advice on latest results please

[Goinginsane1]

tsh- 4.49 (0.27-4.2)

Free T3- 4.6 (3.1-6.8)

T4- 18.4 (12-22)

Folate- 35.8

B12- 81.5

Vit D- 92.6 (50-250)

Ferritin- 90.1 (30-169)

CRP HS1 5.53 (less than 3).

I’ve put 3 stone on over the last 4 months which I needed to do as I was so underweight from anxiety.

my hair has been falling out daily for the last month causing me more anxiety, hence why I thought I’d check my thyroid again privately.

Should I increase dose and how much by as my t4 is quite high?

[TiggerMe Ambassador]

You've plenty of head room with fT4 at only 64%, you could start with and extra 12.5mcg alternate days and see how you feel

[MarvelDC]

I’m guessing this was done by medi check, medi checks ferritin readings are always naturally higher than NHS ferritin readings, plus high inflammation markers which you have can also falsely raise ferritin levels, you could be iron deficient since anxiety and hair loss are signs of low iron, the only way to know is do an iron panel test and look at your other markers

[SlowDragon Administrator]

was test done early morning, ideally before 9am, only drinking water between waking and test and last dose levothyroxine 24 hours before test

How much levothyroxine are you taking

Which brand

Do you always get same brand of levothyroxine at each prescription

With TSH over 2 your results suggest you need to increase levothyroxine

How much by ……depends on how long before test last dose levothyroxine was taken

Hairloss

Request GP do full iron panel test including ferritin for anemia

Exactly what vitamin supplements are you taking

[Goinginsane1 in reply to SlowDragon]

test was first thing in the morning before thyroxine which was 26 hours before and had only water.

I’m on 75mg and have accord brand everytime.

Hair loss has only been the last month or so which I thought was linked to sertraline and anti depressant I tired but stopped it about 10 days ago however my hair is still falling out loads.

I take an iron tablet daily, zinc and copper combined (half the tablet), omega 3 with vit d, probiotics and a standard boots own b complex.

Do you think I should swap the b complex for a higher potency one that I have here at home?

I don’t think my iron will be low but I could be wrong as I supplement it daily 💁

[SlowDragon Administrator in reply to Goinginsane1]

How long before test was your last dose levothyroxine

You hair is likely falling out because your high TSH shows your dose levothyroxine is not high enough

Get increase in dose to 100mcg levothyroxine daily

Retest thyroid levels in 8 -12 weeks

which brand levothyroxine are you taking for 75mcg

Are you taking your antidepressants well away from Levo

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.

Some supplements or medication like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

Ferritin looks good level

Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing.

It’s possible to have low ferritin but high iron

Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test

If taking any iron supplements stop 5-7 days before testing

Medichecks iron panel test

medichecks.com/products/iro...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

Good iron but low ferritin

healthunlocked.com/thyroidu...

[Goinginsane1 in reply to SlowDragon]

last dose before test was 25 hours prior.

yeah I think it’s either hormones or due to the TSH going over.

I have ordered a man iron panel blood test to double check that but I would be surprised if it is.

my t4 is the higher end isn’t it? Its been higher previously and when I increased dose I had a whole load of over active symptoms. I am nervous about increasing this time too but is my t4 okay now in order to increase it? Should I increase by just 12.5 first do you think?

I have stopped taking the anti depressant 10 days ago.

I have accord brand and cut 50mg in half to make 75mg. Take it at 7.30am and a couple of hours before breakfast.

I had low ferritin levels 18 months ago and have been taking one iron tablet from drs a day ever since. When I’ve tried to stop it I get symptoms and have to restart it. My ferritin levels have come up now though but only because of the daily tablet.

Do I need to add more b12 as well as the b complex do you think, maybe mouth spray to increase that level as it’s gone down.

Also be put on 3 stone and now 10 and a half stone but feel healthier for it. I have been eating more and trying to cut back on the amount of sugar now. I am gluten and dairy free due to stomach acid issues previously and I haven’t had stomach acid issues since this change and managing to eat more with no issues there thankfully.

[SlowDragon Administrator]

Free T4 (fT4) 18.4 pmol/L (12 - 22) 

Ft4 is 64.0% through range

Free T3 (fT3) 4.6 pmol/L (3.1 - 6.8) 

Ft3 only 40.5% through range

So as you took last dose levothyroxine 25 hours before test, this shows poor conversion of Ft4 (levothyroxine) to Ft3

I would agree with TiggerMe Initially increasing by 12.5mcg 4 days per week (1/4 of 50mcg tablet)

Keep remaining 1/4’s in weekly pill dispenser

So that’s adding 50mcg PER WEEK

Retest in 8 weeks

quite likely you will need addition of T3 prescribed alongside levothyroxine especially as you have already found it necessary to be dairy and gluten free

Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists who will prescribe T3

Ideally choose an endocrinologist to see privately initially and who also does NHS consultations

thyroiduk.org/contact-us/ge...

Lactose free levothyroxine

Vencamil (currently 100mcg only) is lactose free and mannitol free. 25mcg and 50mcg tablets hopefully available from summer 2024

March 2023 - Aristo now called Vencamil

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

How to get Vencamil stocked at your local pharmacy

healthunlocked.com/thyroidu...

Helpful post about different brands

healthunlocked.com/thyroidu...

List of different brands available in U.K.

thyroiduk.org/if-you-are-hy...

[Goinginsane1 in reply to SlowDragon]

Thank you