confused with results

[2hope]

I had my results back from monitor my health, and the reason I was testing was my puffy eyes as they get like that when I am either overmedicated or under medicated.

In October, I was taking 125mg four days and 112.5 mg three days and when I had my bloods done, the results were:

FT3 - 4.4 pmol/L (3.1 - 6.8)

FT4 - 17.7 pmol/L (12 - 22)

TSH - 0.23 mu/L (0.27 -4.2)

TPO - Negative (10 IU/mL)

I since started alternating the dose between 125mg and 112.5mg so that I don’t have the high dose and low dose but I was getting worse puffy eyes. Today I got my results which are:

FT3 - 4.3 pmol/L (3.1 - 6.8)

FT4 - 16.5 pmol/L (12 - 22)

TSH - 0.88 mu/L (0.27 -4.2)

I am so confused and fed up, not sure what to do and I can’t keep buying tests but what do I do when every morning I am waking up with puffy eyes.

I have also noticed weight gain which is upsetting as I can’t be more careful about my diet. I have started doing treadmill on incline four days a week, I am doing twenty minutes low weights to help with my muscle and I am trying to eat higher protein to stop my sugar cravings, I do have a sweet treat which might be some ice-cream but nothing extensive.

Can someone please help me on what to do.

[Regenallotment Ambassador]

So your results in October suggest you would benefit from a small increase and your results today are lower than those, which fits your symptoms of feeling worse and gaining weight.

You are under replaced according to FT4 and FT3 I tend to feel better with FT4 nearer 19 and FT3 over 5.

Puffy eyes for me can also be allergy, wheat dairy, sulphites and the reaction is worse when more hypo. I use Allevia lactose free antihistamine to clear that up.

[2hope in reply to Regenallotment]

Thank you for responding, I am just confused on how much to increase my dose as I don’t want to go overboard with it. I don’t have wheat but I have dairy products but the puffy eyes only seem to get triggered when the dose is high or low.

[Regenallotment Ambassador in reply to 2hope]

Have you tried 125mcg 5,6, or 7 days?

If it were me I’d inch it up 6 weeks at a time and see how you feel.

bear in mind that some folks need less as the seasons change so by April/May/June you may feel better or need to drop back.

How are all your vitamins? Are you optimising those?

Another question… was test early morning with last dose 24 hours before?

[2hope in reply to Regenallotment]

I haven’t tried 125mg 5,6 or 7 days. I think I will increase after today’s results.

I do take selenium, vitamin d, and b complex, but need to have them tested at some point.

Yes, the test was done at 7:45 am and last dose was 24 hours before.

[jgelliss in reply to 2hope]

How are your vitamin D, B12/Folate, Iron/Ferritin? Many of us me included was not aware how much having my vitamins Optimal. The vitamins are the components for our Thyroid Hormones to work Optimally. I can't Emphasize it Enough. It made a Huge difference for me. But most Dr's won't tell you or don't know much about it.

[Anthea55]

Eye problems are among the many symptoms of thyroid disease, see this page from the Thyroid UK website

thyroiduk.org/signs-and-sym...

TED is Thyroid Eye Disease. Has anyone suggested looking at this for you?

[2hope in reply to Anthea55]

I have just looked up TED and I don’t really have the symptoms of bulging eye or dryness. Mine is more hypo symptoms with puffy eyes and heavy eyelids. When I wake up, it looks like I have been crying and my eyes look smaller and the area below looks puffy. I have tried applying topical eye creams that are for puffy eyes but nothing works.

[Anthea55 in reply to 2hope]

Do make sure that anything you apply to your eyes is preservative free. It works at first, then gets worse.

Look at this previous post, with 41 replies, which shows that there are a lot of people with eye problems on this forum.

healthunlocked.com/thyroidu...

[pennyannie]

Hello 2Hope :

T4 is a storage hormone and I see little point worrying about a slightly different dose some days of the week - as if you look at these 2 sets of results there is nothing much different -

As these stand - both sets show you under medicated -

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% :

Your T4 was running at 57% with a T3 at 35% and the adjustment to dose gave us

Your T4 now running at 45% with a T3 at 32% :

Is there any reason why you don't just increase your dose of T4 to 125mcg daily - with a view to increase again, if comfortable, and build your thyroid hormones into a stronger place in the ranges ?

Do you have any recent readings for ferritin, folate, B12 and vitamin D as these all need to be up and maintained at optimal levels before any thyroid hormone replacement works well and is fully absorbed, utilised and converted in the body.

Do you have Hashimoto's and liable to erratic own thyroid hormone production and why you seem to be anxious and just circling around on a similar overall dose of T4 ?

Are you using any product on or around your eyes as this may not be thyroid related ?

Sorry - I maybe should have looked back at your previous posts first to understand better where you are in your thyroid health journey.

[andyjs2 in reply to pennyannie]

Hi, my two cents. If increasing your T4 dose doesn’t help, I would add in T3 since you are apparently not converting enough T4 to FT3 even though your FT4 is reasonable. If you have the means, it would be interesting to know if you have any of the DIO1 and/or DIO2 gene defects that have been found to impact T4 to T3 conversion. (DIO1 SNP’s rs2235544 and rs11206244 and DIO2 SNP’s rs225014 and rs12885300). If you do, it is possible that no amount of T4 will fix you (as was my case).

[pennyannie in reply to andyjs2]

I think you meant this post for the person who posted - 2hope ?

so I shall notify her for you -

 2hope

[jgelliss in reply to andyjs2]

Exactly.

