I have just had a notification to call GP on my latest test results. I have posted them below. These are NHS but at least the did T4 and TSH for a change.
I have been feeling a bit under the weather the last 2-3 weeks- slightly hypo tired, sluggish and not sleeping. I was hyper from Graves but ended up hypo after second lot of RAI.
My TSH has just tipped back over the ref range but free T4 has increased. Test was done at 8.20 am BUT I completely forgot I was having it and had taken my Levo. Is that why T4 shows and increase while TSH increased too?
I take 125mcg a day. First thing, no food / caffeine within 30 mins to an hour.
Latest results below. Just trying to prep before I speak to the GP. I have previously taken 150mcg but had palpitations, anxiety etc.
My last dose change was July when I went from 100 to 125mcg.
Thank you!
T4 7.9-14.5
Dec24 12.8
July 24 9.9
May 24 8.2
Nov 23 10
TSH 0.38-5.33
Dec 24 6.7
Oct 24 5.3
July 24 20
May 24 40
Nov 23 34
Written by
MadM24
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Your TSH is 6.7 seems high, forum advises around 1 normally
and T4 is about 70% but you had levo a few hours earlier.
I think this will raise T4 over its actual reading a bit.
So you look like you need dose increase on T4. 2nd time around at 150 mg might be different as your body gets used to it ?
Are you autoimmune type of thyroid sufferer ? Ask for TPO to be measured as first step ?
Have you had T3 measured ever ? cannot get it done on NHS and do privately as do many on here.
Forum advises having strong / high levels of vit D/ B12 / folate and ferritin. These take a while to get bloods done and then to supplement if needed to optimise them. (if Doctors doing bloods they might do these too)
I have not had T3 done since being hypo but they did used to do it occasionally on the NHS while I was hyper.
Unfortunately I’m not in a position to pay for private tests at the moment but will try to sort it in the new year.
I take a multi vitamin with iron which has B1 and B12 and vitamin D at 100% RDA but no idea what my actual levels are. When budget allows I will get a test as GP won’t do it.
I guess hopefully 150mcg might feel better second time round. I like the idea of alternative the 125/150 first as a half way house so I think I will ask to try that.
I have always had Teva but when I went from 75 to 100 it switched to Accord and now to 125 I had accord for the 100mcg and 25mcg Teva and that has been the case since being on 100 and 125. Last time I was on 150mcg it was all Teva so maybe if I can stick with accord it will be better.
Good to know that forgetting and taking my Levo was probably the cause for the increase in T4.
I take a multi vitamin with iron which has B1 and B12 and vitamin D at 100% RDA
Well, the pill might contain them but you won't be absorbing them because the iron will block absorption. Iron should be take at least two hours away from everything - four hours away from thyroid hormone - except vit C.
Multi-vits are always a bad idea. They contain things you don't want/need, poor quality ingredients, and not enough of anything to treat a true deficiency. No, 100% RDA is not enough for a deficiency. It's like pouring water into a bucket with a hole in it. You never quite manage to get the level up.
Far, far better to get vit D, vit B12, folate and ferritin tested and just take what you need. More is never better.
You still have Graves Disease as its an Auto Immune disease for which there is no cure - but now your thyroid has been burnt out in situ and rendered disabled and non functioning -
and so from a treatment perspective you are Primary Hypothyroid due to having had RAI thyroid ablation for Graves Disease -
though there is not any special guideline and we all get lumped together as hypothyroid - irrespective of how we got there, or even if we had a medical intervention and living without this major gland.
You can't ever ' go hyper again ' though you may become over medicated / wrongly medicated especially if reliant on just TSH and T4 blood test readings - as currently seems to be the routine in primary care.
Your HPT axis - the Hypothalamus - Pituitary - Thyroid feedback loop on which the TSH relies on as working well - is now broken - as you have had a medical intervention and your body physiology changed and this feedback loop now open ended - as your thyroid non responsive - through having had RAI thyroid ablation.
