Nhs results

[Nellie2016]

Good Afternoon, Medichecks Thyroids and iron panel results i put on here 10 days ago but my Gp did my Vitamins also done thyroids 29th Aug. Atm ive been on 5 mcg t3 100mcg Levo and i was going to up to 10mcg T3 not sure now looking at Nhs results? are my vitamins ok? Vit d is above not had any vit d supplements for month now on Fri i went down with just vomiting and i have missed some t3 meds but these results were done before

[TiggerMe]

Your folate is low, I think you have said before that you take a B complex so perhaps add a separate folate to boost things up

Are these results 24 hours after last dose of T4 and 8-12 after last T3?

Free T4 (fT4) 11.9 pmol/L (7.9 - 16) 49.4%

Free T3 (fT3) 5.5 pmol/L (3.8 - 6) 77.3%

I'd be inclined to say you need a little more T4, perhaps just an extra 12.5mcg every other day might do the trick

[Nellie2016 in reply to TiggerMe]

Medichecks looking at these i had room for more t3 so confusing

10 days ago these medichecks

[TiggerMe in reply to Nellie2016]

T3 doesn't hang around in the blood as long so making sure you test at the same interval after last dose makes quite a difference can you remember how each test was done?

Free T4 (fT4) 17 pmol/L (12 - 22) 50.0%

Free T3 (fT3) 5 pmol/L (3.1 - 6.8) 51.4%

How did you feel after adding the first 5mcg of T3?

When you are closing in on hopefully your optimal dose you need to experiment a little to find your sweet spot, it could be a little more T3, T4 or both but you need to sneak up on it so you don't overshoot as that can make you feel horrible too 🙃 

[Nellie2016 in reply to TiggerMe]

I did 12 hours last dose of t3 before early morning blood draw 8.30am and 24 hours last dose of t4 im not sure now what to do i had room to add more t3 on Medichecks bloods results Nhs results say different i cant say i felt that great since adding 5mcg t3

[TiggerMe in reply to Nellie2016]

Perhaps get your folate sorted and then see how you feel?

[Nellie2016 in reply to TiggerMe]

I think when i do my b12 injections maybe it lowers my folate? But I have noticed last couple of weeks ive been more agitated n tearful still am so not quite sure on adding another 5 mcg to 10mcg t3 after looking at nhs results i really do find it all very complicated 🙄 folks on here must think why cant she just get it! I do try! got a lot of hairloss going on that makes me upset

[TiggerMe in reply to Nellie2016]

Don't beat yourself up it isn't easy to get and everyone is individual so it really comes down to trial and error 🤗 many of us take years to find the sweet spot

You are absolutely right you need to keep your folate levels up as it works together with B12, so stick with your current dose and add a good methyl folate, getting vits and mins optimal is just as important as T3&4 dose

[Nellie2016 in reply to TiggerMe]

I did read you Bio very interesting i so miss my fitness hiking cycling Thank You for your advice

[TiggerMe in reply to Nellie2016]

You'll get there, just be kind to yourself it's a steep learning curve🙂

[Nellie2016 in reply to TiggerMe]

I dont have any more Levo to add more im on 100mcg atm with 5 mcg t3 a day

[TiggerMe in reply to Nellie2016]

I get prescribed 100mcg T4 but I still have enough wiggle room to add the extra 100mcg a week that I need without having to argue the toss with my Endo if I get my prescription requests in asap 😏

You've head room to add a little more T3 if you'd rather? You'll find out quite quickly if this is the right thing for you

[Den_And]

Hi Nellie2016, I had similar results from a recent test. The super low TSH would seem to indicate your body is saying no more T4 for now, I’ve got enough even with a mid range T4 result. I would suggest lowering your Levo dose to 50mcg/100mcg every alternate day to try and get TSH into range. See what happens with another bloods test in 6 weeks.

You're T3 looks fine so leaving at 5mcg should be OK. My specialist has never prescribed me T3 (just a test result showing good in range conversion) so presumably you were given this as previous results showed you weren’t converting.

[Nellie2016 in reply to Den_And]

This is all very complicated i know adding t3 can lower tsh but since adding it i cant say its making me feel any better

[Den_And in reply to Nellie2016]

If Hashimoto’s is diagnosed it makes many hypothyroid symptoms worse you’ll have to live and work with. Tiredness and concentration have been my most significant symptom throughout.

Tiredness (fatigue), lethargy and excessive sleeping.

Mild weight gain.

Constipation.

Dry skin.

Feeling cold.

Slower-than-normal heart rate (bradycardia).

Joint stiffness and muscle pain.

Dry, brittle hair; slow hair growth; or hair loss.

Low or depressed mood.

Puffy eyes and face.

Memory problems or difficulty concentrating.

Heavy or irregular periods.

Decreased libido (sex drive).

Infertility

Many suggest going gluten free helps with the symptoms.

