Been on Levothyroxine for 34 years (Hashimotos)Recent private blood test results are:
TSH 0.009
Free T3 4.6
Free Thyroxine 26.2
I feel well at this dose but have been advised by GP that I am over medicated.
Also, Ferritin is on the low end at 69.1
Do I need to take iron supplements?
Vit D is deficient at 18, but I will be starting supplements for this.
Folate Serum 14.5
Vit B 12 -Active 79.6
Any thoughts or advice would be welcome.
Well, you're not over-medicated per se. It just looks like you are a poor converter and need your FT4 that high to get enough T3 - which is low, anyway. Which is not a good thing long-term. Tell you doctor that you will reduce your levo if he will give you some T3 to bring your FT3 level up - or refer you to an endo that will give you T3. How much levo are you taking?
That said, as you have Hashi's, that might have something to do with it, too. Do you have other results done previously on the same dose?
Also, how long was the gap between your last dose of levo and the blood draw?
Hi Greygoose,Thanks for the reply 😊
I take 150mcg levothyroxine daily and I have had constant struggles with GP's over the years, wanting to reduce the dose going on TSH results alone. I did reduce a couple of times over the years only to end up very ill each time.
These test results are via Medicare as a result of joining this forum and learning so much about my condition, I don't have any other full blood test results only TSH levels done yearly.
Blood test was done at 8am with no food or levothyroxine until after the test, last dose of levothyroxine was around 20 hours before blood test.
OK, well, that's a shame. It's always good to have other tests for comparison. So, the best thing to do, if you can, would be to stay on that dose - if you feel well on it - for another six weeks, and then retest to see where you are.
I'm afraid GPs understand nothing about thyroid/Hashi's. They just don't get the education they should!
I'll retest in 6 weeks for the comparison and take it from there.Thanks for the advice.
You're welcome. 
Getting vitamin D, folate, B12 and ferritin OPTIMAL may improve conversion rates
Exactly what vitamin supplements are you taking
Vitamin D, you need loading dose
What’s the range on folate
Look at increasing iron rich foods in your diet
NHS Guidelines on dose vitamin D required
ouh.nhs.uk/osteoporosis/use...
GP will often only prescribe to bring vitamin D levels to 50nmol.
Some areas will prescribe to bring levels to 75nmol or even 80nmol
leedsformulary.nhs.uk/docs/...
GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)
mm.wirral.nhs.uk/document_u...
But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better
pubmed.ncbi.nlm.nih.gov/218...
vitamindsociety.org/pdf/Vit...
Once you Improve level, very likely you will need on going maintenance dose to keep it there.
Test twice yearly when supplementing
Can test via NHS private testing service
Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.
There’s a version made that also contains vitamin K2 Mk7.
One spray = 1000iu
amazon.co.uk/BetterYou-Dlux...
It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average
Vitamin D and thyroid disease
grassrootshealth.net/blog/t...
Vitamin D may prevent Autoimmune disease
newscientist.com/article/23...
Web links about taking important cofactors - magnesium and Vit K2-MK7
Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine
betterbones.com/bone-nutrit...
medicalnewstoday.com/articl...
livescience.com/61866-magne...
sciencedaily.com/releases/2...
Interesting article by Dr Malcolm Kendrick on magnesium
drmalcolmkendrick.org/categ...
Vitamin K2 mk7
betterbones.com/bone-nutrit...
healthline.com/nutrition/vi...
Hi SlowDragon,
Medichecks private blood test GP advised
4000iu (100mcg) daily for 10 weeks then to drop to 400iu (10mcg) daily as a maintenance dose.
Also advised improving iron levels through diet, but I'm considering an iron supplement to be on the safe side.
Thanks for the links 😊
4000iu (100mcg) daily for 10 weeks
yes ….or 5000iu for 8 weeks
Then important to RETEST vitamin D levels
Highly likely you will need significantly more than 400iu as maintenance dose
Test twice yearly and aim to maintain at least over 80nmol minimum
I'm considering an iron supplement to be on the safe side.
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing.
It’s possible to have low ferritin but high iron
Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test
If taking iron supplements stop 5-7 days before test
Medichecks iron panel test
Thanks, and yes, I agree it would be wise to have a more detailed iron level test, I'll keep checking in on here for advice as I progress and I will be monitoring bloods regularly.
No advice but just solidarity! Your results and dose are almost identical to mine and similarly when I had a dose reduction inflicted on me (150–>100) I became v ill v quickly after decades of feeling fine. Good luck getting T3 though - it’s a flat no where I live from GP and Endos so I live with the niggling fear I’m over medicated on Levo and storing up future problems.
Thank you 😊Looking after your health shouldn't have to be a battle with healthcare providers, but unfortunately with thyroid issues it seems to be the case.
Your results are very similar to mine after bring treated for Hashimoto's for 20 years. TSH is suppressed and T4 is high but you feel well. If you lower the dose, you feel unwell. There might be something else going on linked to low vitamin D.
They need to test magnesium which is essential in converting T4 to T3. Vitamin D is very low. You need vitamin D3. What dose are they suggesting? A lot of GPs/Endos but you on a very high loading dose that can make you feel ill. Then when it is stopped, you crash down again. Better to have a regular daily dose to bring it up to 50+.
Please ask them to test calcium, vitamin D and Parathyroid Hormone (PTH) from the same blood draw first thing in the morning before meds and food. Low vitamin D raises PTH which in turn increases calcium levels in the blood. The calcium is being drawn from your bones. The four parathyroid glands sit behind the thyroid. They are the size of grains of rice. They control levels of calcium and phosphorus in the blood. Sometimes, like the thyroid, one or more overwork because of low vit D and become enlarged - a benign adenoma. This is HYPERPARATHYROIDISM (known as HPT).
Have you ever had a neck and chest scan to see if you have a goitre (common in autoimmune thyroid disease - Hashimito's and Graves)?
Low ferritin suggests iron deficiency which needs to be treated too.
When I was in your situation in 2019 with similar thyroid results, tests also showed that I had vitamin D deficiency, raised calcium and raised PTH - diagnosed as hyperparathyroidism. A DEXA scan showed that I had osteopenia and kidney tests showed a decrease in kidney function but no stones thankfully. A scan of my neck and chest showed an enormous goitre in my chest and an enlarged thyroid in my neck. I had surgery to remove the thyroid and goitre. The surgeon also removed two very large parathyroid adenomas.
Once I had surgery all my symptoms disappeared. My surgeon reckons that I had HPT for a very long time. I'm now on a maintenance dose of levothyroxine to replace the T4 I no longer make. I feel well.
Hi, Thanks for your advice and it's good to hear that you finally feel well.
I'm information gathering from all the input and support on here and it has been extremely informative so far.
I have added
Magnesium, calcium and PTH to my list of things to check.
Thank you 😊
Personally I have started to collect resources with the signs and symptoms of nutritional deficiencies and over doses cause I don't have the money to be able to afford an Integrated Practice M.D. or the cost of the lab tests they would order. It is all about balance ! Thank you
How about Iodine level. Personally I am beginning to believe many doctors know NOTHING about the thyroid and that is why we are all messed up !
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