No thyroid hormone replacement works well until the core strength vitamin and minerals - those of ferritin, folate, B12 and vitamin D - are up and maintained at optimal levels and RAI is known to trash vitamins and minerals so we need to get these checked out and your doctor may oblige and we an advise where optimal sits - as some ranges are too wide to even be sensible.
Multi vitamins are not recommended as we need A grade supplements as pure as possible and dose each independently - with iron supplements well away by some 4 hours - to other supplements - for for utilisation and absorption of all.
A fuuly functioning working thyroid would be supporting you on a dailybasis with trace elements of T1. T2 and calcitonin + a measure of T3 at around 10 mcg + a measure of T4 at around 100 mcg.
T is a pro-hormone and needs to be converted in the body into T3 which is the active hormone that runs the body and said to be around times more powerful than T4:
We generally feel best when the T4 is up in the top quadrant of its range at around 80% with the T3 tracking just behind at around 70% through it's range - and at around a 1/4 ratio - T3/T4.
Some people can get by on T4 monotherapy.
Others find that at some point in time T4 seems not to work as well as it once did - and that by adding in a little T3 - alongside their T4- likely at a lower dose - they are able to restore T3 and T hormonal balance and well being.
Some can't tolerate T4 and need to take T3 only - as you can live without T4 but you can't live without T3 :
Whilst others find their health improved better taking Natural Desiccated Thyroid which contain all the same known hormones as that of the human thyroid gland and the original successfully used treatment for over 100 years until Big Pharma launched synthetic T3 and T4 treatment options on the NDT in around the middle of the last century.
I think I sent you some links previously - I found the most rounded of all I researched is that of Elaine Moore. who like you and me went through RAI thyroid ablation and then needed to start researching on how to get herself back to better health and well being - and now a World leading researcher and advocate for better management and treatment options for Graves Disease.
If you don;y know how to find your previous posts and all your replies simple press on your Profile Icon sitting alongside the Menu - Alerts - Posts - Chats and My Hub sections on my laptop on this screen - top right :
To read anybody else's Profile just press their icon which sits alongside anything they have written on the forum - where you will find ther thyroid journey all they have ever written on this patient to patient forum
Hi there , I don't really understand blood results so unfortunately I can't help you on this matter . But I am a bit confused as my gp told me to actually take my levothyroxine when I last had my thyroid levels checked . So could this have given a false result 🤔
Chocolate1970 . the reasons and evidence to support not taking our levo dose just before the blood test can be found in the replies to this post: (look at 3rd reply and the next few, by me) healthunlocked.com/thyroidu.... list-of-references-
it is not so much a 'false' result exactly, because the fT4 level really is at that level at that time , but it only stays at that level briefly (from about 1-6 hours after the dose is taken) , it goes up and down pretty rapidly during this period ,then for the rest of the day it is a bit lower.
So it is a better idea to test further away from the last dose (when the level is more stable) ,and not to test during this brief period . This gives a much better idea of the average levels we have for most of the day , rather than seeing a briefly higher level of fT4. For consistency it's easiest for this to be "24hrs from last dose" ie just before you take the next one.
Unfortunately GP's are not trained to take this into account, they either don't know about it at all , or if they do know, they think the difference is insignificant , or because they are only testing TSH and not looking at fT4 anyway. However regardless of what they think , the science does support it , Time of last dose makes a difference to fT4 result , and should be taken into account .
for example , if they tested your fT4 2 or 3 hours after your last dose and that result is a little bit over range , they may decide to reduce your dose when you feel well.. but if your blood test appointment happened to be a few hours later , it would probably have been in range., and they would not do anything ..... by not taking time of last dose into account when looking at fT4 results the NHS make it a lottery. It would be much better if they understood what thye are doing and why , but since they apparently don't , it is a good idea that we learn enough to understand it for ourselves.
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results advice 
Further blood results - advice please
Jumping all over the place.
Latest test results 
TSH/Levo Roller-Coaster. Endo consultation next week. HELP!!! 
