Help interpreting results please

[SilverSavvy]

Having been on a combination T3 plus levo trial for a year, these are my latest results. I am on the trial because my last results indicated I am a poor converter. I was knocked back from taking 100mcg levo to 75mcg by a doctor who doesn't know me when my TSH lowered because I was newly on T3. Of which I take 10mcg daily. I feel much better for combining the two but my weight is still intransigently high and this is causing problems with other things like general capacity to exercise/stay fit etc. Not to mention long term effects down the line.

Please could someone who knows tell me if I am in balance?

TSH: 0.626 (range 0.27-4.2)

Free T3: 4.1 (range 3.1-6.8)

Free Thyroxine: 15.4 (range 12-22)

Thyroglobulin Antibodies: 17.4 (range 0-115)

Thyroid Peridoxase Antibodies: 10.6 (range 0 - 34) First time they have ever been above 9

Folate - Serum: 10.4nmol (range >7)

Ferritin 148 (range 30-332)

Vitamin B12 Active 89.1 (range 37.55-188)

Vitamin D 70.3 (range 50-250)

My CRP is 3.74 which is more than the 3 recommended as in range but I recently had a bad virus a month ago so I'm guessing that is the cause.

Many thanks for any help with analysing this.

[SlowDragon Administrator]

which brand of levothyroxine are you taking on 75mcg

Which brand were you taking on 100mcg

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

T3 ….day before test split T3 as 2 or 3 smaller doses spread through the day, with last dose approximately 8-12 hours before test

What vitamin supplements are you taking

[SilverSavvy in reply to SlowDragon]

Yep, all of above done correctly

Using Mercury Pharma continually

Vitamins Better You D3 with K2 and Biocare Methyl B Complex

[SlowDragon Administrator in reply to SilverSavvy]

Did you stop vitamin B complex 5-7 days before test

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

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

[SlowDragon Administrator in reply to SilverSavvy]

Free T4 (fT4) 15.4 pmol/L (12 - 22) 

Ft4 only 34.0% through range

Free T3 (fT3) 4.1 pmol/L (3.1 - 6.8) 

Ft3 even lower at only 27.0% through range

So if testing correctly you are almost certainly NOT on high enough dose levothyroxine

Request/politely insist on 25mcg increase in levothyroxine daily

Retest again in another 8-10 weeks

You may need to increase Levo or T3 after next test but we only ever increase Levo OR T3 at any one time

Most people when adequately treated on Levo plus T3, typically find they need both at least 60% through range

Often TSH will be extremely low or suppressed

[SilverSavvy in reply to SlowDragon]

Thanks SlowDragon, that is exactly what I thought viz the levo. I was on 100mcg at the start of the trial. It came out at 80% of range on that basis so I dropped it by 12.5mcg and felt good on that - but untested at time. Docs didn't like the suppressed TSH tho and demanded I reduce to 75mcg then haven't touched it since. I think this is why I can't lose weight. Thanks for giving me the number of 60%..gives me a great target to aim for.

And that's assuming they don't strip me of the T3 which they are threatening to do coz computer says no in our area. Gah!

[SlowDragon Administrator in reply to SilverSavvy]

TSH is frequently 0.01 on Levo/T3 combo

And that's assuming they don't strip me of the T3 which they are threatening to do coz computer says no in our area. Gah!

Which ICB area

If NHS endocrinologist says you have clinical need, GP can not/should not meddle

Over 66,000 prescriptions in England in last year on NHS for T3. Number rising steadily

Searchable by ICB area

openprescribing.net/analyse...

[SilverSavvy in reply to SlowDragon]

NHS Endocrinology waiting list is about 2 years in our area...which isn' t even mentioned on the attached list. Had to see one privately. Doc is well onside having seen clinical evidence of lack of conversion. But we are both having to fight for me to keep getting it.

[SilverSavvy in reply to SlowDragon]

Do you mean almost certainly NOT on high enough dose of levo? I'm assuming you do.

[SlowDragon Administrator in reply to SilverSavvy]

Yes…..now Edited

Whoops - sorry

[SlowDragon Administrator]

How much vitamin D are you taking per day

improving vitamin D to around 80nmol or 100nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly when supplementing

Can test via NHS private testing service

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7.

One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average

Vitamin D may prevent Autoimmune disease

newscientist.com/article/23...

Are you supplementing magnesium

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Recipe ideas

bbc.co.uk/food/articles/mag...

Interesting article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

[SilverSavvy in reply to SlowDragon]

I take about 1000iug - that's one spray of the BetterYou Vit D3 with K2

I take the Methyl B complex from Biocare which has plenty of everything when I'm not testing. I do stop that 7-14 days ahead and then I use BioCare Methylfolguard which is folate and B12 only.

[SlowDragon Administrator in reply to SilverSavvy]

Very unlikely 1000iu daily is high enough as shown in your results

Increase to 3 sprays per day

Retest in 8 weeks

You might need higher dose in winter

Have never had my magnesium levels tested. Maybe I should.

Test is not worth doing

Suggest you try Thorne Citramate. Doesn’t affect gut

Large capsule. Open and tip powder in small glass water.

Start with half a capsule of powder initially?

Best taken early evening or bedtime…..at least 4 hours away from levothyroxine

My heart goes very wonky with palpitations. Am being tested for that presently.

Heart needs plenty of magnesium

And

Plenty of T3

Likely to see palpitations diminish as Ft3 levels improve

Personally I get ectopic heart beats when Ft4 or Ft3 are too low

[SilverSavvy in reply to SlowDragon]

This is all great info, tks Slow Dragon.

[SilverSavvy in reply to SlowDragon]

Haven't tried magnesium yet except BetterYou spray on legs at night. Not sure I like it as it seems to make me very sensitive to things. Have never had my magnesium levels tested. Maybe I should.

I do get very sensitive after I have had a bad virus. My heart goes very wonky with palpitations. Am being tested for that presently. Wondering maybe about getting my adrenals and cortisol levels checked. Do viruses mess with that in hypo patients do you think?