I have a gp appointment in 4 days , I’ve done private blood test through medicheck and wanted some help with results as I still feel that my bowels are slow and rubbish , low calorie careful diet , I weigh a stone and a half more that a year ago !
My levothyroxine is 100 micro-grams daily ( I didn’t take it on my test day til after )
My inflammation CRP HS is 1.39
Ferritin is 275ug/L ( a bit high I think )
FOLATE 20.1nmol/L
Vitamin B12 active 64.9pmol/L
Vitamin D 78.8nmol/L
TSH 1.16 mIU/L
FREE T 3 4 pmol/L
FREE THYROXINE 25.8pmol/L
is it a bowel issue or maybe still a thyroid issue?
Written by
Gilbert2023
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Ft4 is above range so Levo is perhaps a LITTLE too high
Free T3 (fT3) 4 pmol/L (3.1 - 6.8)
Ft3 very low at only 24.3% through range
Ferritin is often higher post menopause
Probably fine
Might want to get full iron panel just to check
What vitamin supplements are you taking
Vitamin D a bit low.
active B12 also a bit low
suggest keep levothyroxine at current dose and work on improving low vitamin levels
Then retest
If Ft4 still over range after next test
Perhaps reduce Levo by 12.5mcg 4 days a week
Lowering Ft4 quite likely to result in even lower Ft3
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
At diagnosis my gp advice was to stop the b12 supplement,so I did for at least 2 months , since then I’ve taken it intermittently but the medichecks result made mr wonder , I have 1000 micro gram tablets …….one a day ?
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement
A week later add a separate vitamin B Complex
Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.
If Vegetarian or vegan likely to need ongoing separate B12 few times a week
Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) Thorne can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12
Post discussing how biotin can affect test results
We generally feel best when on T4 monotherapy when the T4 is up in the top quadrant of its range ar around 80% with the T3 tracking just behind at around 70% through it's range at around a 1/4 - T3/T4 ratio.
The accepted coversion ratio when on T4 only once the T4 is in the top quadrant of its range is said to be 1 / 3.50 - 4.50 with most people feeling at their best when they come in this ratio of 4 or under :
So with a T4 at 25.80 and a T3 at 4 - if I divide your T4 result by your T3 result your conversion ratio is coming in at 6.45 and very wide of the centre showing you struggling to convert T4 into T3.
Since your T4 is over the range the knee jerk reaction is to reduce your dose of T4 down but this may also lower your already too low a level of T3 and make you more hypothyroid and it is too low a level of T3 for you that causes all the symptoms of hypothyroidism which includes constipation and weight gain.
With hypothyroidism your metabolism has slowed - and diets do not work but make the situation worse as your body senses less food intake so immediately holds on to any stores it has sensing famine - and the more you diet the more difficult it will be to loose and keep off any weight as you are down regulating your body's own natural metabolic rate.
The thinking doctor - if allowed a free hand to dose his patient accordingly - might well drop your T4 dose but add in a little T3 - Liothyronine - so to rebalance these 2 vital thyroid hormones.
No thyroid hormones work well until the core strength vitamins and minerals - ferritin, folate, B12 and vitamin D are up and maintained at optimal level -
I now aim for a ferritin at around 100 - folate around 20 - active B12 125 ( serum B12 500++) and vitamin D up at around 125.
and conversion of T4 into T3 which happens in the liver can also be compromised by inflammation, antibodies, any chronic long term illness, physiological stress ( emotional or physical ) depression, dieting and ageing.
T3 - Liothyronine is a thyroid hormone - just as T4 is a thyroid hormone - and both produced by the thyroid on a daily basis at around 10 mcg T3 + 100 mcg T4 - with T3 said to be around 4 times more powerful than T4.
T4 is a pro-hormone that needs to be converted in your liver into T3 the active hormone that runs the body much like fuel runs a car - and there are several reasons why you may not be able to convert well the T4 into T3 as mentioned in my first reply.
There are also genetic reasons why some can't convert T4 into T3 - but first off we need to rebuild back the vitamins and minerals anyway before we ask to be referred to an endocrinologist to be considered for more than T4 - the cheapest option.
Of course you could argue that being referred to an endo for a hormone that was originally readily prescribed by your doctor some years ago, also a waste of a specialists time and money - but that's where we are and in certain area of the country we face a post code lottery where financial constraints rather than medical need are applied in what we presume to be health care trusts.
You can look and see if your primary care provider is supportive of T3 by the number of prescriptions it writes but there is no way of know for sure if this applies to ' new patient ' prescriptions - go into openprescribing.net and then enter Liothyronine as the drug and see how supportive your surgery is compared to other surgeries - and you can also see by ICB area how active your area is compared to other ICB health boards.
SDragon has given you suggestions to the Thyroid UK list and yes, if you can afford to go privately you may well find a different playing field, and if this is not an option, you can source your own thyroid hormones and start self medicating as many forum members have been forced to do in order to get their lives back on track.
I wouldn't recommend your self medicating yet - try the correct routes through your doctor first and start reading up so you become your own best advocate and have built up the confidence to DIY - if all else fails - there is a big playing field here of forum members self medicating so you will be supported if push comes to shove.
Thyroid UK - thyroiduk.org - also have so much more information on their website including a list of hypothyroid and hyperthyroid symptoms - and this tick box exercise is very good at helping you focus on your own symptoms some of which you have likely been living with for ages and just tolerated - as we generally are not understood by symptoms and just offered anti depressants as some sort of consolation prize -
as treated just on blood test results which if in range are seen as ' ok and good to go ' - even when plainly there are issues and the ranges too wide to be used in isolation to treat patients properly
My daughter in law suffers with hypothyroidism! So much information here, thanks Pennie! I shall look up that last website and inform myself more concerning these issues mentioned here! 🩷🙏
I found this very informative altogether Gilbert 👌
And not taking other vitamin supplements with your prescribed medication together makes sense as it could reduce the effect of your medication first thing in the morning 👍
Well done for your progress with other problems you had in your life 💙🙏
According to your body weight and also blood test, that is how much mcg levothyroxine your doctor will prescribe you! 👍
Have a read on this website I send you Gilbert 👌 I think the more we understand about our health problems the less scared we becone and can also discuss any problems concerning our meds etc with our Doctors! 👍🙏
If I feel a bit constipated and haven't been to the loo for 3 days I drink 2 teabags of Peppermint tea with a good teaspoon of honey in it at night time 👌My breakfast
I have 6 table spoons of oats, some raisins mixed with hot boiling , sometimes I put some blueberries 🫐 in it as well and cover it with a little plate and leave it to soak for 30 or 60 mins! No need to cook it or microwave the mixture! Then I add 1 banana 🍌 half a orange 🍊 or alternatively fresh slice of pineapple 🍍 or a whole kiwi 🥝!
But banana goes in it every day Gilbert 👌
Then I add half a teaspoon cinnamon and a teaspoon honey!
Mix around and breakfast ready! Love it 🤩
Since February 2019 after my heart attack I always had porridge with fruit for breakfast 👍
ok but symptoms vary between people with the autoimmune type, I have 3 daughters all with this , one has never struggled with weight or constipation but has symptoms that I don’t , does your daughter in law have my symptoms? is she post menopause?
was it taken later in the day than the medichecks one?
if so that would account for it being lower. (tsh is highest very early a.m. , falling to lowest around 1-3pm ish . then rising again .
also worth looking to see if range for GP's tsh is different from medichecks range . different ranges shouldn't make too much difference with TSh results , but it could account for small change in tsh result.
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