New blood test results, what would you do next

[Regenallotment]

What do you make of this?

Brief history, was over range in July, back under control Sept, levels dropping now...starting to feel it.

Aristo Levo 75mcg per day 22 hours before, Roseway compounded T3 half dose (2 x 2.5mcg per day) 14 hours before. Biotin stopped 5 days before, all other vitamins maintained normal dose, had b12 injection 48 hours before, fasting test 6am, timing unavoidable due to work commute etc.

TSH 0.1 mIU/L (0.27 - 4.2) -4.3%

Free T4 (fT4) 18.1 pmol/L (12 - 22) 61.0%

Free T3 (fT3) 4.6 pmol/L (3.1 - 6.8) 40.5%

T4:T3 Ratio 3.935 

Thyroglobulin Antbodies (TgAb) 21.1 IU/mL (≤ 115)

Thyroid Peroxidase Antibodies (TPO) 181 IU/mL (≤ 34)

C-Reactive Protein (CRP) 1.72 mg/L (≤ 3)

Folate - Serum 45.4 ug/L (8.83 - 60.8) 70.4%

Vitamin B12 150 nmol/L (37.5 - 188) 74.8%

Vitamin D 106 nmol/L

Ferritin 70.4 ug/L (30 - 150) 33.7%

How do I feel?

Cognitively I am 100% which is fantastic, weight gain 3kg over normal for me in last month, legs ache climbing stairs, bowel movements way firmer than usual. Feeling very sleepy at 4-5pm driving home. Night sweats and heavier than usual bleeding are back (despite HRT) - I think for me these are FT4 symptoms. Resting heart rate showing a lower trend over last 16 weeks according to my watch, HRV has improved over last 2 months now around 60-70, was 38-40 in July when I was over range. Other than that I feel pretty good day to day, my mood is lighter and more positive than at any time in the last 10 years which is a miracle.

Plans - add a Three Arrows heme back in twice a week to bring the ferritin back up (was 140 in Jan and had palpitations). Is that enough?

Unsure - Do I increase Levo to 100 twice a week? or try 7.5 mcg T3?

On 100mcg Levo and 5mcg T3 in July I was way over range FT4 27 FT3 10.0 sweating, frenetic and very hungry. So conscious I need to make finer adjustments.

CRP question - my CRP has risen from 0.74 in Sept 2022 to 1.49 in July 2023 and now 1.72 Nov 2023 should I be worried about this upward trend? I live / eat autoimmune friendly GF/DF/soy/most sugar/most alcohol diet, daily Iyengar Yoga. Not particularly stressed at present.

🌱

[Lalatoot]

If those were my results I'd be increasing the t3 as it is still lagging behind, 2.5mcg perhaps.Wait 8 weeks, see how you feel and look at new blood results.

[Regenallotment Ambassador in reply to Lalatoot]

Thanks 🙏

[Bertwills]

I agree with Lalatoot. Nudge the T3 up a little. Have your antibody levels gone up? The CRP could be a low level winter virus response? Maybe your HRT needs to be tweaked? At least you feel pretty good & are not feeling stressed, which with the Christmas onslaught, is good going!

[Regenallotment Ambassador in reply to Bertwills]

Thanks 🙏 Antibodies are down but yes Covid a few months back, you have a point there 👆🌱

[Noelnoel in reply to Regenallotment]

heavier than usual bleeding are back (despite HRT)

Morning!

Could that be the reason for declining ferritin?

[Regenallotment Ambassador in reply to Noelnoel]

100% I have fibroids.

[SlowDragon Administrator]

I agree with Lalatoot ….try increasing T3 by 2.5mcg

Retest in 8 weeks

[Regenallotment Ambassador in reply to SlowDragon]

Thank you 🌱

[TiggerMe Ambassador]

Surprising that your B12 isn't higher?

It does sound like the symptoms I get when fT4 is a bit low... but like the others say adding a little T3 seems to be what the bloods are suggesting... and quicker to adjust... though perhaps a little extra T4 a couple of times a week may be needed too...

Looks like you are going to need to find your seasonal dosing, summer hols and warmth a little less, winter working a touch more...

Being a bit low on thyroid hormones seems to make periods worse one way or another just so our little cups really overflow with joy 🙃🤗

[Regenallotment Ambassador in reply to TiggerMe]

🤣 you do make me chuckle, ok so I’ll base my dosage on the annual hedgehog activity scale, and yes indeed my moon cup hath overfloweth, I am abundant it would seem 🫣😬 Yeah, I was thinking that with T4 too. Tempted to do both till I get palpitations and then drop back again 🫢 but will do as advised because SD & LLL have always been right then look at that next maybe. 🌱

[GlowCoach Administrator]

I'll agree with all the others.

About the CRP, its still under range I would imagine so not an issue.

What did it get to when it raised up?

You could try a good quality omega 3 supplement (can be fish oil or algae) which are great for inflammation and a number of other things including dry eyes which I believe you have.

We should be eating oily fish at least once a week and another portion of fish as well.

The fact is that most people don't plus declining levels of omega 3 in fish anyway.

