Help on results please.

[Soaping]

Good morning all,I wanted to know what my readings were two hours after taking my thyroid meds on an empty stomach to try and work out if im being over medicated and why im getting missed heartbeats and a little tightness in the chest on and off during the day.

I went up to 5mcg three times a day on liothyronine. levothyroxine stayed the same 75mcg.

But went back down to 5mcg twice a day 3 days before test but still the missed heatbeats etc continue.

Any thoughts please, im waiting for my private Endo to get back to me.

Thank you

[SlowDragon Administrator]

Do you wear a fitness watch

If yes can it record ECG

drsanjayguptacardiologist.c...

As the heart rate slows down patients with hypothyroidism may be more prone to developing ventricular ectopics. These are extra but ineffective heart beats that come in when the heart slows down and this may manifest as missed beats or heart flutters.

suggest you go back to 3 x 5mcg per day

Retest in 6-8 weeks with last dose T3 at 8-12 hours before test

When did you last test vitamin levels

[Soaping in reply to SlowDragon]

NThank you for your reply, no I do not have a fitness watch. Can't get much fitness when waiting for my hip replacenent 😔.

My vitimin levels are all fine.

Do you think 75mcg T4 is still the right dosage with such a low TSH.

[SlowDragon Administrator in reply to Soaping]

A fitness watch can record resting heart rate, and record lowest heart rate at night

Taking almost any dose of T3 will significantly lower or suppress TSH……if anything your TSH is relatively high for someone on T3

Last dose levothyroxine should be 24 hours before test

[Soaping]

Okay thank you Slowdragon.My resting heart rate usually 64bpm.

[DippyDame]

The heart needs a lot of T3....your FT3 is low.

Your ...

FT4 is 68% thro the ref range

FT3 is 43.24 % ditto

Dose at test = 75mcg levo +5mcg × 2 daily

Adding T3 reduces both TSH and FT4 so I'd be inclined to stay with 75mcg levo

Did you test close to 9am...leaving a 12hr gap after last T3 dose and 24 hrs after last T4 and at least an hour away from food and drinks

You are undermedicated...suggest you try 10mcg T3 twice daily.....you have plenty room for this increase

Test again after 6 weeks on a constant dose....TSH, FT4, FT3, vit D, vit B12, folate, ferritin and antibodies TPO and Tg

You say nutrient levels are fine....can you post the levels?

[Soaping in reply to DippyDame]

Hi DippyDame, I wanted to know what my readings were two hours after taking my thyroid meds on an empty stomach to see how high i got, also with hip replacement coming up i didnt want TSH suppressed. And im also scared with the missing heartbeats that if i put t3 up will it cause me to have a stroke? I didnt have a heart problem but what if i have and dont know it?

[TiggerMe]

Have you tried taking your T3 in one go as I find this gives me a much smoother ride, split doses meant I never had enough in my system to last long so the dip would follow a couple of hours after

[Soaping in reply to TiggerMe]

Hi TiggerMe, I havent tried im scared with the missing heatbeats and getting a bit of tightness in the chest on an off to take extra. Ive never felt any ups or dips in energy on T3 yet?

[TiggerMe in reply to Soaping]

I understand but missing heartbeats are often a sign of low fT3, I'm not suggesting taking more just gradually combining your doses and see how that feels, by having more in you bloodstream it can allow for more cellular uptake which is where we want it to be

[Soaping in reply to TiggerMe]

I understand thank you.

[AKatieD]

The way you have tested means that you don't know the baseline levels of your hormones that we look for to understand how well medicated we are.

You also don' t know how far you are through the rise in hormone levels that occurs after taking medicine - is it still rising or at a peak and how high it will go. Unless you (or other people) have tested at that 2 hour point, you can't compare results.

All you can say is that, compared to the usual pre- treatment results, your levels are not high and were presumably lower before you took the T3/4.

You probably need a dose increase as neither T3 or T4 are high even after medication, but you would need to test pre- medicine for a clearer picture.

[Soaping in reply to AKatieD]

Hi AKatieD These results were bloods taked two hours after medication and fasting.

Thank you for your message.

[AKatieD in reply to Soaping]

Yes, that was my point.

[Soaping in reply to AKatieD]

Bloods taken as advised by private endo morning before taking your meds which was 24 hours after T4 and 16 hour after T3.

TSH 0. 65 (0.37-4.2)

T4 16.9 (12-22)

T3 3.6 (3.1-6,8)

Vit D 130 (50-125)

B12 1224 (197-771)

No ferritin was advised.

[AKatieD]

So definitely NOT overmedication of thyroid hormones affecting your heart as both results confirm. Could be too little thyroid hormone or other cause, we could not know for sure.

NHS will try to scare you out of taking T3 if you get heart problems with talk of too much causing irregularities, but you need to keep in mind that your T3 is not high, so it could not be that.

Have you considered your other hormones? If you are female, sex hormones can affect heart function too (eg oestrogen and testosterone) and these go wonky as we age. I found HRT has prevented the worsening of osteoartritis that consultant said could only get worse and would need knee replacement.

Presumably you are checking heart out with cardiologist to rule out structural heart issues? If it is to do with heart rate, an electrocardiologist is the right speciality to help (I have developed occasional irregular heart rate - called atrial fibrillation). Adding testosterone to my HRT seems to have reduced the Afib events.

Best of luck

[Soaping]

Thank you, i dont really want NHS as yes they will definitely say its the T3 . My End is an excellent one so i will discuss all my concerns and hope he wont take me off the trial 😔