Blood results in - help please!

[mids_thyman]

Hi everyone,

Can you help me please?

My last blood results (2 months ago) came in with higher levels:

TSH: 3.7 (TSH levels normal (normal range 0.27 - 4.2 mU/L). Increased from 0.98 6 months ago.

FT4: 18.6 (normal range 12 - 22 pmol/L). Was 19.3 6 months ago.

FT3: 4.8 (normal range 3.1 - 6.8 pmol/L). Was 4.9 6 months ago.

At the time I had been feeling extremely fatigued, so I upped my Levothyroxine to 100mg (from 75mg), and also tried to be much more regimented about when I take it. I'd previously got a bit slack and began to take them with food in the mornings, but am now waking up early and having them before food.

The combined effect of these 2 changes is a little more than I would have anticipated, and I have just got my 8-week retest results back, and some are now marked as out of range:

TSH: 0.12 (TSH levels normal (normal range 0.27 - 4.2 mU/L).

FT4: 26.2 (normal range 12 - 22 pmol/L).

FT3: 6 (normal range 3.1 - 6.8 pmol/L).

I assume I have gone a little too far with the double changes, but what are people's opinions?

And if so, is my next step to reverse the changes in dose, drop back down to by 25mg (back to 75mg), and continue to take my Levo in the middle of the night? And then retest in 8 weeks?

I know this sounds daft but I've always been focussed and led by my TSH levels. What am I aiming for in terms of FT4 and FT3?

Any help greatly appreciated, thanks in advance.

Mids_thyman.

[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

most importantly how do you feel?

If you don’t feel over medicated suggest you remain on current dose and retest again in another 8 weeks

retest vitamin levels at next test

When did you last test vitamin D, folate, ferritin and B12

Exactly what vitamin supplements are you taking

[Jaydee1507 Administrator]

How did you take this test? What time of day and when was last Levo dose before the test?

How do you feel?

Personally I wouldnt want my FT4 over range. You could decrease slowly by 12.5mcgs and see how that affects your blood results.

[mids_thyman in reply to Jaydee1507]

Thanks Jaydee and SlowDragon,

The test was taken first thing in the morning, before any medication or food. I hadn't had any Levo for 24 hours, and the previous dose was 100mcgs.

As far as how I feel, I've recently had Covid and am type 1 Diabetic. And so feel pretty exhausted all the time. But I have seen some improvements in the last few days,

Are you guys saying that TSH 0.12 is OK? But my aim really should be to maintain as low as possible a TSH whilst keeping FT4 in the normal range?

Cheers,

Mids_thyman

[Jaydee1507 Administrator in reply to mids_thyman]

FT4 needs to be within the upper quarter of range and FT3 around 70%.

Your FT3 is currently at 78% so just drop back by 12.5mcgs. Not sure what size tablets you have?

Its fine for TSH to be below range, it doesnt cause symptoms as such, just GPs going to freak out a little (for no reason).

Taking a little too much thyroid hormone can make you feel tired. There is a huge cross over of hypo & hyper symptoms hence the need for blood tests.

[mids_thyman in reply to Jaydee1507]

Thanks, that’s really useful.

What about my other theory about taking it away from food and drink? I was really slack on this before, often taking it with a caffeinated coffee when I woke up.

I’ve read that absorption could be reduced by up to 50%, which could have been happening to me to an extent.

Do people think this is significant? Could I have gone from 37.5mcg (75mcg@50% absorption) to 100mcg?

I must admit, the difference in the two blood tests took me by surprise. I was expecting a slight change in TSH over 8 weeks

Thanks,

Mids_thyman

[helvella Administrator Thyroid UK in reply to mids_thyman]

A lot of the coffee information is unclear. Many sources do not clarify whether they are considering with or without milk, with or without sugar, amount of coffee (I drink coffee strong, black, without sugar, and in a decent size mug first thing), or even notice whether or not it is decaffeinated.

I'd not be at all surprised if a small, weak coffee without milk or sugar has little impact (not no impact!). Whereas a large, strong coffee with milk and sugar could make a big difference.

We need to get a barista involved!

[Jaydee1507 Administrator in reply to mids_thyman]

I'm certain that if you were taking Levo with anything else other than water then absorption was affected. By how much will probably vary depending on what is eaten or drunk and how long after taking Levo.

[Brightness14]

why not take 4 x 100, 3 x 75 levo a week = 89.28 or 3 x 100, 4 x 75 levo a week = 85.71. ether of these two would bring your FT4 down a little.

[mids_thyman in reply to Brightness14]

Awesome, thanks for all your help everyone.

I have just one more question. The retest was done 8 weeks after I changed my doses. Are these results considered stable or could they still be going up/down before they eventually settle out?

Thanks,

Mids_thyman.

[Brightness14]

They should be fairly stable after eight weeks, bodies have been known to alter though it's best to go by how you are feeling too.

[mids_thyman]

OK. Just one more question then. 😀

As I said, hypo-thyroid is is just one thing I have going on. Type 1 diabetes, and lingering long-covid being some others. Oh, and getting older!

Trying to work out if I’m feeling well/better isn’t that simple! I’ve read elsewhere that even once you have the correct levels of Levo, it can take a while to feel better. Is that the case or should I be feeling notably better now?

Mids_thyman