More advice please on blood tests

[Koababy20]

Hi again, and further to my last post could someone please advise me on recent blood tests.

After appointment with Roseway labs Pharmacist on 23rd April I increased T3 to 10ug daily . Since my previous bloods showed T4 at the top of the range I reduced that from 100ug daily to 100ug 5 days per week and 75ug 2 days per week.

Since I felt no benefit whatsoever from the t3 I increased to 15ug daily from 16th May .

Bloods taken on 16th May (all protocols followed and supplementing with appropriate vitamins ) are as follows:

TSH 0.17 (range 0.27-4.20)

T4 17.7 (range 12-22)

T3 4.6 (range 3.1-6.8)

Previous bloods 15/04/24

TSH 0.39

T4 21.9

T3 4.4

My mood /anxiety is awful, stamina poor as well, still feeling very hypothyroid overall…

When would it be appropriate to increase T3 again?

Should I increase T4? My T3 level has hardly budged since the last bloods???

I will be speaking to my very supportive GP on Friday. I was thinking of asking for a mild anti depressant in the short term.

Any thoughts/opinions would be gratefully appreciated as always.

Many thanks in advance,..

[Jaydee1507 Administrator]

Can you tell us the timings for last dose of Levo & T3 before this test?

Recommeded protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw, last T3 dose 8-12 hours before blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process).

Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo/T3 just prior to blood draw can show a falsely elevated result and your GP/Endo might change your dose incorrectly as a result.

[Koababy20 in reply to Jaydee1507]

Hi Jaydee, bloods taken 9.15 am fasting , levo last taken 24 hrs before and T3 15 hrs before (5ug). No biotin supplements taken for 4 days prior to testing

[Jaydee1507 Administrator in reply to Koababy20]

15 hours is a litle too long for T3 timing. Try for 8-12 hours next time, otherwise you get false low result.

You have only allowed 4 weeks from last increase so need to retest once you have been on a stable dose for 6-8 weeks, the longer the better to allow the dose to settle. Your numbers may change even after 8 weeks.

It can take months to feel the benefit from a dose increase so hang in there and give it all time.

[Koababy20 in reply to Jaydee1507]

Thank you for your advice Jaydee, I will try to be more patient……

[SlowDragon Administrator]

There’s no history on your profile page

Looking through previous posts

You have Ord’s thyroiditis

Are you on gluten free and/or dairy free diet

Can’t see any recent vitamin D, folate, ferritin or B12 test results

Please add here

What vitamin supplements are you taking

Dose T3 increased April 23rd

Tested May 16th - which is only 3 weeks later …..so far too soon

Only test after minimum 6-8 weeks after any change in dose or brand of levothyroxine or T3

May 16th

bloods done 3 weeks after increasing to 2 x 5mcg dose T3

Was last dose T3 approx 8-12 hours before test

Now on 15mcg per day

Are you taking your T3 as 3 x 5mcg doses spread through the day

Which brand of levothyroxine are you taking

Do not retest until end of June at the earliest

[Koababy20 in reply to SlowDragon]

Hi SlowDragon, thanks for getting back to me….I supplement with vitamin B complex , Vit D3 , Magnesium Malate, Selenium, Fish oil,

Yes gluten free since start of February…

Last bloods on 22nd Feb showed Ferritin was low (45.9), been trying to eat lambs liver as often as I can, but need to work on this…

Vit D test on 19th March showed result as 77nmol/L (no range given)

Folate test on 22nd Feb was 14.5ugl (no range given)

B12 test on 22nd Feb was 908ngl (no range given)

T3 dose split 10ug am and 5ug pm.

Last T3 approximately 15 hrs before last test.

I take Almus brand of Thyroxine.

I was just surprised at the lack of increase in T3 even after almost 4 weeks….could the lower TSH be preventing the T4 from converting into T3? Paul Robinson suggests in his book that you can initially feel worse after starting on a small dose of T3 as conversion is worse due to lower TSH ?

If you are able to look back at my first post, this gives some idea of my thyroid background…

Thank you so much for responding, I do appreciate your advice….