New test results after NHS ones

[CinnamonNutmeg]

Hi

I got some good advice after being dispirited last week by 'normal' results from my GP.

I got a set done by Monitor my health, hope you can read them.

My question is, should I go back to my GP and ask for an increase in Levo from 75mcg to 100mcg or is that not going to help my T3 - which is presumably why I'm not feeling any different to when i started this lark in September 2023?

Or do I need to try and get T3 directly by seeing an endo privately?

I couldn't find what a reasonable T4:T3 ratio would be but guessing mine isn't it!

All my vits are Ok except for perhaps folate which is 5.9 ug/L (3-20.5) which I will start to supplement.

Not sure what my next step should be. Why isn't it simpleeeee?

Thanks

[CinnamonNutmeg]

Ah, Ok results didn't copy they are:

TSH .75 (0.27-4.2) 11.7%

FT4 16.4 (12-22) 44%

FT3 3.5 (3.1-6.8) 10.8%

Ratio T4:T3 4.686

[pennyannie in reply to CinnamonNutmeg]

Hello CinnamonNutmeg :

We generally feel best when the T4 is up in the top quadrant of the range with the T3 tracking slightly behind at around 60/70% through its range.

If just looking at the T3/T4 readings - the accepted conversation ratio is said to be 1 / 3.50-4.50 T3/T4 with most people feeling at their best when they come in this ratio at 4 or under:

So looking at your results - first I think you need a dose increase in T4 - to at least try and see if T4 monotherapy works for you - as it is the easiest, cheapest, treatment option to manage :

Maintaining optimal core strength vitamins and minerals a given - folate is too low -

I now aim for a ferritin at around 100 - folate 20 - active B12 125 ( serum B12 500 ++ ) and vitamin D around 125 :

[Jaydee1507 Administrator in reply to CinnamonNutmeg]

Going by your free hormone results you have a long way to go before you're optimally replaced on Levo. Your FT4 needs to be well above 50% and all vitamins at optimal levels before thinking about adding T3.

Optimal vitamin levels help conversion.

Exactly what were your vitamin results for ferritin, B12 & D3?

Usually for folate members take a good methyl B complex which helps keep all the B's in balance.

If GP questions the need for a dose increase quote them NICE guidelines stating dose by weight 1.6 x weight in kilos = approx final levo dose.

nice.org.uk/guidance/ng145

Ask for the increase as a 'trial' which often goes down better.

If first GP refuses then keep asking different GPs and dont give up!

[CinnamonNutmeg]

Thanks both, and I had some good advice from greygoose too on my previous post about how to approach my GP

My ferritin in April 2024 was 122 (30-250)

Vit D in August 2017 was 78 (75-200)

Vit D in Dec 2023 was 91 (50-200) which considering I've been taking 1000iu daily for over a year is not brilliant

B12 in March 2019 was 264 (200-900)

B12 in Dec 2023 was 707 (200-900). I;ve been taking 1000ug daily for about 9 months but will change to the methyl B complex to help with the folate.

Righttttt, off to do an e-consult with my GP to ask for an increase- wish me luck !

This board is brilliant , so much knowledge, thanks so much