Happy New Year to All. Asking for help with bloods again please.

[Doodlebug50]

TSH 4.2 mIU/L (0.3 - 4.5) 92.9%

Free T4 (fT4) 17.2 pmol/L (10.00 - 22.00) 60.0%

Free T3 (fT3) 3.2 pmol/L (3.1 - 6.8) 2.7%

T4:T3 Ratio 5.375 

Medication for endocrine

Carbimazole 40mg daily

Levothyroxine (Almus) 100mcg

Relapsed Graves June 2023. Struggled with GP to have T3 and T4 tested again, since June, as they tell me only TSH necessary. Haven’t seen Endocrinologist for 18 months now.

Been feeling totally fatigued, weak muscles, shoulders ache, legs ache, awful back ache for over a year now, swollen ankles, wheezing, breathless, stomach aches and constant nausea. I grow constant hard skin on balls of feet, corns and painful weird, growth things between toes.

I fasted and didn’t take Levo’ or Carb’ for 24 hours before bloods taken. I also take Vit B complex, Vit D3 + K2, steroid inhaler, waiting for rheumatology appointment and chest xray. I’m 63, had hysterectomy 23 years ago, due to fibroids, was left with ovaries, GP refused to give me HRT patches until last year.

[SlowDragon Administrator]

post 7 months ago

healthunlocked.com/thyroidu....

Have you retested vitamin levels since?

B12 and folate were very low

Exactly what vitamin supplements are you taking

You probably still need separate B12 as well as good quality vitamin B complex

No ferritin result.

Having low iron or ferritin can cause significant fatigue

And you were on very high dose vitamin D, so very important to retest twice a year

[Doodlebug50 in reply to SlowDragon]

Thank you for your reply SlowDragon, no I haven't had vitamins retested unfortunately, my GP thinks I am being ridiculous, as TSH within range and I can't afford to have it done privately. I am using the vitamins you recommended before.

[SlowDragon Administrator in reply to Doodlebug50]

How much vitamin D are you taking now

You were taking a very high dose on previous post

Too much vitamin D is toxic

You need to test annually if supplementing

[Doodlebug50 in reply to SlowDragon]

I stopped taking them, after your advice and got the Better U spray you advised from Amazon, the dose is 1000IU of vitamin D and 25μg of vitamin K2.

[pennyannie]

Hey there again -

So - your TSH has bounced back so I see this as a sign that your immune system has calmed down again and this phase of Graves now over.

I replied in some depth some months ago - and all I said then - still stands -

Your T3 is now much too low to function on and why you have all these symptoms -

Have you stopped the Propranolol as this slows the conversion of T4 into T3 -

I would think you could start reducing the AT drug and allowing more of your own new daily thyroid production to be released into your blood stream - and hopefully, given enough time your thyroid will reset itself and with a much higher T3 reading.

though not sure if you need to stop totally the T4 - or phase it out -

A Happy New Year back to you and to asiatic as this forum member is well versed with B&R treatment and hopefully around today to help and advise you

[Doodlebug50 in reply to pennyannie]

Hi pennyannie, thank you for your reply. I phased out the Propranolol about eight months ago, I still get palpitations, but not the fast heart rate, I had when they originally sent me to hospital three years ago. I will push for an Endo' appointment and see if they will let me reduce and come off the pills now, I don't like to do it without their say so (but maybe I will).

[pennyannie in reply to Doodlebug50]

Ok then - it's not like you haven't been here before - and it looks about time to me - hopefully  asiatic will pick up this message - though our messaging service on this forum has been acting up the last few days :

Good Luck :

[asiatic]

Apologies. Only just noticed your flag pennyannie . From my experience with B&R you are ready for a reduction Doodlebug50 You are registering TSH and now have hypo symptoms. Reducing B&R can’t be rushed and you will need a FULL thyroid panel after every change. I would start with reducing Carbimazole to 30mg. Post your results. You may need Levo adjusted before reducing further to 20 mg. Your aim should be to keep fT3 about half way in range and fT4 within range. If you get down to say 5mg. Carbimazole and 50 mcg Levo, you have to decide whether to stay longer on this lower dose to perhaps avoid a relapse. Expect this way of reducing to take almost a year. Slow and steady is the best approach

[Doodlebug50 in reply to asiatic]

Hi asiatic, Thank you very much for your reply, I will follow your advice and see how I feel. Thank you.

[asiatic in reply to Doodlebug50]

Yes…..how you feel takes priority. Good luck