Advice Please 🙏🏻

[Margiepargie]

Hi all,

Could anyone please give me some advice on my latest bloods please? The last time I posed on here the advice was to up my dose from 100mcg to 125mcg. Do I need to go up a bit now again?

since my last post I have been diagnosed with Polymyalgia rheumatica and have been on 20g of steroids. I am now slowly reducing my dose of steroids over the coming months. I’m feeling very tired, having sleeping problems, heart palpitations and generally feel as if my body is vibrating. Now I’m not sure if this is down to the steroids or it’s my thyroid as I’ve had the same symptoms in the past before steroids. So any help/ advice would be greatly appreciated🙏🏻

FT3

4.3 pmol/L

(normal range 3.1 - 6.8 pmol/L)

FT4

22.9 pmol/L

normal range 12 - 22 pmol/L)

TSH

0.01 mu/L

(normal range 0.27 - 4.2 mU/L)

[SlowDragon Administrator]

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

Ft4 is above top of range this could be making you feel unwell

TSH is low, this might be because of high Ft4 but could also be effected by steroids

Suggest you try SMALL reduction in levothyroxine…..perhaps reduce to 112.5mcg 4 days per week

Get a weekly pill dispenser and cut 25mcg tablets in half

Retest in 6-8 weeks

Also get vitamin D, folate, B12 and ferritin levels tested at next test

What vitamin supplements are you taking

Previous post 5 months ago showed low vitamin levels and you say you are vegetarian, gluten and dairy free

Serum total 25-hydroxy vitamin D level (Xabo0) 57.5 nmol/L

Serum folate level (42U5.) 2.9 ng/ml [3 - 20]

Serum ferritin level (XE24r) 43 ng/ml [13 - 150]

Serum vitamin B12 level (XE2pf) 219 ng/L [197 - 771

Your conversion rate of Ft4 to Ft3 is poor

You may eventually need T3 prescribed alongside levothyroxine

[Margiepargie in reply to SlowDragon]

Hi, yes test done as you said. Not taking any supplements at the moment. I have got a nasty virus at the moment and have had for the last two weeks, so not sure if that would make a difference.

I will go down a bit then a retest. Thank you so much for your help. 🙏🏻

[greygoose]

Not only will a virus affect your conversion, but your Hashi's could also be causing the high FT4. So, this test doesn't really give you any helpful information. Too many variables.

So, if you feel over-medicated on levo - maybe you are, maybe you aren't, impossible to tell at this point - reduce your levo unofficially, because you're probably going to need to go back on your full dose eventually when the virus has totally gone, and your Hashi's has calmed down again - if, indeed, that is the problem. Don't let your doctor reduce your prescription, because once they've reduced a dose it's hard to get them to put it up again! Or are you self-treating, now?

[Margiepargie in reply to greygoose]

Hi,

Yes I’m self treating now. I managed to get a dose increase from my previous GP. I’m at a new practice now and not too sure how they will be. I’m not going to tell them anything until I get over this virus and retest. Thank you so much for your help xx

[greygoose in reply to Margiepargie]

You're welcome.

[Brightness14]

I have the same symptoms when my FT4 is over range, but FT3 is too low, as yours is.

When I lower my FT4 slightly and raise my FT3 wi th T3 these symptoms disappear. Of course it could be the steroids.

[CarpieDiem]

I'm currently trying to get my thyroxine higher as I used to be on 175mcg and now on 125mcg and my last blood test was 4.5 and my doctor says this is normal, but it's not. According to everything I've read it should be below 2.I've recently received a copy from Thyroid UK of Dr Tofts article in Pulse magazine if you let me know your email address I can forward you a copy.