I am currently taking 37.5 mcg Levothyroxine. I have recently had thyroid bloods taken privately as GP would not do t3. Please could someone tell me how these results look - particularly the conversion t4 to t3? How is this worked out?? I have been dealing with many defiencies recently and keep feeling like I have no energy. Had an iron infusion in March and taking vit D, Bcomplex.
How did you take the test? What time of day and when was last dose of Levo before the test?
Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process).
Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo/T3 just prior to blood draw can show a falsely elevated result and your GP/Endo might change your dose incorrectly as a result.
Your conversion isnt great, however, your FT4 is only 41% of range and I would expect to see it in the upper quarter when fully replaced so plenty of time for things to improve.
TSH well above 1 so time for next 25mcg dose increase.
Having no energy is part and parcel of this condition when Levo dose not optimised. It takes many, many months to get to where you need to be I'm afraid.
It's ideal if you can always get the same brand of levo at every prescription. You can do this by getting GP to write the brand you prefer in the first line of the prescription. Many people find that different brands are not interchangeable.
Always take Levo on an empty stomach an hour away from food or caffeine containing drinks & other meds. Many people find taking it at bedtime works well for them.
Thank you for replying. I did as it is suggested , as above, in regards to having the blood test. Hoping that I will get a dose increase. GP has not been helpful, Thank you.
37.5mcg is a peculiar dose, is that prescribed or one you have devised yourself. Starter dose is normally 50mcg. And we normally titrate up in 25mcgs increments. On the face of it your TSH is far too high, your FT4 is lowish and your FT3 is pretty poor. You are certainly ready for a dose increase.
I started on 25mcg and then was increased to 50mcg in Aug 2018. At the time I was having palpitations and was blamed on increasing the levothyroxine, therefore, it was changed to 37.5mcg and that is where I stayed!! My TSH has never been below 2 since I was diagnosed in 2013 - it has mainly between 3-4, sometimes above 4, according to my records. Of course, I was unaware that it should be below 2 until recently, as falls in the normal range that the GP looks at. I have been to the GP multiple times over the last 10 years with exhaustion, infections and stomach issues. I am sure there must be some link. Hoping that the Thyroid specialist will help me. Thank you very much for your reply.
Palpitations can be due to being on inadequate dose levothyroxine
And/or
Low iron/ferritin
Low vitamin levels are extremely common when left on inadequate dose levothyroxine
You need Vitamin D, folate and B12 levels tested
Plus BOTH TPO and TG thyroid antibodies
Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or somewhere near full replacement dose (typically 1.6mcg levothyroxine per kilo of your weight per day)
Some people need a bit less than guidelines, some a bit more
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)
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).
About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s.
Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)
20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis
In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)
Thank you for your reply. We have had contact before re. my previous blood tests, but just had these more recent bloods taken since then. I have been on 4000iu vit D tablets daily since March due to deficiency, taking folic acid , b12 injections & iron infusion. I am under a specialist Dr. for this, who is guiding me. All these levels are being monitored regularly. It was really the thyroid side of things that I wanted to sort, as wondered whether years of my levels not being optimal may have made these deficiencies worse, along with other digestive issues that i have. Thanks for all the info.
You can't really tell how well you convert when you're so under-medicated. Once you get your TSH down to around 1 and your FT4 over mid-range, then you can get a good idea how well you convert. At the moment it doesn't look too good, but then you haven't got much T4 to convert. When you get on a decent dose of levo, things might change.
It seems fairly clear that you need more levo as the others have already pointed out.
You may very well feel worse as you titrate the dose upwards ....this is usually the body telling you it appreciates the increase but it still needs more
Undermedication and overmedication can feel very similar
Slowly correct your medication and you will start to recover....but be patient!
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