Ive finally received my test results and have posted them below. Im a 57 year old male with a physical job (builder) with type 2 diabetes (low range) and only just benn put on statins although i was fine until very recently ref the statins.
Quick history: Thyroid removed in 2006 due to Thyroid cancer. Eventually prescribed 200mcg of Levo. Then told after test that my levels were too high and in danger of heart issues (AF apparently)
They dropped my medication to 175 mcg. Had blood tests as advised by the excellent people on this site. They now want to drop me to 150mcg mainly due to my Serum Free T4 result of 34.5 (12-22) I did as advised ref not taking Levi before the test. I was asked if i was happy for them to reduce the levo to 150 mcg which i thought was an odd comment. I said i wasn't happy as that would mean a 50mcg drop in 3 months. The Dr suggested she contact an endocrine team for advice then arrange a telephone appoint, which i agreed to once i had advice from this Forum.
My results are as follows:
VIT D 67 mol/L (25-300)
B12 355ng/L (130-800)
SERUM C reactive protein 1mg/L (range below 7)
FOLATE 4.7ug/L (4-27)
FERRITTIN: 155ug/L (30-400)
SERUM TSH LEVEL: 0.01 (0.27-4.20)
SERUM FREE T4 34.5 (12-22)
I would appreciate any advise as im quite tired with a 25mcg reduction and im now facing a further 25 mcg drop if the Drs have there way as they say im now over-treated and at risk of cardiovascular disease. I dont have any of the symptoms she suggested such as heart palpitations, difficulty sleeping, excessive sweating or feeling hot and shaky.
Thank you in advance. Any advice that will help me argue my case (if i even warrant an a argument as they may indeed be right !) Im just not clued up at all really.
Thanks
Wolthebuilder
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wolthebuilder
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Hi there, I've put them into percentages which makes things a little clearer...
TSH 0.01 mIU/L (0.27 - 4.2) -6.6%
Free T4 (fT4) 34.5 pmol/L (12 - 22) 225.0%
Folate - Serum 4.7 ug/L (4 - 27) 3.0%
Vitamin B12 355 nmol/L (130 - 800) 33.6%
Vitamin D 67 nmol/L (25 - 300) 15.3%
Ferritin 155 ug/L (30 - 400) 33.8%
What is missing is a Free T3 result which is the all important active hormone, you can try and get them to do this or grab a Full Thyroid Panel finger prick test from Monitor My Health (NHS lab) THYROIDUK10 saves you 10%... though timing isn't ideal for posting so I'd put pressure on them to do it which the Endocrinology team can authorise
As you can see from the other results your folate is very low so you need to get a good B Complex like Thorne Basic B or Igennus Super B which will sort this out and boost your B12 which would be better around 80%
Ferritin not too bad but they should really do a full iron panel on you as ferritin isn't always correct if you've had any inflammation or virus
Yes your T4 dose is too high but possibly not causing you symptoms due to these things being low you aren't converting well enough... high fT4 over a long period is not good for you but you will also feel awful if they lower it without checking where your fT3 level is.... the flip side is that too much T4 can also add to poor conversion!
Really need a full thyroid panel to see what is going on but in the mean time grab some supplements 🤗
You can refuse the dose reduction but you need to get them to sort you out long term
thank you so much for your helpful reply. Can I buy B12 supplements or do I have to look at an injection from the Doctors. I’ll get Vit D supplement as well as Folate supplement as well. Thanks again
B12 is combined in the B Complex along with folate which ought to do the trick as your B12 isn't terrible 🤗
The Dr's won't give you a B12 jab unless you are deficient and then only if they have checked your intrinsic factor shows you need jabs
We mention these two brands as they are so much better than anything else around, there is also one from VitaBright which compares to Igennus, I've bought some to try
I used to get an oily, weird flavoured ( think it was meant to be orange) little phial that I took monthly. It was 25,000iu from my GP. But as I said above it was stopped when the NHS did a big cull of "unnecessary" medications. I buy my own now.
My CCG stopped prescribing vitamin D several years ago. I was on a monthly prescribed mega dose due to deficiency. I got a letter telling me I could buy 10ug over the counter. Needless to say if I'd been less informed I'd be comatose by now 😆. I take 4000iu with K2 daily. Its pretty cheap and easily sourced.
Your levo dose is extremely high. I totally understand that your T4 level must be kept high to suppress your TSH. My sister has the same diagnosis and treatment. However, her TSH is kept suppressed rather than undetectable. Maybe your levo T4 does need reducing so the T4 is just above its range. Important you need to check your T3 level. T4 converts to the important T3 hormone. T3 gives you energy to keep your body functioning properly whereas T4 just sits around waiting to be used in converting to T3. Also keep a check on your vitamins b12, folate, ferritin and vit D. These are also very important to be optimal. There are lots of good supplements available
The fact they have put you on statins suggests that your fT3 is low which would cause your cholesterol to rise, chances are you need a combination of T4 and T3 and then you can bin the statins!
