Recent blood test results

[eckist]

Can anyone help please. I stopped taking levothyroxine a few months ago to my GPS displeasure and now take a natural thyroid which suits me much better, I feel more like my old self. My recent blood tests are TSH 0.02, T4 10.9 pmo/L (8-18) and T3 4.2 pmo/L (3 8 -6) which means I've gone hyper. I've started to reduce my natural thyroid (Metavive 1) from 6 tablets down to 5 and then down to 4 in a few weeks.Has anyone got any thoughts on this, thank you

[TiggerMe Ambassador]

You've not gone 'hyper' or what would actually be termed over replaced...

Free T4 (fT4) 10.9 pmol/L (8 - 18) 29.0%

Free T3 (fT3) 4.2 pmol/L (3.8 - 6) 18.2%

T4:T3 Ratio 2.595 

Your levels are still on the low end so if you feel well I wouldn't reduce your dose, your TSH has dropped down due to you introducing T3 so now you need to just look at your free levels

Last time you posted 4 years ago you had only just started 25mcg levo did you get up to a full replacement dose?

[eckist in reply to TiggerMe]

Thank you for your reply, much appreciated. My GP will be calling me to discuss my results which will be interesting! I'll reduce to 5 a day and see how I go. When you say look at my free levels could you elaborate, sorry, I'm not good at this

[TiggerMe Ambassador in reply to eckist]

Yep, your GP will have a meltdown as most of them only know about TSH 😅

Your frees are the amount of actual hormone in your blood stream so as you can see your are on the low side for both

[Sparklingsunshine in reply to eckist]

I'm curious as to why if you are no longer taking NHS Levo why your GP is still doing blood tests. Normally they leave you to your own devices if you decline the standard NHS treatment.

If you are self treating you might find your GP's comments, shall we say unhelpful, and you arent obliged to have NHS thyroid blood tests anymore.

[eckist in reply to TiggerMe]

Yes, I increased Levothyroxine to 50mcg and more recently gp wanted me back down to 25 but I've not taken levo for a few months now and feel better for it. Bearing in mind what you've said I think I'll continue with 6 Metavive. Thank you!

[TiggerMe Ambassador in reply to eckist]

50mcg is still a very small dose so likely you were never fully replaced if they were just looking at your TSH level, your frees are still low with what roughly equates to 52mcg T4 and 15mcg T3

[pennyannie]

Hello Eckist :

Do you feel hyper - what symptoms are you dealing with ?

Both T3 and T4 are in their range -

True the TSH is low - but this generally happens when taking any form of T3 thyroid hormone replacement and when nearing becoming optimally medicated when already diagnosed hypothyroid.

The TSH was originally introduced as a diagnostic tool to help confirm a diagnosis of hypothyroidism and was never intended to be used once the patient was taking any form of thyroid hormone replacement.

[eckist in reply to pennyannie]

Thank you for your reply, my energy levels fluctuate but seem to be improving and my sleep is improving since taking Metavive. I have a fair amount of hair loss which is concerning but new growth is appearing thankfully. Constipation is an issue. Maybe its a matter of wait and see and I'll continue with 5 a day. Gp won't be pleased with my results that's for sure

[pennyannie in reply to eckist]

Well your doctor isn't living with all of these symptoms - is he -

and why is he bothered as you are not taking the NHS medication and not obliged to run the thyroid function test anyway -

I stopped taking T4 several years ago and self medicate - I've never been called in for the thyroid function test since I advised the surgery of what I was doing -

I wrote in saying that I would make myself available for a thyroid function test if they would run a T3 and T4 and not just a TSH - and never heard a word but Levothyroxine disappeared from my prescription form around 18 months later -

I also suggested I could send in copies of my private blood tests yearly to go on my health record - no answer -

I delivered my letter by hand - so know it got there.

You could try vitamin C to bowel tolerance -

I'm currently taking grapefruit segments every morning for breakfast followed by an egg - and this seems to be working at the moment -

How are your ferritin, folate, B12 and vitamin D as if these aren't maintained at optimal levels this can impact your health and slow conversion of T4 into T3.

[eckist in reply to pennyannie]

It sounds as though you've been through the mill, well done in managing, can I ask what, if any, supplements you take? I've started to have sea kelp and selenium and I feel both are helping. I take vitamin C, magnesium, zinc, vit B complex and D etc. Both vitamin B12 and D have been tested and are at ok levels. Folate is 18.6 ng/ml and ferritin 133 ug/L. I have venesections every few months to stop iron levels going too high (haemochromatosis)

[pennyannie in reply to eckist]

I take a brand Natural Desiccated Thyroid which has a declared value of T3 and T4 in each tablet and is pig thyroid, dried and ground down into tablets referred to as grains.

