Time for a review

[Loopnova]

I don't like to keep putting on you experts and asking, but here I am again, sorry! I'm not sure what to ask for at the next appointment with my consultant.

This is what's happened this year:

Jan - On levo dose of 75. TSH: 0.9 (0.27-4.2), T3: 3.6 (3.1-6.8), T4: 20.1 (12-22). TPO 37.6 (0-34)

Then in March I started on T3 (5mcg twice a day) and levo reduced to 50.

May - TSH: 1.59 (0.27-4.2), T3: 4.4 (3.1-6.8), T4: 14.1 (12-22). Had my levo increased back up to 75. TPO 20.7 (0-34)

August - TSH: 0.9 (0.27-4.2), T3: 4.9 (3.1-6.8), T4: 21.3 (12-22)

November - TSH: 0.04 (0.27-4.2), T3: 5.2 (3.1-6.8), T4: 21.7 (12-22) TPO 38(0-34)

So he'll say I'm over medicated and reduce levo, which I guess is fair. It'll prob go down to 67.5 a day. I've always felt better when I'm under 1 TSH though.

There's not a massive change between numbers from January and now, which is weird, but I do feel a lot better than then.

Is it weird that TPO reduced when my levo dose was reduced, then went back up?

I've been strict gluten and dairy free since August by the way.

Symptom wise I'm doing alright, I'm able to do everything, all my exercise and fitness etc. But I get tired, and I have to factor in rest time/days like I never used to have to (pre-thyroid issues). I struggle with early mornings and sleep isn't great. Might not all be thyroid though I guess, but exploring that first.

Any thoughts please?

[SlowDragon Administrator]

So he'll say I'm over medicated and reduce levo, which I guess is fair. It'll prob go down to 67.5 a day

Do you always get same brand Levo at each prescription

Retest 8-12 weeks after dose reduction

You may need further increase in T3 after next blood test

What are your vitamin levels?

What vitamin supplements are you taking

[Loopnova in reply to SlowDragon]

Yes always the same brand of Levo.

Vit B: Jan - 145 (37.5 - 188). May - 143 (37.5 - 188), Nov - 132 (37.5 - 188).

I take Thornes Basic B Complex on a day.

Vit D: Jan - 141 (50-250). May - 163 (50-250) Nov - 223 (50-175). I've since reduced my dose to one tablet every other day as that was a bit high).

I take Vit D3 + K2 (from 5greens)

I also take Magnesium Glycinate. Don't regularly test that - the last time was October and it was 0.8 (0.7-1).

[Loopnova in reply to Loopnova]

I’ve also just had results from a cortisol blood test which was 525 (166-507). So slightly high first thing in a morning. Don’t know if it was a one off.

[SlowDragon Administrator in reply to Loopnova]

No iron or ferritin test?

Higher cortisol common when Ft3 is a bit low

[Loopnova in reply to SlowDragon]

I had ferritin checked in October and it was high at 312 (13-150) but it was a week after I’d had Covid so I didn’t worry too much. It was high at 232 (30-207) back in May and went to my GP and when they retested it was 169 (10-322) They then did full blood count and liver function, tested all sorts that I don’t know what they are, and said it was all normal.

[SlowDragon Administrator in reply to Loopnova]

so that all sounds fine

How old are you

Pre or post menopause

Higher ferritin is normal after menopause

Updated reference ranges for top of ferritin range depending upon age

healthunlocked.com/thyroidu...

Thank you for your incredible patience while you have been awaiting the outcome of our ferritin reference range review. We conducted this with Inuvi lab, which has now changed the reference ranges to the following:

Females 18 ≤ age < 40. 30 to 180

Females 40 ≤ age < 50. 30 to 207

Females 50 ≤ age < 60. 30 to 264

Females Age ≥ 60. 30 to 332

Males 18 ≤ age < 40 30 to 442

Males Age ≥ 40 30 to 518

The lower limits of 30 are by the NICE threshold of <30 for iron deficiency. Our review of Medichecks data has determined the upper limits. This retrospective study used a large dataset of blood test results from 25,425 healthy participants aged 18 to 97 over seven years. This is the most extensive study on ferritin reference ranges, and we hope to achieve journal publication so that these ranges can be applied more widely.

[Loopnova in reply to SlowDragon]

I’m 43. The next consideration is if I’m perimenopausal but wanted to make sure the thyroid side of things is as good as it can be.

I tried HRT patches for three months last year which had no effect. I didn’t know that perhaps alternative methods or doses might make a difference though.