Advice re latest blood results

[Niadancer]

Hello, I have been prescribed 10mcg T3 and 50mcgs T4 by my endocrinologist.

In Aug last year I increased my T4 by 12.5mcgs every other day, and my results were in January were :

TSH 1.53mU/L 0.55 - 4.78 (23.7%)

Free T4 13.8 pmol/L 10.0 - 20.0 (38%)

Free T3 5.4pmol/L 3.5 - 6.5 (63%)

My T3 increased from 48.7% to 63%

I then added 12.5 every day and these were the results from Medichecks in May:

TSH: 1.24 0.27 - 4.2 miU/ I 24.8%

FT4: 16.2 12 - 22 pmol/ I 42%

FT3 4.3 3.1 - 6.8 pmol/1 32.43%

I was wondering why my T3 had dropped from 63% to 32.43% as I had hoped that the slight T4 increase would help the T3 to increase rather than decrease..

After asking advice from people on this forum, I reduced back to 12.5mcgs every other day to see what would happen.

I had a blood test in August, and was surprised to find my TSH has increased to 77.54%.

Full results for August are:

TSH 3.83 0.55 - 4.78 77.54%

T4 14.2 10.9 - 21.2 32.04%

T3 5.2 3.0 - 7.1 53.66%

In some ways I do feel better on the T3/T4 combo, but am having a variety of symptoms, which suggest I am not quite medicated optimally. My symptoms include: heart palpitations, memory problems, especially with words escaping me, problems with my digestion again, night sweats, shortness of breath/ pain in chest when walking etc. Some days I can be fine, then others not so good. I find mornings quite difficult, I feel sleepy for the first couple of hours and then improve.

As it was just a PA who reviewed my August results, saying that I was within range, and I'm not seeing my endocrinologist until January, I was thinking of writing to him to ask for a slight adjustment in the prescription. I'm just not sure what to ask for and wondered whether anyone could offer me any advice please.

TIA

[SlowDragon Administrator]

That’s a pretty low dose unless you’re very petite

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

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

Is this how you do your tests

Presumably you have Hashimoto’s

Are you on gluten free or dairy free diet

Exactly what vitamin supplements are you taking

Looking at your helpful profile you self organise frequent B12 injections

Do you also take vitamin B complex daily

Vitamin D?

[Niadancer in reply to SlowDragon]

Thanks for your reply SD.

I do all the recommended actions prior to taking the test. My vit D and folate were a bit too high, so I have reduced my supplements. I'm not petite. I'm about 5ft 7ins, but shrinking lol. I've just been diagnosed with osteoporosis after a fall in February. I do take b vitamins every day. I tried gluten free for a few months but didn't feel any different. I am going to try again later in October after my holiday. I don't eat dairy. I don't know whether to ask for an increase in T4 or T3

[humanbean]

In Aug last year I increased my T4 by 12.5mcgs every other day

I find it worthwhile to work out my average dose of T4 when my dose isn't the same every day. Then if/when I change my dose I can do the same again and see how much the change is "worth".

50mcg per day + 12.5mcg every other day works out as an average of 56.25mcg per day

For someone who has such low Free T4 I would have thought an average increase of 6.25mcg per day wouldn't do much even though it did change your results. Such small average increases are usually only used when someone is very close to their optimal level. Based on your symptoms you are nowhere near optimal.

shortness of breath/ pain in chest when walking

I had these symptoms when I was very low in iron. Have you got test results for ferritin/iron, B12, folate and vitamin D?

[Niadancer in reply to humanbean]

Thanks for your reply. It would seem that I need to ask for an increase in T4 perhaps. Below are my iron results from November '23. I added the 12.5mcgs myself as end didn't want to change anything

Iron results

[Niadancer in reply to humanbean]

Folate was: >24.0 ug/l range 3.0 - 20.0Vit D 25-OH 101nmol/L >25

I have vit b12 injections so I know that is okay.

[redhead41 in reply to Niadancer]

I believe vit d is still too low - nearer 200 or even250nmol/l would be better.

[Niadancer in reply to redhead41]

Oh. I thought it was too high, so have reduced the supplements. Will start again. Thanks

[Sunflower535 in reply to Niadancer]

The admin on here would say your Vitamin D should be between 100 and 150. So I think you are okay - but that's just my opinion based on reading from this site. Just be careful not to overdo the Vitamin D.

[redhead41 in reply to Niadancer]

Please check the units as the other units give a lower range.

[AKatieD]

Have you changed any other hormones ( like adding HRT or adjusting dose) or changed the frequency of your b12 jabs?

[Niadancer in reply to AKatieD]

No. I don't use hrt. I have lengthened the interval between the b12 jabs slightly.

[AKatieD in reply to Niadancer]

I find sex hormone levels affect my thyroid so if you could be peri- menopausal, fluctuations in hormone levels could affect your thyroid. Also definitely find that b12 frequency affects me too ( although hard for me to isolate impact as never varied b12 frequency alone and tested T3/4).

[Niadancer in reply to AKatieD]

I'm well past menopause, but this illness did start when I was perimenopause.

[Wua13262348 in reply to Niadancer]

I am post menopausal too.I agree with AKatieD re. sex hormones. Randox Health do a Female Hormones finger-prick, home test for £29-£39 which is excellent value. The symptoms you are describing are estrogen, progesterone and testosterone imbalance symptoms. I have just been researching it for myself and was totally unaware just how much all three affect the lung function and oxygen availability. So breathlessness, sleepiness , pain in chest and night sweats etc. are most likely due to the above. I have just been given an inhaler which I have not used as I can clearly see from my Randox tests that my progesterone is way too high and out of range and estrogen too low. Do a general google search by asking questions like ,"does low estrogen cause shortness of breath in a post menopausal woman?" and "does high progesterone cause "sleepiness in a post menopausal woman?" You get the idea. All your symptoms you are worried about could be due to your post menopausal levels of your sex hormones, and you will likely be offered an inhaler, like me!!! They just don't seem to realise !!!!

[Niadancer in reply to Wua13262348]

Thanks for your reply. I have often wondered whether other hormones, or lack of, might be playing a part in this. I will definitely do some research, and take a test to see where I'm at. My chest pain and shortness of breath are intermittent, as are the other symptoms. There does seem to be a cyclical element, especially hair loss and itchy scalp, that I also have, which suggests hormone imbalance to me.