Hi! I’m from the states and having been reading your blog to get good info which I appreciate. Also have a shortage of endos in my area and they focus on DM. Can someone look at my labs and give feedback? I am still having a lot of muscle joint pain and fatigue. I have been taking b12 shots now on drops, d3 and mag 800mg.for at least a yr. My weight won’t budge and my stomach is huge.
4/24 labs:
B12. 971 (200-1,100)
Folate 11.1 ( low <3.4)
Vit d 55 ( 50-100)
Tsh 4.82 (.4-4.5)
T4 free 1.2 (.8-1.8)
Started Levo50mcg 4/24
now labs 7-24
T3 96 (76-181)
Tsh 2.19 (.4-4.5)
T4 free 1.4 (.8-1.8)
I followed advice here about testing before meds before 9 am
Any thoughts?
Thanks!
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Goldenrescuemom
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Agree with SD - you definitely and simply need to increase from 50 to 75 daily Levo.
I’m also going to guess that’s TOTAL T3 and not FREE T3.
Since you’re in the US, let us know what kind of insurance you have (private? Medicare?) as you need to start getting the right set of blood tests each time you go.
In the US it’s hit or miss if you get the right “thyroid panel”, and outdated or useless tests are often included.
You should be able to just ask for these, you might want to call your insurance and ask if they cover them and how frequently (mine has no cap).
Here is what I get every time:
1) TSH
2) Free T3
3) Free T4
Plus these vitamins
4) ferritin
5) folate
6) B12
7)Vit D3
These should be tested at least once:
1) TRab
2) TSI
3) TPOab
4) TGab
But if it’s all the same, you can get the TPO and the TGab every time.
There are many doctors who know nothing about the thyroid.
Hard to believe, but very true.
Yours might be awesome and informed! In which case - no problem!
But if your doctor included total T3 and not Free T3, I’d wonder what she was thinking . If she looks at your results, while on 50 mcgs, and hears your symptoms - and doesn’t agree you need an increase to 75 for the next 2 months and then a full blood test done, then you should consider she might not fully understand.
In that case - regroup and plan your strategy! You (usually) can’t teach a doctor about something they think they know about. You just have to educate yourself and find ways to ask and get what you need.
In any event - you are now on the journey to educating yourself… so you can confidently ask for exactly what you need. It’s a process.
.
50 mcgs Levo is a starter dose. General (directional) dosing guidelines are 1.6 mcg per kg of body weight. That means that on average you will see “most/many” people settle somewhere around 100 give or take. If on Levo only, it can be. 100-125-ish.
Don’t expect your doctor to know this, but great if she does.
What many doctors might/do understand if anything is that we generally look for TSH to be around 1. So if you make your case and she says “all normal” because they are “in range”, then she at the very least she might understand the TSH target of 1. Which requires an increas in Levo.
Being “in range” is no more than saying your shoe size falls somewhere between 5 and 10. But if you are a size 8, and you have a size 5 shoe on, who cares if it’s “normal” - it’s not optimal for you.
We are all different though. So it’s through your own understanding of your blood work along with your symptoms that you will be able to advocate for yourself and move towards feeling better.
it’s Nature Made Magnesium oxide. 400mg and I take 2. This is primarily for constipation and I take it at bedtime. It works and I don’t notice a problem.
Magnesium is practically impossible to test for, although likely all of us need it, hard to test if we are taking too much.
That amount is probably a little high or as much as double … but also possible the magnesium part is less than 400 and the rest is made up by the oxide part??
I’m in the states too. I had more luck with my family doctor treating my low thyroid than an endo. I went to my appt prepared with a list of all my symptoms. I also used the calculator to figure out my percentages through my test results to show that I was in the lower percentage through my test results. I was on 50 mcg Synthroid for about 18 years (and 5 mcg Cytomel for close to a year), never knowing I was under medicated until I started to investigate why I felt so terrible all the time and realized my symptoms were all related to low thyroid. When I explained all of this, with my test results, my doctor agreed to try me on 75 mcg and to test again in four months.
Hi Goldenrescuemom . I’m in the UK, and started my treatment at a very similar time to you. I was also on 50mg levo to begin with. My GP has increased this to 100mg based on my latest test results. Now, my full lab results are in a couple of my posts if you want to take a full look, but my initial TSH was similar to yours (4.62, range 0.27-4.20), and my post 8 weeks on 50mg 2.06 (same range). I’ve only been on the new dose for 3 days but starting to feel better than I had been as I crashed badly for the second half of the initial 8 weeks which was really hard.
It is frustrating how differently doctors treat and approach thyroid treatment. I’ve had to go private as my NHS GP was unable (unwilling!) to treat me as I wasn’t over 5 for TSH and thus deemed subclinical despite being symptomatic. Ahem, we carry on.
Good luck with persuading your doctor to follow guidelines and advice 🙂
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