[Regenallotment Ambassador in reply to GlowCoach]

Thanks for this, I eat sardines and salmon most weeks, hemp seed oil in my smoothies and avocado. But yeah…maybe more consistent and frequent needed. we’ve been doing about krill oil in Geography and the class want to try it so I can use that up after they’ve all had a go 🤭🌱

[McPammy]

I’d redo a blood test ‘after’ taking your medications to see how high it gets. Your TSH is under range showing you’re taking too much thyroxine. I’d guess it’s too much levo causing your symptoms, aching legs or tiredness is a sign of too much thyroxine. I’ve had experience of cramp or aching on too much levo and night sweats. The only way to tell if it’s T4 or T3 or both causing over medication is to do a blood test after taking your meds I find. I try to do both with and without meds so I definitely know I’m in range which is where I feel symptom free and happy.

[Regenallotment Ambassador in reply to McPammy]

Thanks but I was recently over replaced and the symptoms and FT3&FT4 blood tests show I’m now under replaced, you can seem I’m 40% through range for FT3. As I take T3 I ignore TSH, my pituitary doesn’t need to signal my thyroid as I’m replacing so irrelevant. It’s also risen from 0.002 so any concerns about it would have been back in July. GP and Roseway advisor not concerned at all.

[McPammy in reply to Regenallotment]

I guess we are all different. I wouldn’t say you’re under replaced with those recent blood results myself. I never ignore my TSH and like yourself I take T3 and T4 medications I believe it’s highly relevant alongside T4 and T3. My TSH is always in range my results Nov ‘23 - TSH 1.19. ( 0.35-5.50). T4 10.10 (7.86-14.41) and T3 5.5 (3.7 - 6.0) after taking my meds that morning. I am symptom free. I aim for a healthy persons thyroid levels. If my levels go high and TSH suppressed I get symptoms of over medication which are unpleasant.

[Lynneypin]

hi. I was interested in Three Arrows heme you mentioned. My ferritin is 30 (been trying Spatone but it’s still dropping)

How did you get on with it?

[Regenallotment Ambassador in reply to Lynneypin]

It’s amazing stuff went from 40-60 and eating liver twice a week to 140 in 2 months. I’m going to bring it in a couple of times a week. Takes aaaages to come on the post though 🌱

[FoggyThinker]

Just to pitch this into the debate: I had dreadful sweaty hot flushes for a while, I think this was because my adrenals couldn't keep up with a too fast dose increase. When I dropped the dose then slowly increased, and took my morning NDT dose early am a la CT3M to help out the cortisol production, the sweats seem to have stopped (thank goodness) when my dose got high enough. It seemed to me to make sense as the adrenals pick up some sex hormone production, but can't do that if they're struggling.

This is purely my inexperienced theorising so I could be way off, but I know you mentioned your cortisol testing a bit low so, if you're not, maybe worth considering the early hours T3 dose (you can read about it on Paul Robinson's website and he has books). Doesn't work for everyone and more palatable if you're popping off to the loo about 3 am anyway! but it does seem to sort my foggy brain as well as the sweats and my temperature is a lot more stable too

[Regenallotment Ambassador in reply to FoggyThinker]

Yes such a fine balance isn’t it. I haven’t had adrenals tested. I do feel I’m closer to understanding which symptoms belong to which condition, but perimenopause remains the moving target. 🎯 it took me 24 weeks to add 2.5 mcg T3 so yes I’m super sensitive but I agree splitting it really helps. 🌱

[Noelnoel in reply to Regenallotment]

Foggy may be onto something there. I can’t seem to tolerate increasing my glandular doses without increasing adrenal cortex a tiny bit. Took me ages to cotton on what was happening. Nowadays I prepare for a Metavive increase by first increasing the adrenal cortex for a few days prior. Works well at the moment

I have a B12 question. Is it ok to pm you

[Regenallotment Ambassador in reply to Noelnoel]

Pm always ok xx

[FoggyThinker in reply to Regenallotment]

Ah, sorry! I thought that you'd mentioned something a while back about cortisol being low, and starting an adrenal supplement; probably someone else altogether. I'm still dopey sometimes even now the brain fog's much better!

[Regenallotment Ambassador in reply to FoggyThinker]

I did try an adrenal supplement and a few folks have suggested it’s low but I’ve never tested. So 10/10 for recall I am impressed 🤣 I think my symptoms were way less than some folks who have been hypo for longer. I seem to be able to repair any passing insufficiency with salts and rest, adrenal cocktail etc. haven’t had the hypo tiredness for some time. I found the supplement slowed me down, slowed everything down, helped show me when I am full of adrenaline and when not. I’ve stopped it and feel I have a better understanding of excitement/anxiety/wiredness v tiredness. I am sorry I made you second guess yourself, you were onto something but I think I’ve ruled out adrenals. Just fine tuning now xxx

[FoggyThinker in reply to Regenallotment]

Ah wasn't it to do with blood sugar as well? I think that's why I took particular notice (need to sort mine out I think, and I keep considering the Zoe thing...). No worries at all, it's really good to hear you're figuring out all your symptoms and solutions; I think I'm getting somewhere with mine, too, but I'm a little behind you. You could be right about duration, I suspect I've been hypothyroid for a very long time although maybe at a lower level than many people? And I've spoken to others in similar situations who have adrenal issues too... I guess eventually it will all get scientifically figured out, that will be a fascinating book to read! xx

[Regenallotment Ambassador in reply to FoggyThinker]

Always happy to share thoughts on Zoe and blood sugar. Ask away 🙂

[BumbleyM in reply to Regenallotment]

Think Zoe helped me a lot with sorting out various nutrition issues, which in turn enabled me to manage the thyroid issues more effectively...