Results

[twizzle303]

Hi everyone, I am on 100mg Levo and 15mcg Lio daily and I feel OK. As I have an appointment with my endo soon, and doing NHS blood tests is rubbish due to the timing issues, I have just done a private blood test. I know my Endo is going to focus on my TSH which is negligible but my T3 and T4 levels are mid level. Any tips on how to direct his attention on the positives please? PS I have had 2 bone density scans in the last 10 years and my skeleton is very strong, very unlikely its going to deteriorate drastically during the few years I have left on this mortal coil and its almost certainly due to a very active life which I try to maintain - keep on hiking 🥾🥾🥾🥾

TSH X 0.006 mIU/L (Range: 0.27 - 4.2)

Free T3 4.7 pmol/L (Range: 3.1 - 6.8)

Free Thyroxine 16.1 pmol/L (Range: 12 - 22)

Thank you 😇

[Forestgarden]

I would focus on how you feel and the fact your ft3 and ft4 are mid range. Also point out (if endo mentions it) that tsh is not completely suppressed... if it was, it wouldn't have registered at all. And put your foot down and resist any changes! Good luck

[twizzle303 in reply to Forestgarden]

Thank you, he is very receptive to informed discussion.

[DippyDame]

"OK" sounds as if you could feel better!

With those labs I'd be inclined to raise T3 to 20mcg which is currently only 43.24% through ref range...ideally we aim for closer to 75%

Once medication is initiated TSH is no longer a reliable marker

T3 reduces both TSH and FT4

Do your doctors understand this?

How you feel is as important as lab results....if this medic tries to raise your TSH you will end up undermedicated and under par.

The lower the dose, the higher the TSH.

Low ( cellular) T3 can result in cardiac issues and in some instances in low bone density.

As with all other treatments/ medications if T3 is used correctly it should be safe.

Just a few thoughts

[twizzle303 in reply to DippyDame]

Thank you I will discuss this option with him

[Angie33 in reply to DippyDame]

Great advice, thank you DippyDame and Twizzle303. This was helpful for me too. I wish you well x

[SlowDragon Administrator]

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

T3 ….day before test split T3 as 2 or 3 smaller doses spread through the day, with last dose approximately 8-12 hours before test

Is this how you did your testc

Free T4 (fT4) 16.1 pmol/L (12 - 22) 41.0%

rather than increasing T3 you might want to experiment with small increase in Levo

Perhaps 112.5mcg daily

This would improve Ft4 and Ft3

Plus test B12, folate, ferritin and vitamin D

[twizzle303 in reply to SlowDragon]

Thank you slow dragon. Yes I did mess around with Levo timings (changed to morning for a couple of days) and Lio split into 3 5mcg tablets instead of a 10 and a 5 to get timing right. I haven't done vits for ages so will do them again thank you.

[Angie33]

Hi Twizzle303, it sounds like you and I have a similar issue. My endo won't allow me to increase my T3, despite it only being mid range as a result of my TSH being 0.01. My T4 is way below the normal range and my symptoms are still very much there. Still so tired daily with brain fog. Very frustrating. Lately I've been advised to ignore my TSH and just increase my T3 and T3 as they are the important hormones which will increase my quality of life. However, having a low TSH is scary. I had no idea this was linked to low calcium and could leave to osteoporosis. I thought the only role of TSH was to guide us with our meds re T3 and T4. Interesting read. Are you going to increase your T3? I was informed I will function better if my T3 is at the higher end of the range.

[twizzle303 in reply to Angie33]

Hi, interesting as you say similar results. Probably take slow dragon suggestion and up my Levo slightly as I was on 150 and reduced to 100 a few months ago. Not so easy to increase Lio as I have capsules not tablets abd cant split them. See how it goes.

[Angie33]

Hi Twizzle303, I am curious how you managed to get a bone density scan? I find it a challenge getting anything from GP's these days, and that's with an under active thyroid.

[twizzle303 in reply to Angie33]

I lived in Cyprus when I hit 50 itcwas a standard test. Then discussion with my endo about his concerns with my low TSH a couple years ago so I suggested to him I have a scan - he authorised it and was very happy with my results - let's hope he remembered