Help with results - TSH dropped

[Klawd]

Appointment with endo in a week, just got Blue horizon blood test back, worried TSH lower, was hoping to get uped another 5mg lio as felt that may help? Did test according to advice on here food, vit'vit's, timing ect.

On 125 levo & 15 lio, def improvment since starting lio but still not right, dry eyes n pain, over thinking stuff, anxiety, specially round 3am - my brain goes into overdriver & seems to think of anything/everything I can fret over? Random achy body & sores on groin area.

TEST RESULT NORMAL RANGE UNITS COMMENT

CHEMISTRY / IMMUNOASSAY

Vitamin D (25 OH) 85 50 - 200 nmol/L

Optimal 75-200

Adequate 50-<75

Insufficient 25 -<50

Deficient <25

Magnesium 0.8 0.7 - 1.0 mmol/L

CRP 0.91 <5.0 mg/L

Ferritin 144 13 - 150 µg/L

Ferritin is the most useful indicator of iron deficiency, but also an acute phase reactant and may be elevated in malignancy, chronic inflammation, liver

damage and iron overload

Serum Folate 20.40 8.83 - 60.8 nmol/L

Active B12 100 37.5 - 150 pmol/L

TSH L 0.07 0.27 - 4.20 mIU/L

Free T4 17.9 12.0 - 22.0 pmol/L

Free T3 5.2 3.1 - 6.8 pmol/L

T4 Total 79.6 66 - 181 nmol/L

Anti-Thyroglobulin Abs 36 <115 IU/mL

Anti-Thyroidperoxidase abs H 83.4 < 34 IU/mL

Any advice please?

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[TiggerMe Ambassador]

Free T4 (fT4) 17.9 pmol/L (12 - 22) 59.0%

Free T3 (fT3) 5.2 pmol/L (3.1 - 6.8) 56.8%

T4:T3 Ratio 3.442 

Folate - Serum 20.4 nmol/L (8.83 - 60.8) 22.3%

Vitamin B12 100 pmol/L (37.5 - 150) 55.6%

Vitamin D 85 nmol/L (50 - 200) 23.3%

So if your Endo is any good a small increase in T3 shouldn't be an issue

You could do with boosting your folate and B12 do you take a good B complex?

Vit D could do with increasing to 100-150 grassrootshealth.net/projec...

[TiggerMe Ambassador in reply to TiggerMe]

Sorry meant to add that I get this night time gaslighting if my oestrogen levels drop too low if that is relevant

[Klawd in reply to TiggerMe]

HI TiggerMe, I take Igennus super B complex ( I only been taking 1 a day & throw an extra cpl in over the week, also take b12, selenium & biotin alternate days ish, in the weeks pill box. I use magnesium spray on belly in evenings, but sometimes forget, I use Estridol cream applicator once or twice a week but I stopped all vits, suppliments ect a good week before the test cause of cortisol test and we were travelling & struggled to get a blood draw. Sorry hadn't put cortisol on, test was done 8.18.15 am.

Cortisol (Random) 292.0 73.8 - 507.0 nmol/L

6am - 10am 166 - 507

4pm - 8pm 73.8 - 291

Endo was reluctant to give me last increase 5mg T3, stated if TSH drops he need to look at T3

So afraid he going to cut it down?

thank you

[TiggerMe Ambassador in reply to Klawd]

Have you noticed if you wake up on the nights you use the Estridol?

Worth upping your supplements, do you get a reasonable amount of salt and Vit C in your diet to help your adrenals

[TiggerMe Ambassador in reply to TiggerMe]

Do you take progesterone too? It really helps with sleep

[Klawd in reply to TiggerMe]

sorry, I get in a muddle with the order of the messages, no I only take estridol as I have prolapse, do you think progesterone may help?

[TiggerMe Ambassador in reply to Klawd]

I couldn't find anything that suggests not using progesterone with a prolapse?

Have you checked your sex hormone levels recently?

[Klawd in reply to TiggerMe]

thank you, no to be honest it's something iv never really thought bout. I used the estridol last night & sleep great, up once for a pee & straight back to sleep best sleep iv had for ages. Would that indicate I'm lacking in sometsomething or does it just do that for everybody?

[Klawd in reply to TiggerMe]

Funny, I used to sleep like a bear when I took it, then it changed quite recently not sure why? Started taking salt again after saw on here we need it, as I had cut it out, ....went cold turkey a few years ago when GP tryed to get me on statins cause of HBP. I really crave it badly some times & recently..... will cram handfuls of crisps in my mouth🥱 .... like a rabid dog (my husband said : ) Yea eat a good varied diet we usually only have fruit for lunch. Can Please look at response to Dippy dame, im likely missing some way to say to you all how gratefull I am to you all, Thank you

Ps is my Ferritin high?

[TiggerMe Ambassador in reply to Klawd]

The forum is fabulous isn't is, I didn't have a clue when I joined, we need to train each other up so that we can pass it on

Your ferritin is up there but it can just be inflammation causing it so just keep an eye on it, have you any iron panel results as this will show you where your iron levels are

[Klawd in reply to TiggerMe]

yes a godsend, saving so many of us poor souls from the dark despair & hopelessnes I'm sure we've all felt with this condition, youve help us find the strengh 💪 Not sure I ccould ever get my head round it to be knowlKnowledgabl to be able to help others, just so gratefull for all of you who do 💞

I will search thru my GP results for iron levels

[TiggerMe Ambassador in reply to Klawd]

Even if you just tell people to get properly tested and don't take the GP's word that everything is "normal" rather than optimal is good enough

[SlowDragon Administrator]

What times are you taking your 5mcg doses of T3

Still taking Roma?

