Help with results please. Been feeling awful

[Charltonjl]

These are my blood results from last week. I'm 44 and currently take 75mg Levothyroxine and 10mg of Liothyronine every morning and up until a few months ago it seemed to be working well so my endocrinologist wanted to see me every 6 months instead of 3 but the last few months I've been feeling lethargic and severely fatigued. It was a fasting blood test. Thank you

[SlowDragon Administrator]

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

On T3 - day before test split T3 as 2 or 3 smaller doses spread through the day with last dose 8-12 hours before test

So 5mcg waking, 2.5mcg mid afternoon and 2.5mcg around 8pm

is this how you did your test?

Which brand levothyroxine and which brand T3

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

What vitamin supplements are you taking

When did you last test vitamin D, folate, ferritin and B12

Do you have Hashimoto’s

[Charltonjl in reply to SlowDragon]

Hello, thank you. It was a fasting (only water) early morning test but I took my levo and lio 24 hours before. My Liothyronine tablet is tiny (through NHS) so very hard to cut even with a tablet machine even in half let alone quarters. I do not have Hashimotos. I have regular tests for vit D, folate etc. Iron and D normally low so I supplement daily with these and k2 also. I take a number of other supplements including omega, boron, alpha lopaic, viatamin c etc. My TSH has never been this low before though. The brands of both my 25mg and 50mg levo is Teva. Thank you so much for your help. Hopefully I've answered everything

[SlowDragon Administrator in reply to Charltonjl]

So you tested Ft4 correctly….last dose 24 hours before test

your Ft4 (levothyroxine) is most likely too low

FT4: 13.6 pmol/l (Range 11.9 - 21.6)

Ft4 only 17.53% through range

Many, many members on levothyroxine plus T3 find they need BOTH Ft4 and Ft3 at least 60-70% through range

Increase dose Levo to 100mcg and retest in 8 weeks

At next test make sure you split T3 at least into 2 doses….with last dose 8-12 hours before test

Easy to cut into 1/2 or 1/4 using a sharp craft scalpel

scalemodelshop.co.uk/plasti...

[Charltonjl in reply to SlowDragon]

Thank you so much. Very useful. And will do re. Cutting Liothyronine. I've heard people don't tolerate Teva too much. Do you think that could be contributing to my issue? Or is it just that I'm under medicated. Thank you again x

[SlowDragon Administrator in reply to Charltonjl]

Impossible to say

Are you taking Teva levothyroxine

Teva is only brand that makes 75mcg tablet

Try different brand at 100mcg

[serenfach]

Pill cutters are cheap and available at most chemists. It stops the cut bit from pinging away never to be found again. It also stops the "oh, its now crumbs, dab with wet finger" problem. Forget the TSH once you start on T3, and it looks like you are underdosed. Hope this helps.

[Charltonjl in reply to serenfach]

Thank you. I do have a pill cutter but this one is particularly small but yes I'vehad the same problem! Thank you. Yes the way I've been feeling I could tell something wasn't right. Not sure what the 'ideal' range should be x

[serenfach]

Most people feel better when the T3 and T4 are in the upper third of the range, and ignore the TSH if you are taking T3. The doctors go mad on the TSH saying it will hurt your bones and heart if it below range, but the research shows this is not true.

[Charltonjl]

Thank you so I shouldn't worry about my TSH being so low? Will increasing my levo dose increase my results to mid/upper range? Or could there be another factor? Thank you x