Morning all, I’m awake early feeling like total rubbish so thought I’d jump on and share in the hope that someone can shed light on my baffling blood test results which came through on Friday!
I’ve been on 75mcg Levothyroxine and 15mcg T3 for the last 6 weeks (having slowly increased T3 from nothing since October. I also decreased Levo from 100 to 75).
I should add that when I decreased levo from 100-75, I was put on Teva instead of Accord despite battling hard with the GP surgery and the pharmacists - I wonder if this could be making a difference?! I’m annoyed that I gave up the battle but it was getting ridiculous and I’d run out of Accord so felt I didn’t have a choice in the end! I need to take something instead of nothing.
TSH 6.69 (0.7-4.2)
T4 13.5 (12-22)
T3 4.1 (3.1-6.8)
Ferritin also low again at 19 (13-150). Serum iron 19.1 (6-26). I didn’t get B12 or VitD tested this time but I’ve been on supplements (B complex, 1000-2000 VitD) for years and levels are usually fine so hopefully they’re at least ok!
Any empathy gratefully received! Thank you 🦋
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underact15
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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)
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
Hi SlowDragon thank you for your replies. That’s how I’ve been testing for the last few years, I think I’m quite consistent.
I did wonder if I should go back up to 100 levo and yes, I’d definitely like to go back to Accord, the GP surgery and pharmacy were frustratingly unhelpful.
I’ll definitely work on my ferritin again, I’ve been on and off iron pills for years.
shows your Ft4 was only 56% through range on 100mcg Levo, so assuming Ft4 was still roughly similar before starting on T3, you didn’t need to reduce dose
Did you ever try increasing dose Levo to 125mcg before trying T3?
You may even need further dose increase in levothyroxine after next test
Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.
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
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Thank you for your incredible patience while you have been awaiting the outcome of our ferritin reference range review. We conducted this with Inuvi lab, which has now changed the reference ranges to the following:
Females 18 ≤ age < 40. 30 to 180
Females 40 ≤ age < 50. 30 to 207
Females 50 ≤ age < 60. 30 to 264l
Females Age ≥ 60. 30 to 332
Males 18 ≤ age < 40 30 to 442
Males Age ≥ 40 30 to 518
The lower limits of 30 are by the NICE threshold of <30 for iron deficiency. Our review of Medichecks data has determined the upper limits. This retrospective study used a large dataset of blood test results from 25,425 healthy participants aged 18 to 97 over seven years. This is the most extensive study on ferritin reference ranges, and we hope to achieve journal publication so that these ranges can be applied more widely.
Have your results been higher in recent times and may now have dropped back after a Hashi flare?
You are undermedicated...lowering levo dose when adding T3 was not necessary....T3 lowers both T4 and TSH but your T3 dose was lowering an already low FT4.
You need to increase your levo, initially back to 100mcg then test after 6 weeks on that steady dose....you know the protocol.
I suspect you will need a further increase and depending on your labs most likely a further one to 150mcg. followed by another test.
If you react badly to excipients in Teva then use that as a reason to push for Accord
Thank you DippyDame I appreciate. That’s the highest TSH and the lowest FT4 that I’ve seen since 2020 so I was a bit shocked, especially because my December bloods (on 100 levo and 5 T3) were quite good! Maybe should have just stuck to that but I was still symptomatic so my doctor decided to go to 75 levo and 15 T3
I think she decided to decrease levo because my FT4 was right at the top of the range in Dec but perhaps I should have stuck on 100 and kept increasing T3 😬 Time will tell!
OK....well , she can't have been dosing you based on the above labs then. I'm confused!
If your FT4 was top of the range (which it certainly isn't above) when she reduced your dose I'd hazard a guess it was maybe a Hashi swing....but don't have the info to judge.
if you keep increasing T3 further you will need to reduce levo.
She wanted to get me up to 15mcg T3 max which I’ve done but I now feel worse! She’s thankfully agreed to see me “urgently” this week so I’ll see what she says
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