Metavive is I believe an OTC product and with no declared measure on T3/T4 thyroid hormones and sourced from cattle and many do very well on these treatment options.

My TSH is 0.01 and my T3 runs at around 90 /110 % with my T4 at around 25/30% through the ranges and if anything I run myself slightly hypo and I still have some niggling symptoms such as a constipation if I don't supplement accordingly.

I also need to supplement ferritin, folate, B12 and vitamin D to maintain these core strength vitamins and minerals at optimal in order to keep myself as well as possible and support T3/T4 conversion.

P.S. Just been advised that your OTC product is sourced from pigs and not cattle -

so just 1 step away from my preferred treatment option NDT - which in this country you'll need a prescription for - many of us source our own thyroid hormone medications - out of desperation as we are not being properly medicated through the NHS.

[TiggerMe Ambassador in reply to pennyannie]

Metavive I, II and Pro are all porcine, III, IV and Pro II are bovine

[pennyannie in reply to TiggerMe]

Ah - ok - wasn't sure - thanks :

[TiggerMe Ambassador in reply to eckist]

Just noticed Sea Kelp which isn't a great idea as it is very high in iodine

[eckist in reply to TiggerMe]

I appreciate your advice, many thanks, I used to take Nutri thyroid as advised by the wonderful late Dr Peatfield, he also recommended kelp, this was around 20 years ago so maybe there is more recent research which advises against taking kelp. It is all such a minefield. I doubt that I'll be able to get a prescription for NDT unfortunately

[TiggerMe Ambassador in reply to eckist]

Kelp might be good if iodine deficient diet but it can also be damaging to the thyroid and since you are taking metavive there is plenty of iodine in that... no not much chance of NDT on the NHS these days but now you know you must have been under replaced on T4 it might be worth another try on a decent dose and if that doesn't work the NHS will in many areas prescribe T3

[eckist in reply to TiggerMe]

I may be deficient in iodine as I don't have dairy products in my diet and very little in the way of seafood of any kind. It may be a good idea to get a test done.Speaking to gp next week so I was thinking of asking for a T3 prescription. The surgery seem to be concerned about me, I wonder why, will try to find out.

[TiggerMe Ambassador in reply to eckist]

[redacted]metavive contains a lot of iodine[redacted] so you likely have plenty as the thyroid is the main user and yours isn't doing much now you are replacing the hormones

[greygoose]

Nooooooooo! You've not 'gone hyper'! The TSH is low because you're taking some T3 (one imagines but with metavive impossible to tell how much). The definition of hyper is not 'low TSH', it's very high FT3/4, which you do not have. In fact, I would say they're too low.

Besides, if you're hypo you cannot suddenly 'go hyper', it doesn't work like that. You can be over-medicated but you are not. TSH is a very poor indicator of thyroid status once it gets below 1.

[eckist in reply to greygoose]

Oh how interesting, thank you, I'm not hyper. The gp's always say that if TSH is low, as mine is, that I am overmedicated so it's not the case. I need to increase my FT3/4 but not to a high level. Can you suggest how I can do that, thank you

[greygoose in reply to eckist]

The only way I know to do that is to increase your dose. But I know nothing about dosing metavive, it's not xomething I would take.

Yes I know gps say that about low TSH, but GPs know nothing about thyroid or treating hypo. Nor do they understand that taking T3 suppressing TSH because the pituitary conxiders you don't need it anymore.

[SlowDragon Administrator]

was test done with last dose Metavive roughly 8-12 hours before test

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test

Your FT4 and Ft3 look low - as in perhaps need HIGHER dose

You need to test vitamin D, folate, B12 and ferritin at least annually

What vitamin supplements are you taking

[eckist in reply to SlowDragon]

Yes, I stopped taking Metavive the day before the blood test which was at 10 am which is the earliest appointment I could get.I will be increasing my dosage as you suggest in order to increase my T3 and T4 levels.

The supplements I take are -

Adrenavive 1

Selenium

Omega 3

Calcium citrate

Vitamins C, D and B complex

Zinc

Magnesium

Kelp

Nutrigest

Probiotics

[BlueShrimper]

As the well informed on here have said GPs generally have very poor knowledge of thyroid issues. I used to be well on 100mcg of level (for a few years) then slowly started to go backwards. I went to see my GP a few times over a 12 momth period complaining of under active symptoms and all he'd say is well your TSH is at 1.o so that means your OK. It was only then I fell over this website that I found more information to help myself. Started self medicating firstly with Armour NDT then a mixture of level and T3. My GP eventually called me in for a review and I told him what I was doing and he got in a flap and referred me to an endocrine depth. They review me every 6 months and prescribe my T3 but I don't have any great confidence in them as they just tow the party (NHS) line.