Which brand of Levo

Free T4 (fT4) 17.9 pmol/L (12 - 22) 59.0%

Free T3 (fT3) 5.2 pmol/L (3.1 - 6.8) 56.8%

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)

T3 ….day before test split T3 as 2 or 3 smaller doses spread through the day, with last dose approximately 8-12 hours before test

Was test done as recommended

You could try small increase in Levo

Eg 137.5mcg twice a week and 125mcg five days

Or

Try an extra 5mcg T3 if Endo will agree

[Klawd in reply to SlowDragon]

hi SlowDragon, I tryed various times taking them & now feel all together when I wake in night bout 2/3am seems to work. T3 Roma, T4 25's Teva, T4 100's Accord.

Test all done as recomended. Endo very reluctant to give me last T3 increase of 5mg, saying very concered at low TSH & if it dropped he'd need to look at T3, I'm very worried he going to reduce it. Will any increase in T3 or T4 meds reduce my TSH further?

thank you : )

Sorry forgot this ; Cortisol (Random) 292.0 73.8 - 507.0 nmol/L

6am - 10am 166 - 507

4pm - 8pm 73.8 - 291

[DippyDame in reply to Klawd]

Your endo doesn't seem to understand that adding T3 lowers both TSH and FT4.....that's how the hormones work!

The most important number is FT3 followed by FT4

bmcendocrdisord.biomedcentr...

Note conclusion of this Study!

TSH is not a reliable marker. It is a pituitary, not a thyroid hormone and was originally devised as a diagnostic test for hypothyroidism. It is a lazy way of trying to monitor hormone dose

thyroidpatients.ca/2021/07/...

I take it poor T4 to T3 conversion has been established so increasing levo may or may not make much difference. You already know that more T3 would help so ask this clueless endo to show you proof that low TSH is a problem because all it really means is that the pituitary is signalling the thyroid to produce less hormone.

Those of us who need high dose T3-only have a low or suppressed TSH.....after about 7 years of unreadable TSH I have no problems!

Medics knowledge and experience of thyroid disease is based on what they believe, not on what science proves to be the case.

It's a complete mess !

Vit D is too low aim 100 -150

Vitamin D should be taken with vit K2 which directs the calcium in the system to the hard tissues (bones and teeth) where it is required and away from soft tissues (arteries) where it can accumulate

Symptoms are an important part of diagnosing but many medics wrongly ignore this in favour of numbers

Your symptoms do suggest undermedication as do your numbers

Have another try at persuading this endo to give you a TRIAL of an extra 5mcg T3.....TRIAL makes them feel they are still in charge and might just be enough to massage their ego!!

You already know that less T3 is a retrograde step...you have already proved it ....fight your case! They need to prove their case with facts not vague guidelines....I bet they cannot!

Good luck

[Klawd in reply to DippyDame]

Thank you DippyDame, I'm nearly moved to tears that TiggerMe, SlowDragon & yourself take your time to help me.......and to be honest, bit in awe of you all & the knowledge you have accumulated ( & managed to retain in your brains : ) as I feel I may never get to grips with understandin this condition 😵‍💫 ......'I know nothing!.....Manuel,that is (faulty Towers)......not Socrates 🤗 So I will dig my big pants out again, ready for battle knowing you are all behind me & given me the strestrength to battle on, Thank you all.

I did go with the trial route last 2 T3 increases, can I refuse a lower dose if he says T3 is harming you?

[TiggerMe Ambassador in reply to Klawd]

Worth saying to him that you are willing to take responsibility for a lowered TSH and trailing a small increase in T3 for the sake of improving symptoms... if he puts this on your records it makes him immune to comeback 😉

If you can get him to send you for a DEXA scan even better!

[Klawd in reply to TiggerMe]

OK, will do, why is dexa scan even better....is that strenght ? Yea.....mine really not good, I have had little strenght even struggle to push a pill out the pack! Way before starting T3.

[TiggerMe Ambassador in reply to Klawd]

It's a bone scan so you'll know if you need to start taking better care of your bones

[Klawd in reply to TiggerMe]

Thank you, if it's not so good is he likely to blame T3 ?

[TiggerMe Ambassador in reply to Klawd]

How long have you been on T3?

Don't see how he can say it's down to T3 or low oestrogen, Vit D etc etc

But if you know about it you can practice some extra bone health care

I got a private scan last year as I didn't qualify on the NHS and it shows osteopenia which is no doubt a combination of menopause, low T3, low Vit D... so at least I know where I am and can monitor and actively do something about it like sorting out all my low things and doing more resistance and weight training along with adding some bonebalance

[Klawd in reply to TiggerMe]

started 23/11/23 on 55mg. Ostophenia? Never heard of that, have you been able to improve?

[TiggerMe Ambassador in reply to Klawd]

Osteopenia is the earlier stage of Osteoporosis so bones are starting to thin.

Hard to know if I'm improving as you can only have a scan every 2 years 🤷‍♀️ Radd has been tackling it for longer and has improved her scores 😅

[Klawd in reply to TiggerMe]

so you just a yung un then? GP told me yrs ago, in passing that I'd arthritis...I ask how he knew he said look at your hands! Just looked same as always to me, tho am getting cateracts done next week so best start preparing myself for the reality of just how much the ol body's deteriated whwhile I couldn't see it. 🫣

[DippyDame in reply to Klawd]

Your FT3 is within reference range so you are not overmedicated, he has no grounds to refuse an increase....except his ignorance!

Charge into battle waving those big girl pants ....he's a bully!

Courage!

[Klawd]

Do you mean shake my booty at the endo....with my big pants on? 😍 ... I'll try anything 😜

thank you. 👍 appreciate all you help 🌻

[DippyDame in reply to Klawd]

Metaphorically!!

[Klawd in reply to DippyDame]

luv it! Might just try both as a back up ...... 💃.if nothing else it might just make him laff 😂