Now I'm really confused – surprising test results

[DandyThyro]

I've been on here before complaining about the same problems which seemed to stem mostly from undertreated hypothyroidism and doctors being too cautious to change my T4 dose. My picture has been complicated for several years by atrial fibrillation which has the grace at times to run to tachycardia (very fast heart rate) , having me run to the doctors/A&E in fear for my life.

6–7 weeks ago I got shingles. It was in my left chest area and armpit, leading to a lot of pain just around my heart. I then developed tachycardia, which is persisting, leading me to absolute exhaustion and not a little anxiety. Drs have been very good about chasing this up; the heart is okay apart from the increased rate, which should settle.

They did blood tests yesterday and contacted me today to say that I should reduce my Levothyroxine immediately (from 50 one day, 75 the next to 50 each day). I also take liothyronine, which they never comment on, but which I reduced 3 months ago from 25mcg a day to 18.75mcg a day.

My thyroid results are

TSH: 0.01 (0.3–4.2)

T4: 20.4 (11.9–21.6)

T3: 8.2 (3.1–6.8)

I'm confused because I've been feeling more hypothyroid than ever.

I had other tests done and they are mostly normal with a couple a little high, which the docs are blaming on the thyroid.

I didn't get D3 tested; it's about the only thing left that might be causing such levels of fatigue. I'll do that soon privately.

I got the test at 11am. The last doses were taken the day before. Previous tests have had either more or less ideal timings but have always shown the T4 to be rock bottom, the T3 in the middle, and TSH annoyingly coasting along in what the docs call 'normal' (ie high for someone on thyroid meds) for years

I have lost two stone since the last test and wonder if this had reduced my need for the medication.

I wonder, because it's actually the T3 that is over range, should I reduce the T3 dosage as well?

Thank you, if you've been able and patient enough to read...

[greygoose]

You have Hashi's, don't you. So your increase in levels has probably got more to do with that than your dose. But doctors don't understand that. If I were you, I'd stop both T4 and T3 for a few days and see what happens to the symptoms.

[DandyThyro in reply to greygoose]

Oh wow, I never suspected Hashi's! Good point.

[Jaydee1507 Administrator]

So exactly how many hours was there between last doses of Levo & T3 before the blood test?

Recommended timing is 24hrs for Levo & 8-12hrs for T3.

Only ever adjust one thing at a time otherwise you wont know where you are.

What other supplements other than vit D are you taking?

What are your latest results for ferritin, folate & B12?

[DandyThyro in reply to Jaydee1507]

Hi Jaydee, it was about 27 hours for the Levo, and about 20 hours for the T3.

I'm not taking vitamin D, I haven't for 5–6 months.

The supplements I take are magnesium, plant sterols, Co Enzyme Q10 and selenium. The emphasis is on heart health with these, apart from the selenium.

Ferritin was 151 (13–150); folate: 19.5 (>3); B12: 396 (200–771).

I'm now wondering about D3 as the others seem to be okay. I'll get a private test before taking any D3.

[Jaydee1507 Administrator in reply to DandyThyro]

Especially with T3 its very important to get the timing right for the blood test to show stable blood levels, otherwise its just guesswork.

In this case though, with 20 hrs from your last dose you have quite a bit too much T3.

Suggest reducing T3 by 6.25mcgs and retest in 6-8 weeks making sure to time last dose as per protocol. Make a note in your calendar to remind yourself.

Your B12 is actually quite low.

What was the range for folate?

I'd suggest starting a good active/methyl type B complex. B complex suggestions: Slightly cheaper options with inactive B6:

amazon.co.uk/Liposomal-Soft...

Contains B6 as P5P an active form:

bigvits.co.uk/thorne-resear...

healf.com/products/basic-b-...

Explanation about the different forms of B6:

helvella.blogspot.com/p/hel...

B complex comparison spreadsheet:

healthunlocked.com/thyroidu...

NHS easy postal kit vitamin D test £31 via

vitamindtest.org.uk

[DandyThyro in reply to Jaydee1507]

Thank you very much for all your advice here, Jaydee. I already didn't take that 6.25 dose today! I will get a private check in a couple of months, as you suggest. I've been online checking out vitamin D tests, but didn't see this one. Seems relatively reasonably priced. I'll check out the vitamin B supplements you've listed. I really do need something. Thanks again.