Blood results - long, long story ...

[AleB]

Hi All,

It's been such a very long time since I last posted. This is my latest blood test (endo increased Levothyroxine by 25) after I had to drop the T3 again.

Currently taking 4 days at 100 levo (split 50mcg am and 50mcg pm), 3 days 87.5mcg levo (split 50am and 37.5mcg pm) I take 1.25mcg lio with the morning dose of T4 and 1.25mcg lio at 2pm.

I think this blood test was taken too early to determine correct values of T4 and T3 and TSH.

I have been on t3 for just over 2 years, each time I have to lower the T3 because I start sweating, and end up with a tremor and very high heart rate for my of 85 - 90bpm. Since starting T3 and reducing the T4, I have experienced constant poor vision, and very poor sleep. Waking every two to three hours.

Endo I feel, doesn't understand thyroid hormones, has now decided to put me on HRT (which I have not started).

CRP <0.15mg/L) range <3

Ferritin 125.00 ug/L (Range 30 - 264)

Folate - Serum >45.4 (Range >)

B12 - Active >150pmol/L

Vitamin D 117.0nmol/L

TSH 1.65mlU/L (Range 0.27 - 4.2)

T3 4.1pmol/L (Range 3.1 - 6.8)

T4 19.6pmol/L (Range 12 - 22)

TgAb 13.90kIU/L (Range 0 - 115)

TPA 14.0kIU/L (Range 1 - 34)

This test was done on the 8th November at 8am, fasting. Strictly gluten and dairy free, and have been for past 5 plus years.

I am struggling to catch my breath, my balance is off, and I can't walk so far. I have a pain in the front of my neck if I go lower on T3, and yet when it builds 3 month's down the line - I end up sweating, hight heart rate and shakes.

Bones crack, shins and wrists. I can't sleep on my right side, I get a burning pain in my right hip.

I don't know whether to come off the T3 gradually and increase the T4 - this will send me over range on the T4, very nearly supress my TSH and just bump my T3 to 3.9 where it was for 10 years!

I don't convert T4 well to T3. I have the DI02 gene

If anybody could recommend what I do now, I would be very, very grateful.

[SlowDragon Administrator]

Was last dose T3 approx 8-12 hours before test

Your results suggest you need to increase T3

Perhaps add a 3rd dose at 1.25mcg

Which brand Levo and which brand T3 are you using

[AleB in reply to SlowDragon]

Hi SlowDragon

Thank you for coming back to me.

My last dose of T3 was at 10pm, giving me 12 hours

Levo Brand is Accord

Lio Brand is Thybon Henning 20mcg, which I painfully split with a scalpel blade

If I try to increase the T3 I end up having sweats and a high heart rate - is this normal until you get onto to optimum level?

[SlowDragon Administrator in reply to AleB]

As you seem extremely sensitive…..I would only increase by 1.25mcg ….so 3 doses per day roughly 8 hours apart

Retest again in another 8 weeks

[AleB in reply to SlowDragon]

Should I reduce levothyroxine? only the increase of 25 has stopped me having to go to bed for an hour in the afternoon. Maybe my T4 was too low, I don't know, it's all trial and error. I appreciate your help, thank you. 😊

[SlowDragon Administrator in reply to AleB]

Currently taking 4 days at 100 levo (split 50mcg am and 50mcg pm), 3 days 87.5mcg levo (split 50am and 37.5mcg pm)

Was test done day after 100mcg or 87.5mcg

Free T4 (fT4) 19.6 pmol/L (12 - 22) 76.0%

Perhaps leave dose Levo as is …….

If you start to feel over treated…..reduce Levo by 12.5mcg once a week?

[sparkly]

I'm a huge fan of hrt and you might be pleasantly surprised. Some of your issues for not being able to tolerate T3 might be due to low or fluctuating, estrogen levels depending if your in peri or post menopause. Or if post menopause and low oestrogen, then this can cause t4/t3 conversion problems. I say this as I had awful issues with my T3 medication. Upping, downing or stopping it just wasn't working and I became very ill. I struggled walking, had severe fatigue, unable to function and remember being breathless just trying to walk upstairs. I blamed it all on thyroid and my nhs endo was at a loss. I then found a private endocrinologist who straightaway said I was perimenopause, had never even heard of it, and this was causing my issues with my thyroid and my t3 medication.

Once i was on estrogen and progesterone and settled, I then returned to T3 after a second, failed attempt with liquid thyroxine.

Thyroid and peri/menopause have connections and if unlucky like me, can mess things up big time. Hope this might be of some help and good luck

[Moonlight5 in reply to sparkly]

Do you see a private endocrinologist that you could pm me?

[Moonlight5 in reply to sparkly]

sparkly

[AleB in reply to sparkly]

Hi SparklyThank you so much for you comprehensive post, it's given me confidence to at least try the HRT. For the past 2 years I have been upping and downing levo/lio, and yes my system seems to be super sensitive to it! Incidentally since November 2022, I think I must have gone through to post menopause. I am going to be using the Evorel Conti patches, I appreciate it might take a while to get used to, time will tell. Thank you again for your post. Xx

[JumpJiving]

AleB Another of your posts said that you adrenals were "off" about 3 years ago and you were asking about cortisol and DHEA testing at that time. Have you repeated those tests recently (ideally early morning cortisol blood test rather than saliva)? If not, it might be worth checking, ideally before starting the HRT. It may be unrelated, but a number of bits that you mentioned in your post can be cortisol related.

[AleB]

Thanks, I haven't tested for a while, when I was on slightly higher T3, the adrenals were fine. Since having to come down by 1.25mcg back in September, and upping the T4 (endos suggestion) by 25mcg, after 6 weeks I had started to get a stabbing pain in the right adrenal. Here I am in December feeling really awful. I kept the T4 at 100mcg levo split am and pm for 2 days and 5 days at 87.5mcg levo, again am and pm split (50mcg am, 37.5mcg pm) T4 stayed the same sine August 2022.