I would be grateful for some advice regarding these results.
The background is that my Levothyroxine dose was reduced from 100mcg to 75 in early February 2024, due to a TSH only test which was below range. By late March I could barely function so I had a private test prior to the GP's TSH test. I informed the GP Practice of the private test results and requested a trial on 100mcg with a follow up full thyroid function test in 6-8 weeks, which was agreed, but in the event the lab only did TSH and free T4. The doctor wanted to reduce the dose back to 75 but agreed when I explained how ill I had been on that dose to let me continue for a further 6-8 weeks on 100, followed by another test. As I suspect they will only test TSH I have now had another private test.
These are the three test results. All were taken early morning 24+ hours after last dose of Levo.
Date: 30.03.24 (Private)
TSH: 0.189 (0.27-4.2)
Free T3: 3.8 (3.1-6.8)
Free Thyroxine: 18.8 (12-22)
Date: 31.05.24 (NHS)
TSH: 0.02 (0.10-4)
Free T4: 22.7 (9.00-22)
Date: 22.07.24 (Private)
TSH: 0.026 (0.27-4.2)
Free T3: 5.4 (3.1-6.8)
Free T4: 27.1 (12-22)
On the test on 30th March my free T3 was very low. Now it seems to be about right but the free T4 is very high. Might this indicate poor conversion?
In spite of the high T4 I have no palpitations or anxiety etc., though I do feel tired. I also still have hypo signs, e.g. very dry skin, vitiligo and think I may have an enlarged tongue as I frequently bite it!
I'm having the NHS test tomorrow and a GP appointment when results are back, so would be very grateful for advice before that.
Many thanks.
Written by
ValTay
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Its not really a good idea to run your FT4 above range. TSH isn't an issue really but to get your FT3 to where it needs to be then it looks like you will need to reduce Levo & add a small amount of T3.
When adding T3 its wise to have all key vitamins at optimal levels. What are your results for ferritin, folate, B12 & D3?
What are you supplementing with?
There are a few options to add T3; you can email info@thyroiduk.org for a list of T3 friendly Endo's. Pick a couple and write a post asking for feedback by personal message.
Roseway pharmacy offer a prescribing service at reasonable cost.
Thank you for your advice Jaydee. In February this year my ferritin was 30 ug/L (10-291), folate 13.5 (>4.1). Both were marked normal. However, I have ordered a private iron test as I thought ferritin was low. B12 was marked abnormal at 1283 ng/L, but the comment was: "unlikely to be of any clinical significance". I do take B12 as I'm partly vegetarian, and they didn't tell me they were going to test B12 so I didn't stop it before the test. I'll get my D3 checked and look into options for T3. Yes, I did try a strictly GF diet under supervision by a gastroenterologist. It made no difference and she advised me to discontinue it. Thanks again for replying.
A ferritin of 30 is considered deficient by NICE guidelines. Start a new post with your iron results and in the mean time have a look at this food list and see if theres anything you can increase that will help your ferritin. dailyiron.net/
Rther thn just taking B12 you would be better off switching to a B complex that also contains folate. It helps keep all your B vitamins in balance as they work together.
B complex suggestions: Slightly cheaper options with inactive B6:
Hello Slow Dragon and thank you for your reply and advice. I went back to levothyroxine about October 2021 as my NDT brand became unavailable and other brands were too expensive, and also seemed to cause bowel problems. My folate, B12 and ferritin were tested by the GP Practice in February this year, though they didn't tell me they were going to do B12 so I didn't stop taking it beforehand, and the result was 1283 ng/L, which they marked abnormal but "unlikely to be of any clinical significance". Folate was 13.5 ug/L (>4.1), marked as normal, and ferritin 30ug/L (10-291), also marked as normal but I've ordered a private iron test as I feel that's a bit low. Thanks again for your help.
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