Hello, I hope you can help me make sense of my results as I've got a doctor's appointment to discuss my medication.I was diagnosed with graves disease about 2010 and had RAI in 2015. I've been under active since and for the past 6 years been on 125mg of levo. My symptoms have been up and down over the years and I've constantly had to fight to stay on this dose as my tsh range has been up and down. I always feel better when my tsh is low. Since August I've been self medicating on 150mg per day and feel better for it, I had my yearly blood test done at 8.50am on 30th November and these are my results, I got a text message from the GP saying they are reducing my levothyroxine to 100mg . I obviously don't want this and I would really appreciate any advice to help me with my upcoming appointment.
Thyroid results : Hello, I hope you can help me... - Thyroid UK
Thyroid results
Hmm... irritating aren't they! Just contact your surgery and say that you don't agree to the reduction as you are within fT3 &4 ranges, you feel well and are showing no signs of over medication, if you don't agree they can't change it 🤗
I like to add in relevant things like resting heart rate, BP, temperature to show that you are monitoring your condition better than they are!
You might want to try 137.5mcg as it may actually improve your conversion which can worsen when fT4 is near top of range? Or alternating 137.5 and 150? It's the small tweaks that often have the greatest effect
welcome to the forum
Essential to test vitamin D, folate, ferritin and B12
What vitamin supplements are you taking
Hello Snap and welcome to the forum :
Graves is a poorly understood and badly treated auto immune disease for which there is no cure and simply flipping the patient from hyper to hypo by either a thyroidectomy or RAI thyroid ablation - somewhat simplistic.
It is essential that you are dosed and monitored on your Free T3 and Free T4 results and not a TSH reading but fully aware that in primary care your doctor will likely be working from TSH results and guidelines with an occasional T4 reading being processed by the laboratory.
When on T4 monotherapy we generally feel at our best when our T4 is up in the top quadrant of its range with the T3 tracking slightly behind at around 60 / 70% through its range.
The accepted conversion ratio when on T4 only is said to be 1 - 3.50 - 4.50 T3/T4 with most people feeling at their best when they come in this range at 4 or under - so if we divide your T4 by your T3 reading your conversion ratio is coming in at around 3.54.
No thyroid hormone replacement works well until our core strength vitamins and minerals - those of ferritin, folate, B12 and vitamin D are up and maintained at optimal levels and it is known that RAI - amongst other things - trashed vitamins and minerals - I now aim to maintain my ferritin at around 100 - folate around 20- active B12 75 ++ ( serum B12 500++ ) and vitamin D at around 100.
Your HPT axis - the Hypothalamus - Pituitary - Thyroid feedback loop - on which the TSH relies on as working well is now broken as by having had RAI thyroid ablation - this circuit loop is now open ended as your thyroid has been burnt out in situ and rendered disabled.
Having Graves your TSH will likely never recover back into what is considered the ' normal ' range and my TSH has been stuck down at 0.01 if I am to be be as well as I can be and I track myself on my Free T3 and Free T 4 readings.
The thyroid is a major gland and responsible for full body synchronisation including your physical, mental, emotional, psychological, and spiritual well being, your inner central heating system and your metabolism.
A fully functioning working thyroid would be supporting you on a daily basis with trace elements of 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 monotherapy.
Some people find that T4 seems to stop working as well as it once did and that by adding back in a little T3 - likely to replace that little bit ' lost ' when they lost their thyroid - they can restore T3 / T4 hormonal balance and wellness.
Others can't tolerate T4 and need to take T3 only - Liothyronine.
Whilst others find their health restored better taking Natural Desiccated Thyroid which contains all the same known hormones as that of the human thyroid gland and derived from pig thyroids dried and ground down into tablets referred to as grains.
We do now have some research which you may find of interest :
pubmed.ncbi.nlm.nih.gov/338...
ncbi.nlm.nih.gov/pubmed/306...
I found Elaine Moore's books and website the most well rounded research of all I read when I became much more ill some years post RAI : details on my profile page - just press the icon alongside my name.
P.S. Is this the blood test result and ranges your doctor is working from - or is this your own private blood test ?
Your T3 and T4 are in the ranges - you can't become hyper once hypo - though you could be seen as over medicated - you may well find that a small dose reduction of T4 - say 12.50 mcg daily making your dose 137.50 mcg daily - improves your T3 reading and makes your percentages through the ranges more balanced -
Do you have any readings there ferritin, folate, B 12 and vitamin D ?
Thyroid results 
Thyroid test results 
Thyroid results 
Thyroid test results help please
