Advice on latest bloods please

[Enuffisenuf]

I want to increase T4 by 25mcg, based on symptoms and previous history of feeling great at 100mcg. As I take T3 my TSH is obviously suppressed and I really thought that I'd got the doc on side. However, the lab report has warnings all over the TSH result, and the doc wants to talk to me!

TSH result below the reference range is consistent with over treatment with Levothyroxine if monitoring primary hypothyroidism. Consider reducing Levothyroxine dose and retesting TSH in 3 months

I have an appointment next Wed and will NOT reduce my T4 again, so would like some ammo please.

TEST RESULTS:

I had Bone profile, HbA1C, Kidney function, Full blood count, B12 (clearly stated Do Not Test on the form) and the following..........

free T3 level - 5.2 pmol/L (3.50 - 6.50pmol/L)

free T4 level - 8.1 pmol/L (7.00 - 17.00pmol/L)

total 25-OH vit D level 84.6 nmol/L (50.10 - 200.00nmol/L)

TSH level <0.01 mIU/L ( 0.38 - 5.33mIU/L)

ferritin 105 ug/L (12.00 - 240.00ug/L)

folate 23.1 ug/L ( >2.90ug/L)

HbA1c levl - IFCC standardised 37 mmol/mol (20.00 - 41.00mmol/mol)

Thank you

[tattybogle]

you are welcome to have a poke about in my ammo pile.. lol :

healthunlocked.com/thyroidu.... /tsh-is-just-the-opinion-of-your-pituitary-about-your-dose-but-your-pituitarys-opinion-is-a-bit-warped-once-you-take-thyroid-hormone.

this one is most useful for people with TSH 0.04 or over , but it's still worth a look: healthunlocked.com/thyroidu... useful-evidence-that-tsh-between-0.04-0.4-has-no-increased-risk-to-patients-on-levothyroxine-updated-new-study-does-show-small-risk

[Enuffisenuf in reply to tattybogle]

Thank you, much appreciated.☺️

[Sparklingsunshine in reply to Enuffisenuf]

I assume your Levo is via NHS, is your T3 also provided by them or do you get it another way? Yes your GP is probably going to look at TSH and panic, its all they worrry about.

But of course taking T3 very often does suppress TSH. Its just what it does. All this worry about them lowering doses is pretty exhausting.

[Enuffisenuf in reply to Sparklingsunshine]

Yes, Levo is NHS.

T3 WAS NHS endo prescribed, but is NOW self sourced since they took it off me when it became expensive.

No one cared about the TSH argument when T3 was cheap.

[Enuffisenuf in reply to tattybogle]

The posts make interesting reading, but they don't quite relate to my situation and I feel that I'd be arguing myself out of a T4 increase.

I haven't been on T4 mono therapy for over 20 years. I was on 200mcg T4 and still had symptoms. The endo prescribed T3 and reduced T4 by 100mcg in total, to alleviate outstanding symptoms, and I felt human again.

My TSH is suppressed. Recently they took 50mcg off me in total, because of the suppressed TSH and my refusal to give up my T3 . TSH hasn't moved an inch

[Sparklingsunshine in reply to Enuffisenuf]

I'm in the same boat, was prescribed 200mcgs of Levo and conversion was still poor, had very high FT4 but very middling FT3. So I self sourced T3 last year and its definitely helped. I havent told my GP, I know I'm just delaying the inevitable " conversation".

Whenever I next get annual thyroid bloods done via NHS my GP will get the vapours. I intend to be honest though. High FT4 isnt desirable for health long term, Levo monotherapy hasn't worked for me, NHS reluctant to prescribe T3 due to cost and because many medics dont believe in it. And even those willing to prescribe have long waiting lists.

So what choice do patients like us have? Stick to the script and suffer ill health, just to keep the NHS happy, or self source something that helps but run the risk of getting into hot water with GP's more interested in covering themselves than making us well. I'd like to ask doctors to answer honestly what they would do if they were us.

[Enuffisenuf in reply to Sparklingsunshine]

I'd shut the NHS down and sack the bloody lot of them! It isn't free, if you work you pay for it. We deserve better.

Better to get it on your records. A bit like wearing clean pants when you go out in case you have an accident. 😊