Consultant appointment tomorrow

[Otto11]

Hi all

Well tomorrow I have my first Consultant appointment since being prescribed T3 a year ago. It has made a tremendous difference to my well-being after many years of under medication. However I’m not there yet. I’m a bit concerned that I’m going to be told all is ok ( which is what the nurse has told me). I just want to be prepared. My recent bloods are as follows All bloods done 9am & following protocol

May. TSH. 0.01. (0.27-4.2) T4. 16. (11-22) T3 5.1 (3.1-6.8)

July TSH 0.02. T4 14.. T3. 5.2

Aug. TSH. 0.02. T4 14. T3 4.7

Oct. TSH. 0.02. T4 13 T3 5.4

I’m worried about my T4 which is falling & I know should be higher through range than my T3

Any idea what they may say at my appointment so I can be prepared

I had a partial Thyroidectomy in 1995 & have been on Thyroxine since 1997.

Wish me luck

Thanks

[Sleepman]

Your feeling better which is good.

I think results are pretty steady, there is always variation.

Good luck, let us know what is said.

[Otto11 in reply to Sleepman]

Will do.

[SlowDragon Administrator]

how much levothyroxine are you taking

Do you always get same brand

Suggest you experiment with very SMALL increase in Levo

Perhaps 25mcg per week as 12.5mcg extra twice a week

Retest in 6-8 weeks

Are your vitamins optimal

[Otto11 in reply to SlowDragon]

Thank you. I’m on 75mcg Thyroxine & 10mcg T3 twice daily. Always same brand. Accord & usually Mercury for 25mcg. T3 is Teva. I would really like a small increase in Thyroxine but not sure he will agree.

[TiggerMe Ambassador]

I'd be feeling pretty grim with fT4 that low ☹️

Free T4 (fT4) 13 pmol/L (11 - 22) 18.2%

Free T3 (fT3) 5.4 pmol/L (3.1 - 6.8) 62.2%

T4:T3 Ratio 2.407 

Looks like they did the usual thing by making you lower your T4 dose when starting and then the addition of T3 further lowers your fT4... I'd be asking for a 25mcg increase in T4, you may have to use the word 'trial' to sweeten the deal 😏

[Otto11 in reply to TiggerMe]

Thank you so much. Yes I was taking 112.5mcg Thyroxine previously then they added T3 10mcg twice daily ( I did it very slowly though) & I was told to lower Thyroxine to 50mcg but I so no it was too low so arranged 75mcg. That was a year ago but I’ve only ever seen a registrar once who prescribed it & I still havnt seen a Consultant yet so really need this appointment to go well.

I’m much better as I actually thought I was dying for 4 years & they were missing something. That said cognition wise I’m still rubbish. I never gained weight when hypo but now have lost almost 20kgs & at 5Ft 8 & a size 10 that’s way too much. I did ask a nurse ( there is a helpline) about my T4 but she said I couldn’t raise it as my TSH was already so low.

I just hope this guy knows his stuff. The nurse told me he is nice. Ok but is he good? 🤞

[TiggerMe Ambassador in reply to Otto11]

I'm wondering if you shouldn't be on a slightly higher dose of T4 and slightly less T3, how did you feeling on the various doses of T3 on the way up?

[TiggerMe Ambassador in reply to TiggerMe]

I've just read on through and see SlowDragon suggested the same thing 😅

[Otto11 in reply to TiggerMe]

I think I was ok. As I slowly felt better than I had for a long time. But still have awful cognitive issues & often need to rest afternoon or evening generally without warning. Still a lot better than before though.

[TiggerMe Ambassador in reply to Otto11]

I still think you need to up your T4 and lower your T3 to gain the right ratio

[Otto11 in reply to TiggerMe]

Thanks so much. See my update today on my appointment 👍

[Otto11 in reply to TiggerMe]

That should read 10kgs not 20kgs

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[SlowDragon Administrator]

You could request a 5mcg reduction in T3 to 15mcg and 25mcg increase in Levo?

[Otto11 in reply to SlowDragon]

Thank you. I will mention it 🤞

[Otto11 in reply to Otto11]

Thanks. See my update today 👍

[serenfach]

I have found that by stating the percentage through the range gives them a better insight. They tend to be number blind, but a percentage makes them see the number differently. I hope it all goes well for you.

[SlowDragon Administrator in reply to serenfach]

Definitely agree…..always add percentage through range alongside results

[Wua13262348 in reply to serenfach]

I love % through the range. My private Endo ( think many on the forum use), hates it .

[Otto11 in reply to serenfach]

Thanks will do.