help with thyroid results please

[mistygrey]

Hi I’m seeing my Endo later today but wondered what do people think of these results? Looks like my FT4 is abit high? Would you change your thyroid meds with these results? I am tired often but have other health conditions. They look a tiny bit hyper (I’m hypo) but I don’t know if I am feeling like that? Thanks

TSH - 0.47

FT4 - 22

FT3 - 4.8

Ranges for labs

0.2-4.5

9-21

2.5-4.5

[TiggerMe Ambassador]

TSH 0.47 mIU/L (0.2 - 4.5) 6.3%

Free T4 (fT4) 22 pmol/L (9 - 21) 108.3%

Free T3 (fT3) 4.8 pmol/L (2.5 - 4.5) 115.0%

Both a little on the high side, you might well feel better with a small reduction, have you felt better in the past on a smaller dose?

[mistygrey in reply to TiggerMe]

Hi thank you, I am on 100mcg levo a day, I felt abit sluggish on the 75mg a few years back. I tried t3 added in also a few years back and it didn’t make me feel great. Not sure what to do as if I drop down to 75 it might be too much of a drop?

[TiggerMe Ambassador in reply to mistygrey]

I did wonder if you were still on a combi of T3 & 4.... you obviously convert really well which is great, I'd suggest dropping 12.5mcg a day or 25mcg every other day depending on how sensitive you are

[mistygrey in reply to TiggerMe]

Thank you I will have a think I just don’t want to lower my dose too much and feel crap. Though I am feeling exhausted alot lately but I do have other health issues ongoing. I know my Endo when I see her later will say those bloods are fine as she never seems bothered 😣🫣

[TiggerMe Ambassador in reply to mistygrey]

Wow... not much of an Endo! But this works in your favour as you can tweak your dose to suit you, too much can also make you feel pretty dreadful and above range fT4 isn't good long term so getting it back within range is the aim.

[mistygrey in reply to TiggerMe]

Thank you so much for your advice, what is the long term affects of higher t4? I’ve read a few bits but not too sure. Would mine be bad long term even if it’s just over the range a tiny bit? I’d need to retest bloods in 6 weeks again also if I change the dose is that right?

[TiggerMe Ambassador in reply to mistygrey]

It can have a negative effect on heart and bones, you aren't Hyper but you are over-replaced as your fT3 is also above range.... the fact is you aren't feeling great at this level which also suggests a small decrease could make you feel a whole lot better and hopefully find your sweet spot

[mistygrey in reply to TiggerMe]

I forgot to add, I did have these bloods first thing at 8 am and didn’t take my thyroid medication before the bloods as I’ve always done this. So took my thyroid meds after this blood test, will that have any effect on the results being accurate or are likely more accurate the way I’ve done it? Thanks

[TiggerMe Ambassador in reply to mistygrey]

Perfect way to get consistent, comparable results 👏

[mistygrey in reply to TiggerMe]

so it would have been roughly 24 hrs or over since my last 100mcg dose

[TiggerMe Ambassador in reply to mistygrey]

Yep, that's the protocol we recommend as T4 is a storage hormone so slow to change, though some people do have a slight disturbance within the first few hours after taking so 24 hours after last dose gives the most accurate result

[TiggerMe Ambassador in reply to mistygrey]

Why is it that you still see an Endo when only on Levothyroxine?

[mistygrey in reply to TiggerMe]

hi as I was on t3 she kept me on her list I’ve also been getting neck pain and have hashimotos so she wanted to keep an eye on me for awhile I only see her once a year

[SlowDragon Administrator]

what vitamin supplements are you taking

When were vitamin D, folate, B12 and ferritin last tested

I would test vitamin levels BEFORE considering changing Levo dose

Do you always get same brand levothyroxine at each prescription

Are you on gluten free and/or dairy free diet or tried either

If you do decide to reduce dose a little…….initially only reduce by 25mcg PER WEEK……so 87.5mcg 2 days and 100mcg 5 days ……retest in 8-10 weeks

[mistygrey in reply to SlowDragon]

My vitamins are all fine I’m also on b12 injections I’m gluten free and mostly diary free also. Can I ask why you’d not lower it every day and only 25mcg per week thank you for your help

[SlowDragon Administrator in reply to mistygrey]

very common to need to fine tune levothyroxine dose

It’s much harder to tolerate reducing dose. Better to reduce slowly

How much do you weigh in kilo?

Guidelines on dose by weight 1.6mcg levothyroxine per kilo of your weight per day

What are most recent folate, ferritin and vitamin D results

[mistygrey in reply to SlowDragon]

Hi I’m 11stone 5lbs at the moment, will need to dig out the last blood results for you

[SlowDragon Administrator in reply to mistygrey]

11st 5lb = 72 kilo

So currently you’re on lower dose than guidelines

But some people need a bit less than guidelines…..some people need higher dose

[mistygrey in reply to SlowDragon]

Hi so I’m on a lower dose but my levels are over the limits that’s weird isn’t it?

[SlowDragon Administrator in reply to mistygrey]

Possibly vitamin levels not optimal?

[mistygrey in reply to SlowDragon]

Hmm could be maybe ferritin or iron? Would that affect them? So technically I should be on more than 100mcg with my weight levels but my levels are showing as over medicated currently on this dose? Thanks

[mistygrey in reply to SlowDragon]

Yes always same brand lactose free levothyroxine