I am 3.5 years into PMR. Honestly can't remember what my Levothyroxine dose was before I was diagnosed however throughout my battle with PMR I was taking 100mcg. and GP added 5mcg Liothyronine in 2020 as I apparently wasn't converting my T4. I had finally tapered to 5mg of Pred in March 2023 and my bloodwork results as I tapered to 3mg Pred. in Nov. are below.
3/2023 TSH 1.08 (.4 to 4.5) FT4 1.7 (.8 to 1.8) FT3 3.9 (2.3 to 4.2) CRP 2.8 (<6mg/L)
9/2023 TSH .03 FT4 1.6 T3 134 (76 to 181) No CRP test
11/2023 TSH .1 FT4 1.5 No FT3 or T3 test No CRP test
The March TSH was the lowest I have ever been, generally running between 1.6 and 2.0. once I was stabilized. The sudden drop to point 03 and even point 1 is concerning. I moved to another state and my naturopath was not wanting to treat me over the phone anymore so have only been seen by my GP. She has me in a holding pattern on my Levo till March 2024.
Should I be concerned? I am 81 and was in my early 50's when I finally convinced my GP that my symptoms should dictate my treatment as my 4.9 TSH didn't seem high enough to him. LOL
When I see doc in March, would like to have a list of necessary tests for my thyroid so everything is covered.
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Dydee
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Low vitamin levels are common when on levothyroxine
Low vitamin levels increasingly common as we get older
What vitamin supplements are you currently taking
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine or liothyronine
For full Thyroid evaluation you need TSH, FT4 and FT3 tested especially as also taking T3
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune
About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s.
20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis
Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease
In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)
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)
Thank you so much Slow Dragon!! I do take a bunch of vitamins, Super B complex, 5000mg D3 and vit. K, Fish oil, calcium, Zinc, magnesium, Lutein, CoQ10, Vit C, NAC, and some I can't think of. LOL I did have all my vitamins/minerals tested for last Spring and I was in good shape. I haven't had to change dosage on my thyroid meds since adding Liothyronine in 2020. I appreciate your input!!
I have never been tested for antibodies however. Will have to check with my doc and see if I can get that done too,
The use of T3 will drop your TSH levels tho I note that you started a small dose of T3 in 2020. If for any reason you were to stop taking T3, your TSH would still remain very low as it can take months to pick up if it ever does. Your September results show very good levels and if you feel well, nothing needs to change.
In March you dr might say you’re over treated because your TSH is so low so if you feel well, be prepared to argue that it’s the T3 effect on TSH that’s making it low not over treatment.
As advised by slow dragon, make sure ferritin, B12, folate and vit d are optimised which will help you to feel your best.
It is reported that elderly people require a lower dose of thyroxine because they are more vulnerable to side effects which include cognitive effects. But it all depends on how you feel. If you want to stay on the same dose ask yourself how you feel. Do you have any problems anywhere in the body? Is your memory still good? Be prepared to fight your own corner if necessary.
Oh and 1 more thing, don’t take your calcium supplement within 4 hours of levo. Any other supplements, food and drink should be avoided within 1 hour of levo.
Hmmmm, did not know that about calcium. I might have broken that rule a lot since I take one an hour or two after Levo. when I eat breakfast. Will certainly change that! Actually, other than a bit tired and a bad back, I feel pretty good. Sleep well most of the time and can keep the bed warm unlike before I was diagnosed. LOL And my memory is great. Thank heavens.
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Sudden change in fT4 levels
Blood Test Results
Conversion
odd new results on combination 
Low Cortisol, Do I Need GP Tests Also ??