With regard to your T3 prescription, my endocrinologist always advised just Levo in supplying T4 and getting that level right and TSH, then test for T3 conversion. Only then if the T4 to T3 conversion was not happening would she consider T3.

[RedApple Administrator in reply to Den_And]

Den_And 'If Hashimoto’s is diagnosed it makes many hypothyroid symptoms worse you’ll have to live and work with.'

Having a diagnosis of Hashimotos, (more commonly called Autoimmune thyroid disease in the UK), does not, of itself, make symptoms worse. The symptoms you've listed are those typically caused by thyroid hormone imbalance (i.e. too much or too little T4 and/or T3). These symptoms can be dramatically improved with the correct thyroid medication. The issue is getting the right dose and balance for the individual, which takes time and is a matter of trial and error.

[Den_And in reply to RedApple]

Don’t disagree Redapple, getting thyroid medication right is absolutely key. Having lived through it for 9 years however for me, tiredness and concentration were a constant whatever the thyroid medication over the years.

[RedApple Administrator in reply to Den_And]

It's important to clarify that what you say is your personal experience, rather than implying that this is how it will be, for everyone, for ever! 😊

[Den_And in reply to RedApple]

Didn’t feel I implied anything. Just my experiences. 😔

[Enuffisenuf in reply to Den_And]

A lot of us have a suppressed TSH when taking T3. Reducing T4 is not necessarily the answer. The concensus seems to be to dose using the FT3 & FT4 and symptoms to guide you.I'm glad that your endo has you on a regime that works for you, but one size doesn't fit all unfortunately. Not everyone needs to take T3 at all, for some of us it's vital.

There are those who take a T3 monotherapy, but I'm pretty sure that wouldn't work for me. When my T4 was reduced to the starting dose of 50mcg, I was very ill indeed. I need T4 &T3 to be balanced, and I'm still struggling to get back to where I was 5 years ago.

[Nellie2016 in reply to Enuffisenuf]

On my results please would you have any advice to add ? i know TiggerMe gave me her thoughts im not sure what to do im new to taking t3

[Enuffisenuf in reply to Nellie2016]

I can only tell you my experience. The NHS happily prescribed T3 for me for 20 years. The initial dose of 20mcg had a noticeable affect. When it was increased I felt really good. It stopped being prescribed when the price went up, so I self source.

My previous GP wanted me to stop so sent me to an endo who supported my regime and told my GP that if I felt well to leave me alone. The GP reduced my T4, and I felt it. I need T3 & T4. I'm fighting to get it back.

I also self treat B12d with injections, and am pretty sure I know the difference between B12 & thyroid symptoms.

I agree with TiggerMe that if you go too far with the T3 you'll know. I lost a lot of weight (6 months hard work once on optimum treatment) and knew I needed to reduce because I felt like the energizer bunny!

[Nellie2016 in reply to Enuffisenuf]

Im definetly not energised atm but i do feel tearful n weak my hearts a bit heavy but being upset n tearful doesnt feel good and my Endo gave me another 5mcg t3 to add making it 10mcg with the 100mcg Levo but on those results doubt i will do i go back to just my Levo i havent a clue what to do i sort of knew with just Levo but t3 i dont

[Enuffisenuf in reply to Nellie2016]

Only you can decide which way to go.Your endo gave you extra T3, so they are happy for you to try a bit higher dose. On the other hand, if you convert well, a bit more T4 could do the trick. Whichever way you get it, you need T3 to function.

If after a few weeks there is no improvement, you can revisit your decision or increase a bit more.

It can be longwinded and we're all different.

I started this journey before the labs told us what is normal, so am comfortable with trial & error. I've been quite gungho and it has worked for me, others need to make small changes from day 1.

Listen to your body.

[HealthStarDust in reply to Den_And]

I do not think I have ever seen a post on this forum suggesting such importance on the TSH and lowering dose when there is room to increase dose according the free levels.

It’s quite refreshing.

I am beginning to wonder if there are harms associated with a suppressed/under range TSH even with the frees look good on levothyroxine only at least, as my frees look pretty good but I feel atrocious and worse in some ways since having a suppressed TSH and I wished I had lowered my dose or stopped taking levothyroxine sooner.

One of my theories is that suppressed TSH may indicate the pituitary is not signalling properly for others hormones such as luteinising hormone, resulting in lower oestrogen thus feeling worse!

Sorry, I know none of this helps you Nellie2016

[Nellie2016 in reply to HealthStarDust]

Your right there now im not sure what i should do my tsh has been under range on and off for some time just on Levo but atm i feel a lot worse since t3 was added so do i need more t3 or more t4 or just go back on more t4 my t4 seems too low atm im confused as i do have another 5 mcg t3 to add making it 10 mcg a day with the 100mcg

[HealthStarDust in reply to Nellie2016]

I’m sorry. I think all you can do is try something, and if it doesn’t work, try something else.

We don’t seem to see it often on the forum, but some people generally do not get on well with levothyroxine, or added T3 or even NDT.