latest test results, test taken at 8.30 before taking Levothyroxine, last taken more than 24hrs previous.
T4 - 20.0 normal 11.0-21.2
TSH - 0.06 normal 0.27-4.20
T3 - 5.0 normal 3.1-6.8
I take 100mcg Levothyroxine and 2000 vitamin d supplements.
My dose was upped last year and I had a couple of months of feeling normal and then back to fatigue, joint pain and my hair hasn’t grown at all in the last six months. Plus my anxiety is back.
Was due a phone call with dr but they just sent a text saying test results showed satisfactory replacement. No communication about investigating further. I will chase up with them to get an actual appointment, but what do I need to get them to do next?
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Button83
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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
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Private tests are available as NHS currently rarely both antibodies or all relevant vitamins
Testing options and includes money off codes for private testing
If anything you are slightly over medicated. Your T4 is pretty high. Did you leave out a T4 dose before the blood draw? If so it goes even higher once you take your T4. Your TSH is indicating you’re taking too much. Suppressed TSH can lead to the symptoms you are describing.
So, if you didn’t take the T4 before your test the level will increase once you’ve taken it. Your TSH shows over medication. You could do another test 2hrs after taking T4 to check how high it’s going. I can guess it’ll be over the level. If so you need to reduce your t4 that’ll make you feel better. The aim is to mirror a healthy persons thyroid levels which are never over levels or under and a TSH around 1.00 to be symptom free
maybe 75mcg levo one day then 100mcg the next and so on
If the TSH is low, that does not necessarily mean that someone is overmedicated. The T3 and T4 are still within range. Many patients, including myself, have a suppressed TSH and T4 at the top or even slightly over the range, and only this way we can feel well. This is very individual and the TSH should not be used as guidance, as it is not reliable at all. The symptoms actually indicate, that she is still not optimised and therefore she experiences fatigue and anxiety.
Here is an interesting article about the over-reliance on TSH measurements:
@Button83 I am not sure if the GP will allow you to increase your dose, but I would certainly not reduce it, as I am sure this would make things even worse. Are you taking a good Vit B complex and Magnesium? This can help with energy. Selenium supplements can assist with making the most of your thyroid hormones. I would also do a Vitamin D test and see, if you may need to increase your dose as well. Hope all works out for you.
I’m sticking with in range myself. If I ever go over range I feel dreadful. Or under range for that matter. In range for myself gives me bags of energy, good mood and feeling of well being. I’ve never felt better in over 20 years from when I was first diagnosed. I’m symptom free.
I agree low TSH doesn’t mean over replaced but suppressed does
My sister has to have her TSH suppressed due to thyroid cancer. She’s is constantly having symptoms and is having a bad time of it due to being suppressed to stop cancer returning.
We are all different. I promote mirroring a healthy persons thyroid results who are symptom free and not over replaced nor a suppressed TSH
I get my vitamin D tested every 3 months I don’t supplement as it’s never below 100 just had it done and it was 113
It must be so frustrating ; just as you thought you were ok, back to feeling inwell again. I think our bodies require slightly different amount of thyroid hormone each day, depending on what we do and eat . I negotiated with my Endo and adjustment of my dose 12. 5 mcg up or down that I could do myself. He agreed . I found that even that small adjustment did not work terribly well. When on 125 mcg for a couple of days, I would start feeling hot, sleepless and have anxiety attacks , when on 112.5 mcg I felt sleepy and tired. I tried various combinations of these two doses over various durations , before finally starting on Armour Thyroid, purchased through Roseway lab . They advised me to start on one grain of Armour and quickly move to two, after a few days. Well, I have found that, for now, I need 1.5 grains and by monitoring my BP and temperature I will know when to go up. I found advise on dosage rather conflicting as some advise to get to the ‚final’ dose as quickly as possible (dr Conway) and others to take it gently . I fall into the latter category; when taking two grains, my BP would go really high 170/107) but I would feel very active and happy; when on 1.5 grains , my BP is below 140/90 - normal for me- but then I have to have a snooze in the afternoon and not be so active . Overall, I feel better on Armour. I don’t think there’s a ‚final’ dose as such of whichever medication we take, and patients should be allowed to make small adjustments to their dose frequently, depending on how they feel, unless a big change of dose is really necessary. Clearly. your dose increase needs readjusting again . Good luck!
Levo is a generic bioidentical T4 hormone formulation, made by several different companies, all using different combinations of binders/fillers. T4 is the storage hormone. Your body needs to be able to convert the T4 hormone to T3, the active hormone that regulates body temp, metabolism and affects virtually every system in your body (heart, lungs, kidneys, etc.) Armour is a Natural Desicated Thyroid (NDT) compound that contains T4, T3, T2, T1 and calcitonin, just like a healthy human thyroid does (although in different ratios). So, when taking levo (T4), you are only adding the storage hormone and depending on your body to convert it into T3 efficiently, in order to have enough active hormone. With some people, if they aren't converting enough T3, Armour helps by supplementing all of the hormones they need. Some people do fine on levo only, others do better on a combination therapy of T4 and T3 or NDT.
My anxiety levels increase when my levels are not optimal for me; this can be when either levels are too high or too low. Having FT4 very high in the range definitely gave me an anxiety spike. I consequently like my FT4 to be no higher than 70% in the range, although I’m fine with FT3 higher. I also adjust super slowly, eg reducing by 12.5mcg alternate days at first until well tolerated. I find a pill cutter handy for this. If you adjust very slowly, then you can more easily find your ‘sweet spot’ when you feel most well.
I'm sure these guys are right about the Levo dosing and Vitamin D but just wanted to chuck Perimenopause in there too, just going on your 83 (birth year?)...if you are female?! Sorry of not Might be worth a chat about HRT as all your symptoms are Peri symptoms too.
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Might be worth a chat about HRT as all your symptoms are Peri symptoms too. 
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