Advice please

[Harebell60]

TSH 0.01 mIU/L

Free T4 (fT4) 14.5 pmol/L

Free T3 (fT3) 0.42 pmol/L

T4:T3 Ratio 34.524 

Thyroid Peroxidase Antibodies (TPO) 0.3 IU/mL

I've been on Levothyroxine 150mg since 1992 with no problems. I'm now 66, widowed 3 years ago. My TSH has gone wayward and GP has reduced dose to 125mg. But I'm suffering symptoms like dry skin, crashing in the afternoon, and inability to lose weight, or get warm. Sometimes the room thermostat has to be above 23 degrees for me to feel comfortable!! None of this seems to matter to GP, just the test numbers!

My Cholesterol has also gone up from consistently ok, to the point they put me on Statins, which made life not worth living. Low mood, insomnia, joint and muscle aches and pains, and general apathy. Their answer? Just keep taking them... I stopped. I freely admit that I put on a stone after my husband's death, and have been living on too much chocolate and kitkats. I am addressing that.

Next blood test is end of Feb.

Would like to get my Thyroid back under control before addressing Chol, is that unreasonable? I believe the two may be linked, but the GP refuses to look at this holistically. Any info I can use to plead my case welcomed.

[GlowCoach Administrator]

Please add the reference range for each test - numbers in brackets after your result.

What time of day was the test taken & when did you last take your Levo before this?

Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process).

Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo/T3 just prior to blood draw can show a falsely elevated result and your GP/Endo might change your dose incorrectly as a result.

The other important detail would be to test and supplement vitamin levels to optimal - ferritin, folate B12 & D3.

When hypo we get low stomach acid which means we cannot absorb vitamins well from our food, regardless of a great diet. For thyroid hormone to work well we need OPTIMAL levels of vitamins.

Have you recently or could you ask your GP to test levels of ferritin, folate, B12 & D3? Private tests are available, see link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/testing/priva...

There is also a new company offering walk in& mail order blood tests in London, Kent, Sussex & Surrey areas. Check to see if there is a blood test company near you. onedaytests.com/products/ul...

Only do private tests on a Monday or Tuesday to avoid postal delays.

[Harebell60 in reply to GlowCoach]

Thank you. No GP doesn't test for B112 etc. But due to past breast cancer I get private tests for D3, which last spring was 90.

Ref ranges:

tsh 0.01 ref 0.35-4.94

FT4 14.5 ref 9.0-19.1

FT ref 2.4-6.0

I will look at all the info you have given me and possibly take up some of the private tests, I'm in the South East so may be able to attend in person. Thank you so much for your reply.

[GlowCoach Administrator in reply to Harebell60]

So your FT4 is only 55% of range and FT3 below range. You will likely struggle to get GP to increase Levo due to suppressed TSH.

Next step - get full vitamin testing run - ferritin, folate, B12 & D3. Sometimes low vitamin levels can affect TSH.

Always book thyroid blood test for 9am or earlier to get highest TSH.

[Harebell60 in reply to Harebell60]

btw, if memory serves, the test was about 2pm, and I would have skipped the dose the day before. I've been taking mine during the night to avoid all the pitfalls of don't eat this/that , have an empty stomach etc.

You mention Biotin supplements. I only take Vit D, fish oil, Coenzyme Q10, and an eye function support tablet & oil recommended by the hospital eye department as we have MD in the family.

Do I have to also avoid foods with Biotin before bloods? Eggs, Bananas? Google lists milk, though I'm on oat milk right now...

[SlowDragon Administrator in reply to Harebell60]

Do you always get same brand levothyroxine at each prescription

Next step

Get FULL thyroid and vitamin testing

ALWAYS test early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Post all about what time of day to test

healthunlocked.com/thyroidu...

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

Only do private testing early Monday or Tuesday morning.

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

As you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

[GlowCoach Administrator in reply to Harebell60]

So if you had tested earlier in the day your TSH would have been higher. Ask GP for restest and refuse to change dose.

No need to avoid foods with biotin, they have low doses and its high doses that are the problem.

Unlikely that any of the supplements you currently take contain biotin. Get vitamins tested though and probably you need a B complex for B12 & folate that will contain biotin.

[greygoose]

Would like to get my Thyroid back under control before addressing Chol, is that unreasonable? I believe the two may be linked, but the GP refuses to look at this holistically.

Well, the two go together, really. High cholesterol is usually caused by low T3. It has nothing to do with Kit-Kats. Cholesterol is made in the liver - because your body needs it - and the liver keeps the level steady by making more the less you consume, and vice versa. However, when T3 is low, which yours undoubtedly is (although difficult to tell without the range) the body cannot process cholesterol correctly, and it tends to build up in the blood.

But cholesterol is not going to hurt you. It doesn't cause heart-attacks and strokes as doctors claim. In fact, there's some evidence that those with higher cholesterol tend to live longer. Certainly low cholesterol is more dangerous than high. So, don't worry about it.

My Cholesterol has also gone up from consistently ok, to the point they put me on Statins

Just a reminder that they can't 'put you on' anything if you don't want to take it. They can recommend you take it, they can prescribe it, but there's no law saying you have to put it in your mouth and swallow it.

You'll find a few articles on cholesterol and statins on my profile page:

healthunlocked.com/user/gre...

[Harebell60]

Thank you all for your wisdom. I will be looking closely at ALL the advice given, vitamins , getting blood tests etc. & sticking to my guns re statins. ( it does say on the leaflet it could be contraindicated in people with hypothyroidism, but gps registra sat there and told me the severity of the side effects i reported were in my head). I'll skip the kit kats anyway 😉 .

And yes, I found recent research that contradicts what we've been told about LDL for years, but Statins are a big money maker for the drugs companies, so they're going to fight that tooth and nail. I read something that suggested higher LDL in age >65 may be protective for dementia.

I've already got the lists for recommended consultants, nhs and otherwise. Reading seems to be good, and within travelling distance. My plan is to see what February's blood test brings (using direction you've given) ,and if GP won't play ball after that, I'll ask to be referred ( private if necessary) to them....

I'm really grateful to you all for your erudite and swift responses...