiallythere]

I should have added that we are advised to combine Vit D with Vit K2....the K2 helps directs calcium to the bones rather than to soft tissues so preventing calcification.

I use the BetterYou spray from Amazon....it avoids the gut

D + K

[pennyannie]

Hello Partiallythere :

So is this result after 6-8 weeks on 25 mcg T3 + 50 mcg T4 ?

Do you split your dose of T3 - and left around 12 hours from last dose T3 and around a 24 hour window from your last dose of T4 ?

Are you under an endocrinologist monitoring your thyroid hormones or self medicating ?

Your vitamins and minerals need some support -

I now aim to maintain ferritin at around 100 - folate around 20 - active B12 75 ++ ( serum B12 500 ++ ) and vitamin D around 100 :

[Partiallythere in reply to pennyannie]

Thanks so much pennyannie - No this from taking 75mcg of Levothyroxine - don't take T3 anymore. Last saw an endocrinologist pre-COVID.

[pennyannie in reply to Partiallythere]

Oh - ok - sorry - does your bio need updating or am I gong mad - !!!

So - once on any thyroid hormone replacement we generally feel best when the TSH is at least under 2 and more likely under 1 and towards the bottom of the range and this should happen as you slowly increase your dose of thyroid hormone replacement.

Years ago people were treated for hypothyroidism once the TSH was above 3 as that's about when the insidious symptoms of this disabling disease start creeping in and eroding away your ' you ' :

We generally feel bet when on T4 monotherapy when the T4 is in the top quadant of it's range as this should, in theory, convert to a decent lievel of the active hormone - T3 - which runs all your bdily functions -

from your physical through to your mental, emotional, psychological and spiritual well being, your inner central heating system and your metabolism.

Currently your TSH is over the range and shouting out for more thyroid hormones :

YourT4 is at around 17% and your T3 struggling at just under 19% through it's range.

When optimally replaced with Levothyroxine your T3 should be tracking, in % terms, behind your T4 - and what you have here is inverted - with T3 higher in % terms than the T4 - as your body is pushing hard to find enough of anything to keep you functioning.

A dose increase in T4 is the first step but I hope I read correctly that you had a partial thyroidectomy so your body will be struggling to ' make do ' on T4 monotherapy since your ' lost ' half your power.

A fully functioning working thyroid would be supporting you on a daily basis with trace elements f T1. T2 and calcitonin + a measure of T3 at around 10 mcg + a measure of T4 at around 100 mcg.

Some people can get by on T4 only :

Some people find T4 seems to stop working as well as it once did and need to add a little T3 making T3 / T4 to restore thyroidal balance - which you tried but for some reason discontinued.

Some can't tolerate T4 and need to take T3 - Liothyronine only :

Whilst others find their health restored better taking Natural Desiccated Thyroid which contains all the same known homones as the human gland and derived from pig thyroids, dried and ground down into tablets referred to as grains.

No thyroid hormone replacement works optimally until your core strength vitamins and minerals are up and maintained at optimal levels and down regulation of T4 to T3 can also ocur because of thyroid antibodies, inflammation, any physiological stress ( emotional or physical ) depression, dieting and ageing.

[Partiallythere in reply to pennyannie]

pennyannie, I cannot thank you enough for this extremely thoughtful and detailed reply! I already am feeling better with the supplements and increase in levothyroxine and it’s only been 5 days. Might be mostly placebo effect, but I’ll take feeling better 😊 I used to be able to get T3 from a reputable source but that stopped and I really haven’t a clue where else to look. But I would like to see if levothyroxine, combined with the right vitamins, will support me sufficiently. I never gave it much of a chance in the early days, switched to NDT from Thailand and tbh I don’t think I received consistently good products each time as symptoms were all over the place.

Fingers crossed I keep on feeling better!

[pennyannie in reply to Partiallythere]

Ok - no worries - I'm waiting on a new laptop so will reply properly in a few days if you want further clarity on anything as my options limited on this little phone and tapping in " tortoise " style !