I posted approx 4 months ago with my latest blood results with the following
Thyroid function test in October 23
Serum free T4 level 14.2 pmol/L [11.0 - 22.0]
Serum TSH level 1.30 miu/L [0.27 - 4.2]
I had some great advice on here (thank you) and was told I was under medicated.
Since the doctor flatly refused to do anything further I have medicated myself and increased my Levo by 25mgs and T3 15mgs.
Private blood test has just come back - T4 seems better but the rest seems worse, can anyone advise, I’d be very grateful? Their advice was a possible problem with pituitary gland?
Latest results posted as an image
Sara
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MurphysMama
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Who advised a possible problem with your pituitary gland? The private blood test people - they post them with ‘advice’
When did you take your last doses oflevo & T3 prior to this test and what time of day was it taken? I take my levo and T3 in the evening and had the test first thing in the morning.
Is it correct that you were on 100mcgs Levo 4 months ago and now on 125mcgs Levo+ 15mcgs T3? Yes - I increased levo to 125 and began T3
Thats quite an increase in a fairly small amount of time thyroid wise.
Did you retest on the 125mcgs levo and what was the result? This is the test for 125mgs the previous results were on 100mgs
The last results you have posted there wasn't an FT3 that I can see. No there isn’t as GP will not test for T3, so I included it in the private one
How are your key vitamins ferritin, folate, B12 & D3?
My ferritin was tested because my hair was falling out - it’s abnormally high, I’ll add so you can see
The reason your TSH is as low as it is is due to the addition of T3. T3 tends to reduce TSH to almost nothing and doesn;t point towards a pituitary issue, it is expected to behave like that.
Its recommended to leave 24 hours from last dose of Levo and 8-12 hours for T3 before blood test.
So your current results might be very slightly high on FT4 and possibly about right for FT3.
We don;t know what your FT3 was on 125mcgs Levo so no idea if you need T3.
Usually when adding T3 its recommended to add 5mcgs, wait a week or 2 and if all is well add a further 10mcgs. Going up to 15mcgs right away can be a shock to your body and you risk missing your sweet spot.
I'd recommend getting folate, B12 & D3 tested now as likely some are at low levels.
Suggest reducing T3 by 5mcgs.
Are you splitting the T3 dose? This helps many people.
No I’m not splitting the T3 dose, I take it in the evening with my levo, and have been doing so for the last approx 6 weeks - so the FT3 result is on the 125mg but your correct I don’t know what it was on 100mgs of levo.
I feel quite lost in all the results to be honest so appreciate your advice
Levo is an inactive, storage hormone. Most people take it first thing in the morning then wait an hour before eating breakfast and having a cuppa. It needs to be taken on an empty stomach an hour before food or caffeine containing drinks.
Some people prefer to take their Levo at bedtime which is also a good option so long as you don't drink tea, coffee or hot chocolate late in the evening.
T3 is an active hormone and it would help you to take it during the day when you need energy. 5mcgs first thing in the morning and then another 5mcgs late afternoon at around 4-5pm.
At this point because we don't have a full thyroid blood panel when you were on Levo alone we can't be sure that you really need T3.
Most hypo people get low vitamin levels and sometimes all you might need to do is test the vitamin levels and supplement those that are low in range. This helps your thyroid hormone to work well and means you may not need T3 as it aids conversion of Levo to T3 naturally.
Its important to take the thyroid blood test the same way every time especially when you re taking T3 as there is a distinct peak after you take it that we dont want to capture with the blood test. Its better to see the stable blood level hence allowing 24hrs for Levo & 8-12 hours for T3. Adjust when you take each the day before your blood test.
Ok understood - thank you very very much for helping me.
I have not left 24hrs with Levo before test, but probably am within the 8-12 hours with the T3. It seems sensible to maybe test again with this in mind. If I continue with T3 I will now definitely take in the day and split it- so thank you once again for all your advice, very much appreciated
Last dose levothyroxine should be 24 hours before test
Testing early morning, ideally before 9am, only drinking water between waking and test
Is that how you do your tests
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
After ONLY increasing Levothyroxine, ideally you would have got TSH, Ft4 and Ft3 tested 6-8 weeks after increasing levothyroxine to 125mcg daily
BEFORE considering adding any T3
You may not have needed any T3 once levothyroxine dose was high enough
So day before test ALWAYS split T3 across the day
5mcg waking, 5mcg mid afternoon and 5mcg 8-12 hours before test
Suggest you retest now with correct timings now and also …..vitamin D, folate, B12 and ferritin too
Ferritin isn’t abnormal
Updated reference ranges for top of ferritin range depending upon age
Thank you for your incredible patience while you have been awaiting the outcome of our ferritin reference range review. We conducted this with Inuvi lab, which has now changed the reference ranges to the following:
Females 18 ≤ age < 40. 30 to 180
Females 40 ≤ age < 50. 30 to 207
Females 50 ≤ age < 60. 30 to 264
Females Age ≥ 60. 30 to 332
Males 18 ≤ age < 40 30 to 442
Males Age ≥ 40 30 to 518
The lower limits of 30 are by the NICE threshold of <30 for iron deficiency. Our review of Medichecks data has determined the upper limits. This retrospective study used a large dataset of blood test results from 25,425 healthy participants aged 18 to 97 over seven years. This is the most extensive study on ferritin reference ranges, and we hope to achieve journal publication so that these ranges can be applied more widely.
No it’s not how I have taken the test, leaving 24hrs before etc. I’m thinking your suggestion to retest may be a good idea, and start again.
Ferritin - doctor told me it was abnormal but ‘had I been under the weather recently’ that could be the reason - I despair at doctors at times - thank you for putting my mind at rest 😊
Would there be any point in MurphysMama backtracking a little and gradually reducing T3 to the point of taking none and then experimenting with more T4. Seems silly to be on T3 if she finds more T4 does the job
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