[2hope in reply to andyjs2]

I don’t take T3 but would be interested if it helps raise my levels. I am not sure whether I have any of the DIO1 and/or DIO2 gene defects, how would you find out?

[andyjs2 in reply to 2hope]

I had my DNA analyzed by a company that is now called DNA Complete here in the US. It cost me $600 three years ago when they were Nebula Genomics but not sure what they charge now. Yes it was expensive but for me it answered a lot of questions and helped me realize that I was one who needed to be on all T3 to feel better.

[jgelliss in reply to pennyannie]

Pennyannie it resonates so much with what your saying. I had TT many years ago . And what I Think is that my set point when my thyroids still worked well for me was that having higher T4 and a small dose of T3 works the Best for me. But that is me. It took me years to figure this out for me. But many on this Great Forum I read do great with lower T4 with higher T3 or even being on T3 sole or T4 sole or even NDT that works Best for them. I personally don't convert my T4's well to T3 and it caused me many issues. Palpitations lower back pain Adrenal, anxiety insomnia, high blood pressure etc. Adding some T3 to my T4 changed my life.Thank You for your Great Informative Posts.

[2hope in reply to pennyannie]

pennyannie thank you for your reply. I was taking 125mg daily around a year ago and when I had my test done ten months ago my T4 was slightly high, so the reading was

FT3 - 5 pmol/L (3.1 - 6.8)

FT4 - 22.4 pmol/L (12 - 22)

TSH - 0.02 mu/L (0.27 -4.2)

I started reducing since then because I had the same symptoms of puffy eyes which I have recognised is a sign that I am high or low. I have decided to increase to possibly 125mg for 6 days and 112.5 mg for 1 day and see if there is any improvement.

I don’t have any recent readings for folate, ferritin, b12 and vitamin d. I am however, taking vitamin d, iron 27mg, and b complex. I will be testing the next time I do my thyroid and hopefully have a bigger picture.

Also I don’t apply anything around the eyes except a concealer under my eyes but I have been using it for a while and the eyes never get puffy. I keep a diary after someone mentioned in this group and I noticed that the puffiness is always either with low dose or high dose.

[pennyannie in reply to 2hope]

Yes looking at the above results - your T3 is still on the lowish side despite T4 being at the top of the range so T4 alone may not be the best treatment option for you.

It is also now suggested that it is better longer term that T4 is not run at the top of the range - and why we now suggest T4 a top tend of around 80% through it's range.

So a reduction in T4 will likely cause a drop in T3 - so to balance this out - a dose reduction in T4 and the introduction of a small dose of T3 - Liothyronine - may well resolve the issue - and for that to happen you will need to be referred by your doctor to an endocrinologist to be assessed as to your need -

Currently in the UK - to obtain a prescription for T3 on the NHS has become something of a post code lottery due to costs, out of date guidelines and some hospitals and ICB/CCG areas placing financial restrictions on endocrinologists to prescribe as they see fit.

Essential that your ferritin, folate, B12 and vitamin D are up and maintained at optimal levels and I read and know from my own experience that no thyroid hormone replacement works well until ferritin is at least maintained up and over 70:

As already asked - do have any thyroid antibodies readings as you may have Hashimoto's a thyroid Auto Immune Disease that tends to target the thyroid and / or eyes ?

Take a look at the Thyroid Eye Disease Charitable Trust - tedct.org.uk - do your eyes look anything like these pictures - maybe have a read round on there ?

[2hope in reply to pennyannie]

I have spoken to two different GP’s requesting to be referred to an endocrinologist and they refuse saying everything is normal. I used to have anxiety getting my results back from the GP because their only solution was to reduce my dose based on my TSH. Thank goodness for this group, I am able to focus on T4 and T3 and increase or decrease based on it and focus on certain vitamins and minerals otherwise I was told to take a multivitamin and I’d be fine.

I had this result four months ago with my antibodies

TPO - Negative (10 IU/mL)

[pennyannie in reply to 2hope]

Ok - so was this a NHS blood test - as the NHS only test TPO and not TgAB - so do not test both sets of antibodies and there are some who never have high ab and are diagnosed Hashimoto's after a thyroid scan or ultra sound.

Are you aware of erratic own thyroid hormone production and ' swings ' in symptoms - where you feel hyper type symptoms but a few days/weeks later feel more hypo type symptoms ?

It is difficult to get acknowledged by the NHS - maybe get the list of recommended thyroid specialists and endocrinologists - NHS & Private - held by Thyroid uk and see if you can see someone - ideally who is Private & NHS ?

Just email admin @thyroiduk.org asking for a copy of the patient to patient recommended list of specialists in thyroid.

You can also start a new post ask to recommendations of whom to see and you can also ask for feedback on anyone you plan to see - but replies will be by Private Message - and your Chat icon that looks like a paper plane should light up as we are not allowed to openly talk about any medical professional.

[pennyannie in reply to 2hope]

If you go into openprescribing.net/ - you can see by surgery how supportive they are at prescribing T3 compared to other surgeries in the area - just type in Liothyroine as the drug :

and you can also see by area how supporting your ICB are compared to other areas in allowing prescriptions of T3 - as it has become something of a post code lottery as mentioned earlier.

Currently your doctor can't prescribe anything buy T4 - and so likely saying your results ' fine ' as they can't do anything about them anyway - as they need to refer you to endocrinology - and if in a ' no T3 area ' there is little point your doctor referring you to the NHS endo.