1) You most likely will require a combination of T4 and T3. The problem with T4-only is that once you reach your individual pituitary setpoint, the majority of T4 will be converted to Reverse T3 by the DIO3 enzyme. You are most likely deficient in T3 levels at this point.
2) Statins can make a person feel tired and achy. The fact that all they do is attempt to correct a symptom (elevated cholesterol) is not good medicine. For some people, T4 will NOT correct this. You'll probably need some T3 to help your liver handle that issue.
3) Doctors in every part of the world have been told over and over that the TSH is the gold standard. It is...for diagnosing thyroid illness. But the level that actually determines your health is Free T3. Knowing what this level is, unfortunately, won't help in the conversations with your doctor, but it will help you to determine how you want to go about being medically treated moving forward.
4) Doctors have the authority to prescribe virtually any kind of medicine for unapproved uses. I always use the example of doctors giving trazodone (an antidepressive) for insomnia. In your case, you would probably benefit from a trial of T3 to see if it (a) lowers your cholesterol (b) improves your quality of life. Your doctor should be able to understand his authority to prescribe T3 in your scenario.
5) Doctors are never impressed with how much thyroid knowledge a patient has; doctors must always feel like they're the more educated person in the room. However, negotiating can be an advantage. In your case, the fact that you don't have a thyroid means that you can't convert T4 to T3 there. This is very important and probably a big reason why you're not able to get satisfaction from taking T4-only. The thyroid gland can vary its production to convert more T4 depending on what the body needs; you don't have this ability anymore. Your doctor should be able to relate to this logic.
6) The reason that doctors are so aggressive in raising the TSH level to something they're comfortable with has to do with liability. If other doctors or the medical board were to get wind that a patient has a suppressed TSH and the doctor wasn't addressing it by lowering the thyroid dose, they'd be in big trouble. It is always assumed by doctors that a suppressed TSH level means very high Free T3 levels. But they won't check FT3 because they've been assured that measuring it is foolish and a waste of time. Telling your doctor you want it tested, therefore, will only result in you being ridiculed or chastised for telling him how to do his job.
"A man convinced against his will is of the same opinion still"
If you want to know what your FT3 level is, you're going to have to pay to get it tested.
7) The reason that doctors prescribe statins is the same...they're afraid of the liability of someone else in the medical community observing them not prescribing a statin to treat elevated cholesterol. That puts the doctor in a bind so they'll always prescribe it.
Tell your doctor that you'd be willing to lower the amount of T4 but only if T3 were added. Since you don't have any symptoms of overstimulation, it's extremely unlikely that the TSH is providing accurate information, that is, that you're in a hyperthyroid state right now.
Offer to document your vital signs daily and record any symptoms of overstimulation. If all that fails, ask him point blank, "Is there something you're afraid might happen if I were to use T3?" or "Is it really because you're concerned about your liability?" or "Why don't we just rule it (↑ cholesterol, fatigue, etc.) out with a trial dose of T3?"
You can get a doctor to listen once you've satisfied his concern about his liability. No easy task.
You are being overtreated with levothyroxine. Drop the T4 dose but add T3.
You don't have a statin deficiency. Get off the statins.
Thank you so much for your clear and very precise advise and comments. Ill get my T3 tested asap and wait for my dr to contact me when she has consulted an endocrine team. Thanks again. Have a great Christmas everyone
I’ve final had a letter to my doctor from an endocrine and diabetes team which states what’s attached. I need to make a telephone appointment with my Dr but could do with some more information please My TSH has been 0.01 for over 4 years now but T4 has been creeping up I’m ok with another drop if necessary (apparently it’s 1.5 mcg per kg and I’m around 97 kg ) but would like something to supplement as I’m tired ie maybe T3 At this rate of change ie they’ve dropped me 25mcg and I’ve gone from 35.8 to 34.5 TSH I’ll be on nothing to get it below 22!
Would like to armed with advice please before phone call last T3 test was 6.7 4 years ago with TSH at 0.01 and T4 at 18.9
I was finally able to make out some of the letter. They're basing their decision on your TSH level.
I'd recommend that you create some sort of spreadsheet showing thyroid dose and corresponding blood levels. You'll want to have a Free T3 blood test to refute their claim that somehow you're basically thyrotoxic. My TSH is completely suppressed but both my FT4 and FT3 are within the normal range. So is my BP and heart rate.
Do you have records of your vital signs? It's not possible to be thyrotoxic while at the same time having normal blood pressure and heart rate. Also, other symptoms are associated with overstimulation, such as sweating, palpitations, nausea, insomnia, anxiety. Basically, it's like a car with the engine idle set way too high.
If you can show definitively that you don't have these symptoms and your vital signs are normal, and you have a normal Free T3, then it's time to ask about why they won't use their medical training and autonomy to prescribe appropriately. They're just assuming that your FT3 is waaaaay above the normal range; they won't budge until you show otherwise.
Just being nosey but do you have your Lipid results, you do as others have said need FT3 testing. Low T3 can and does increase cholesterol and Dr's know very little about FT3, mine hadn't heard of it and even less about cholesterol. Hope you get sorted, statins aren't the best ,
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