September 2023 (Non Fasting, about 3 hours after taking Levo)
TSH <0.05
FT4 20.1 range (9-25)
May 2024 I reduced my levo by 25mg
July 2024 became unwell hypo symptoms still bad now.
September 2024 (Non Fasting about 3 hours after taking Levo)
TSH <0.05
FT4 16.2 range (11.5-22.7
After the advice taken here I did a private test (Fasting, before taking levo and before 9am and the results
November 2024
TSH 0.01 range(0.27-4.2)
FT4 22.3 range(12-22)
FT3 4.9 range (3.1-6.8)
Any thoughts would be very welcome, why do I still have loads of hypo symptoms? On Dec 4th I see my endo consultant and I can see he will be insisting on a further reduction due to low TSH.
Thanks
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Your results show you are a poor converter, a small reduction in T4 might actually improve your conversion but you'd also need to have optimized your folate, ferritin, B12 and Vit D
I don't know about my Endo only seen him once and he was very adamant that the TSH has got to be in range. I'm assuming he's not going to be very open to a T3 discussion. I will take my results along with me. I'm surprised my FT4 is at the top of the range considering I hadn't had any for 26 hours.
You could put a new post up naming him and asking for private message feedback?
So he is definitely going to want to reduce your levo dose don't agree to more than 12.5mcg drop or 25mcg alternate days, so you really need to skewer him about your mid range fT3, if he isn't T3 aware then might be time to look around for a new Endo
It's often somewhere between 3-4 so your fT3 isn't too far below your fT4 but it's about finding where your personal sweet spot lies for many it's fT4 around 75% with fT3 around 65% with reasonable conversion
You still have hypo symptoms because you are still hypo. Your FT3 is only 29.63% through the range, which is much too low.
September 2023 (Non Fasting, about 3 hours after taking Levo)
Do you always have your blood draw 3 hours after taking levo? Or was that a one-off? Your FT4 was very high in your last test, so if you left the recommended 24 hours, you are either a very poor converter or you have Hashi's. Or, you took your levo too close to the blood draw.
Resist all attempts to dose by the TSH. Just say no, and point out your very low FT3.
The bloods have always been taken after levo as I didn't know about the guide lines. This time it was actually 26 hours after last dose of levo. I do have hashi'.
That's probably why your FT4 is higher, then. But you've always had a false 'high' FT4 if you have the blood draw after taking your levo, so we have no real idea how well you convert. But as I said, do not allow any doctor to reduce your dose based on the TSH alone.
I would suspect low vitamin levels after dose reduction
What vitamin supplements are you taking
ESSENTIAL to test vitamin D, folate, ferritin and B12
have you had both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease and or especially after dose reduction in levothyroxine
About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s.
Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)
NHS only tests TG antibodies if TPO are high
20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis
In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)
Essential to test vitamin D, folate, ferritin and B12
Lower vitamin levels more common as we get older
For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) we must maintain GOOD vitamin levels
What vitamin supplements are you taking
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)
Testing options and includes money off codes for private testing
Hi, thanks. Yes I have hashi's and several other autoimmune conditions. My VitD is low normal and I have doubled my VitD. All the others are normal but not sure where in the range of normal.
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