Good afternnon everyone. Hope you are all well.
Recently had my bloods back, which reveals FT4 at 23.7, TSH at ,0.02, and FT3 9.0
Unfortunately the GP hasnt provided the ranges for these so I myself cannot tell if they are good or bad.
However the endo instructions are to now increase my carbimazole from 3 days per week, to one every day! To me this seems like a big increase?
Id be grateful for your thoughts
previous post discussing same dose everyday
healthunlocked.com/thyroidu...
What are your most recent vitamin D, folate, ferritin and B12 levels
Hiya. Sorry for delay in replying. Been choc-a-bloc....I've had b12 and folate bloods done recently but the Gp hasn't provided the ranges. ( I'm trying to get them)
But for what it's worth B12 is 317ng/l
And foliate is 10.2 ug/l
Folate range is likely either 3-20 or 8-60
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement
A week later add a separate vitamin B Complex
Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.
If Vegetarian or vegan likely to need ongoing separate B12 few times a week
Highly effective B12 drops
natureprovides.com/products...
Or
B12 sublingual lozenges
uk.iherb.com/pr/jarrow-form...
cytoplan.co.uk/shop-by-prod...
In-depth article on different forms of B12
perniciousanemia.org/b12/fo...
B12 range in U.K. is too wide
Interesting that in this research B12 below 400 is considered inadequate
healthunlocked.com/thyroidu...
perniciousanemia.org/b12/le...
And why aiming to keep B12 over 500 recommended
perniciousanemia.org/b12/le...
Great reply by @humanbean on B12 here
healthunlocked.com/thyroidu...
Low folate
supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)
This can help keep all B vitamins in balance and will help improve B12 levels too
Difference between folate and folic acid
healthline.com/nutrition/fo...
Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid supplements
thyroidpharmacist.com/artic...
B vitamins best taken after breakfast
Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose and may need 2 per day and/or may need separate methyl folate couple times a week
Post discussing different B complex
healthunlocked.com/thyroidu...
Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) Thorne can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-6 days before ALL BLOOD TESTS , as biotin can falsely affect test results
endocrinenews.endocrine.org...
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12 if last test result serum B12 was below 500 or active B12 (private test) under 70
Hey Slow.
Thanks for your detailed reply. I've yet to get the ranges for my B12 and folate so not sure if Im deficient yet. Ive saved your post for future ref. Thanks again.
Hey there
Can you please edit this post as it shows 2 x T3 readings and no T4 reading -
and can you add the ranges as detailed on previous blood test results you sent in some months ago -
T4 range is either 10.80 - 25.50 or 12-22 depending on which laboratory ran these blood tests :
It is suggested as per the reseach papers I have already sent to you - that the longer one stays on the AT drug the better the longer term outlook is for the patient - and generally the NHS allocate a window of 15-18 months on this medication -
So I think it prudent to stay on the AT drug at the lowest possible dose that doesn't tip you into hypothyroidism for as long as possible.
Your TSH appears to have been bouncing around these past few months though dipped down again in this last blood test so I take this to means this phase of Graves is coming to an end and your Graves antibodies decreasing -
and I think you are more likely going forward to be dealing with Hashimoto's AI thyroid disease as previously mentioned.
Morning Pennyannie. Thanks for reply and sorry for my delay....been busy the last few days....I have edited my post as per your request.
The gp hasn't provided the ranges for these last blood results but I'm trying to get them.
Although we've discussed the benefits of being on carbimazole for 12-18 months, I suppose I'm confused why the endo would suggest such a large increase in my dose? (Over 50% increase) To me, this opens up the possibility of going hypo, which seems silly.
Surely it would be better to increase my dose slightly to every other day? This would hopefully prevent the hypo situation? Hope that makes sense!
Well I think the difficulty maybe is that your endo was not aware that you had stopped / reduced your dose of the AT drug yourself - and increased your dose believing your were taking what had been prescribed - have I got that bit right ?
Both your T3 and T4 have increased from your last post and the endo needs to do something and puts the ' breaks on harder ' and that means an increase in the AT drug to block further own natural daily thyroid hormone production which in turn should lower back down your T3 and T4 at your next blood test.
Previous results were a T3 @ 5.10 and a T4 @ 18.80 with both said to be around 54% through the range - which she thought was with you taking the Carbimazole ?
So looking at your current results - your T3 and T4 are rising again so it was too early to completely come off the Carbimazole.
Current results are a T3 @ 9 with a T4 @ 23.70 - we have no ranges - but it looks like there needs to be some further invention from the endocrinologist - doesn't it ?
I don't think I've ever seen a T3 range that is as high as a top end of 9:
You need to start introducing the AT drug again - and it's too soon to totally stop the Carbomazole.
Did you tell the endo you had stopped taking the AT drug ?
Hiya. Thanks for reply.
The endo was aware that I stopped taking Carbim in Oct 24, and her subsequent advice was then to restart carbim 3 days a week which I started doing in early November 24. So the blood results recently posted are based on that dosage.
I got the ranges from the GP today....10.8 - 25.5 for T4. And 3.1 - 6.8 for T3
So my thinking is:
If we 'need to put the brakes on harder', when my T3 and T4 were in range in Nov 24 after not having any carbim, and my subsequent bloods in Jan 25 show my T3 as through the roof (after taking it 3 days per week) then I dont understand why the endo wants to increase my dose from 3 days per week to seven? Surely it would be better to titrate the dose more gradually upwards, as opposed to >50% increase in one go. Perhaps 1 tab every other day? To me, this massive increase runs the risk of me going hypo no??
Let me know your thoughts. I may of course have my thinking all upside down and back to front, but Im sure someone will put me straight if thats the case! 🙃
No- you are not thinking upside down - but upset and your confidence knocked as you thought you were doing ok though know you need to go back on the AT drug because of this last set of blood test results -
Every day your body produces new, own thyroid hormones - T3 and T4 - and so I think it logical to dovetail into this and take the AT drug daily - rather than create peaks and troughs -
The AT drug also dampens down your immune system and with your thyroid hormones rising your immune system has become more active again and the AT dose suggested is to dampen down your immune system :
If you should start experiencing hypo type symptoms it's easily rectified by reducing down the AT drug- but I think first off we need to stop your thyroid levels rising any higher and try and get back coasting along with your T3 and T4 at around mid point in the ranges.
It's a learning curve, and you were going in the right direction and will do again -
what we didn't factor in is that your TSH hadn't moved and that your immune system still active - which could also be because of Hashimoto's - as I think initially you had both sets of antibodies over range and positive.
One's immune system is a law unto 'itself ' and your immune system needs a little longer than we thought to calm down - it's frustrating I know and please try not to be upset - though appreciate its easier said than done - but its a waiting game, and we just nee to wait a little longer.
Thanks pennyannie. I'm not upset at the increased dose, just more confused really. But I understand its better to have a more consistent dose to avoid the peaks and troughs. I will take it daily, but I bet I'll go hypo!!
But you know now how to solve that problem-
However the problem that is not a quick fix is your immune system and you need to dampen down these antibodies -
whether they be Graves or Hashimoto's at this point in time - they need kicking into the long grass and staying there for the foreseeable future.
Fingers crossed! Thanks for your help! 🙏
How are your symptoms?
If its the same ranges as my GP /hospital and labs I use frequently (FT4 12-22) and (FT3 3.1-6.8) then you are still over range, which isn't good for your health long term.
The aim of taking the carbimazole will be to bring these down into 'normal' ranges.
Hiya. Symptoms aren't too bad really! I get the occasional palpitations but that's about it!
Blood Test Results 
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Blood Results
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