High T4 - Test Results

[Fortie]

CRP -HS 2-690 mg/L Range under 3

Ferritin 185.00 ug/L ( 30-650)

Folate - sample error

Vit B12 Active 83.2 pmol/L (37.5 - 188)

Vit D 73.5 nmol/L (50 -250)

TSH 0-135 mIU/L (0.27-4.2)

Free T3 4.8 pmol/L (3.1 - 6.8)

Free T4 26.7 pmol/L (12-22)

Thyroglobulin Antibodies over 4000 kIU/L (0-115)

Thyroid Peroxidase Antibodies 20.3 kIU/L (0-34)

Spoke with surgery today on the advice of Medichecks - Clinical Nurse has asked me to reduce Levo from 162.5 to 100 and retest in 2 wks

Please can I have your comments on the results.

Dec results were TSH 3.51 & T4 17.5 no action or advice except GP stating results Normal when the T4 on my records was showing as abnormal

[Regenallotment Ambassador]

I’ve had FT4 that high, I did a dramatic reduction in Levo for a month and then a tapered increase to just below testing every 6 weeks or so on each dose. Do you have symptoms of over replacement? Loose bowels, face sweats, overheating, palpitations are my tells. Wishing you well 🌱

[Fortie in reply to Regenallotment]

a bit anxious/ feeling warm at latter part of day and a bit uncomfortable in the chest so yes now realising it is because something has changed and therefore the dose that I was on is now making me overmedicated

[SovietSong]

162.50mcg daily is a big dose and your T4 is way too high but dropping right back down to 100mg in one go is madness and a two week gap before testing again is nowhere near long enough.

[Regenallotment Ambassador in reply to SovietSong]

For a short term, reducing like that, it’s actually quite a good way to get the symptoms down. I went from 125mcg to 50mcg and then gradually back up to 75. Depends on the causes of being over range and length of the autoimmune episode if it’s that. Mine took from June to September to resolve. If the GP is checking in two weeks that’s a very good sign. 🌱

[Fortie in reply to Regenallotment]

Many Thanks - will see how it goes

[Fortie in reply to SovietSong]

sorry that was meant to be 3 wks time for a retest

[GlowCoach Administrator]

Thats a huge dose reduction and likely inadvisable. GPs make heavy handed adjustments sometimes.

Did you allow a space of 24 hours between taking your Levo and the blood test?

Can you correct the TSH value as there seems to be a typo and its not clear what the TSH was.

Vitamin D should be around 100 - 150. Buy one that includes vit K2 to help it go to your bones. Some are available in oil or you can take it with an oily meal for better absorption. Many members like the ‘Better You’ range of mouth sprays that contain both bit D & K2. Use this calculator to work out how much to take to get your level to 100-150.grassrootshealth.net/projec...

[Fortie in reply to GlowCoach]

The medicheck result for TSH is 0.135mIU/L range 0.27-4.21

yes space was 24hrs.

Have actually bee on Winter loading dose of Vit D for 10 wks from 24th Nov 23 and since then have been supplementing D3000 Betterfor you and K2 and still not optimal ?

[Regenallotment Ambassador in reply to Fortie]

keep going with it, took months and months for mine to come up 😊

[GlowCoach Administrator in reply to Fortie]

As I understand it the NHS loading dose doesn't take your level to what we would describe as optimal. Some people do need a little more D3, I am one of them. There are genetic SNPs that mean you don't absorb it well or need more of it.

You could try 4,000iu D3 + K2.

Probably a dose reduction of 25mcgs would be enough to bring your FT4 back in range and I wouldn't recommend reducing by any more anyway. Suggest re negotiating that.

Restesting in 2 weeks isn't going to be an accurate result. It takes 6-8 weeks for a dose change to level out.

[Fortie in reply to GlowCoach]

Ok many thanks will increase the Vit D to see if this helps. This was the first time checking Vit D after 2 subsequent loading doses Feb 2023 & Nov 2023 and supplementing D3000 throughout the summer

[greygoose]

You have Hashi's (or Ord's) so the sudden rise in the FT4 level is far more likely to be due to a Hashi's 'hyper' swing than your dose of levo. Your Tg antibody level backs that up because they are at their highest during/just after a swing. To a lesser extent, so do the TSH and FT3 levels which haven't had time to catch up.

I doubt the clinical nurse has any idea about any of this, hence her strange advice. Did she change your prescription? Because if I'm right, your FT4 level is eventually going to drop again, by itself as the excess hormone is used up or excreted, and you will become hypo again. Not that it's all that high, anyway. So, if your prescription has been changed, it might be difficult to get it put up again. In cases like this, it's best to just reduce/stop levo yourself without involving anyone else.

That said, how long was the gap between your last dose of levo and the blood draw?

[SlowDragon Administrator]

more sensible advice would have been to reduce to 150mcg and retest in 8 weeks

[Polo22]

The " Clinical Nurse" obviously has no idea what she is talking about. I do hope they don't change your PX, do not agree to a massive reduction. Go with the advice from the people who know what they are talking about on here, smaller reduction, retest in 8 weeks. Hope things settle for you and you feel better soon.

[irishacres]

Hi Fortie My T4 went from normal range to 34 in 3 months. I was on 175mcg so reduced to 150mcg but T4 was still 31. So don’t worry too much. I’m still reducing to get T4 down

I would advise trying to reduce meds but you must wait at least 6-8 weeks before retesting. 2 weeks is too early and will give you a false result.

Do you know whether your Brand has changed? I would be interested to know.

[Fortie in reply to irishacres]

it did but not for long (Teva) but went back to Accord 150 & Mercury for 12.5

[irishacres in reply to Fortie]

I’ve queried mixing brands with my Endo and on the gov.uk website there was a warning sent to all doctors NOT to mix brands and put a brand name on the prescription if anyone starts to have symptoms. My T4 skyrocketed when my pharmacist changed brands without telling me (I have my meds in a plastic dosette box with no brands shown). I am now back on TEVA so it will be interesting to see if my T4 comes back down.

[tattybogle]

Hi Fortie,

162mcg down to 100mcg is likely far too big a reduction, and is highly likely to leave you feeling undermedicated. In my opinion it would be been wiser to suggest you reduce to 137.5 mcg or 125mcg for now , and then re-asses after a couple of months. That would probably be enough to improve your symptoms of overmedication and bring your results back into range. I developed overmedicated symptoms/ high fT4 on 150mcg after being fine on it for years, and lowering to 125mcg was enough to fix the problem )

Also 3 wks is not long enough for a retest.. retest should be at least 6 wks to allow the TSH time to adjust in response. (TSH can take quite a long time to respond to changes in T4 levels)

Bear in mind , after any dose reduction , for the first 4/5 weeks you are likely to feel a bit off as the body adjusts, so you shouldn't judge the effect of a new dose on how you feel until you've been on it at least 6 weeks (and preferably 8-12)

[Fortie in reply to tattybogle]

Many Thanks - might cancel the blood test she made and rebook for 6 wks