Recent blood results, help interpreting

[thyroidqueen12]

Hi everyone,

I haven't posted in a while, but would like my latest blood results checked with the knowledgable people on here. I've been on a treatment of 125mcg of Levothyroxine and alternating days of 5mcg and 7mcg of liothyronine. I have been feeling better on this dose, and was slightly too highly dosed when taking 7mcg everyday (hence my doctor switching to alternating days)

Serum TSH level 0.37 mU/L [0.3 - 4.2]

Serum free T4 level 16.3 pmol/L [9.0 - 23.0]

Serum free triiodothyronine level 4.6 pmol/L [2.4 - 6.0]

Let me know whether everything still looks good and in range for my treatment?

On a side note: I have had an episode a couple of weeks ago of a very ITCHY day. Where the skin all over my body is extremely itchy. It only lasted for a day, so it was quite strange. I am wondering whether it was just a flare up type of day as I have Hashimoto's and i've experienced flare-up days before, where I felt exceptionally unwell, groggy, tired and itchy. I used to get this sometimes when my thyroid levels were bad, but I'm wondering whether these symptoms can be caused by overdosing in B12, folic acid, selenium or vitamin D? My doctor didn't test my vitamins the past few months, but they were in range the last time and I have been supplementing with these for over a year. Just wondering if anyone else experiences this sometimes?

Thanks in advance!

[Jaydee1507 Administrator]

Firstly its not a good idea to be alternating T3 as it is immediate release and your body will get confused by differeing amounts each day.

Its possible to do alternate dosing with Levo as it is a storage hormone.

Free T4 (fT4) 16.3 pmol/L (9 - 23) 52.1%

Free T3 (fT3) 4.6 pmol/L (2.4 - 6) 61.1%

Your FT4 is on the low side, would expect that to be around 70%, same with FT3.

Your TSH is within normal rnage but when taking T3 and optimally replaced it would usually be very low if not suppressed although many Endo's do not understand this.

So overall I would say that you are under replaced currently and probably raising your Levo might help.

If your doctor isn't testing vitamins then you should take responsibility for that.

What were the latest results for vitamins with ranges?

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[thyroidqueen12 in reply to Jaydee1507]

Hi,

Thanks for your response. I spoke with my endo and she said it's more about how I feel than the where percentage my results are in the range. She did say that they pay close attention to the TSH alongside the others. When I was dosing at 7.5mcg of levothryoxine everyday, I had very strong hypoglycaemic symptoms which were very worrying- this almost went away fully after lowering my dose. I also had additional anxiety (and higher heart rate) which I only realised once I came off. However when I switched to 5mcg every day I felt worse, so we settled on alternating days- which so far has been the best option. She does say it's unusual that this makes me feel better due to the immediate release of T3, but it could be that my body is storing some of it. I also have not noticed that I feel worse (or have more symptoms) on 5mcg T3 days than on the 7mcg T3 days. Although my plan is to keep a more diligent medical diary to truly check this.

I brought up my itchy flare ups, and the endo is getting my NHS GP to test for some additional tests, as well as checking my vitamins before the next appointment.

I also have symptoms of feeling VERY tired in the mornings, but I don't remember a time when I didn't suffer from this, and it's definitely worse in winters. I mentioned this to my Endo, and they checked for cortisol previously. But they said my cortisol looks good, but this result could be false because I am on the contraceptive pill. The only way to accurately test my coritsol apparently is to come off the contraceptive pill, which I'm not ready to do at this point in time.

All in all, I find it hard to know when I am 'fully better'. I definitely feel better now than I did previously, but I still don't know if this now feeling is normal or whether it could be better. I also suffer quite a lot with my mood and am trying to work on the mental side of my health journey as well. (Just through therapy not medication) So hoping that I will eventually end up in a place where I feel great.. Although does anyone ever feel great? No idea..

[Jaydee1507 Administrator in reply to thyroidqueen12]

Its essential to test vitamin levels once a year even if supplementing so suggest you get that done.

The only ones you are taking that might cause you issues if you took too much would be selenium and vitamin D.

You could ask your GP about sleep apnoea if you feel bad after waking up.

A small dose raise of Levo might help also.

[thyroidqueen12 in reply to Jaydee1507]

I take folic acid (1000ug daily), vitamin B12 complex (1000ug daily), selenium (200ug daily) and a vitamin d3 gummy daily. (amazon.co.uk/VITALDIN-Vitam...

[Jaydee1507 Administrator in reply to thyroidqueen12]

Thats a 2,000iu vit D which is quite a low dose and you may well need even twice that amount to get your results to optimal. Suggest you get Vit D tested.

NHS easy postal kit vitamin D test £31 via

vitamindtest.org.uk

Its also recommended to take vitamin K2 alongside D3 to help it go to your bones where it is needed.

Methylfolate is the recommended form of folate. Folic acid is an inactive form and a good percentage of the population cannot use it if they have MTHFR genes.

200ug of selenium is quite high. 400mcgs is the safe upper limit for a daily selenium supplement. Suggest you could pause that for a few months and restart at once to twice a week.