Hi, following my post a few weeks ago I now have results of a blood test from MMH. Unfortunately, my first attempt was unsuccessful (not enough blood) so had to wait another week for pack etc.
so, to recap Dec 24 my blood results at GP were TSH 0.008 (normal range 0.35-4.94) FT4 22.3 (normal range 9-19.0) with a BP of 220/100. Levo reduced from 200/175/175 to 150 daily. Commenced on Propanolol 40mg bd.
Mid Jan results at GP TSH 0.01 (range as above) FT4 20.4 . BP coming down. GP Reduced Levo to 100mcg which I queried and then was told 125mcg. By that time I was barely functioning on 150 mcg so decided to stick with that dose for longer before reducing.
I took the MMH test to primarily check T3 as it is never checked at GP, and also Vitamins as recommended here. TSH 0.01 (range 0.27-4.2) T4 28.1 (range 12-22) T3 4.6 (range 3.1-6.8). My TSH has been suppressed for over 30 years following hemithyroidectomy for cancer (no thyroid tissue now) so that remains much the same but I can't figure out why the T4 has shot up. Possibly Propanolol? Perhaps I was wrong to have continued with 150 ? I have now decreased Levo to 125/100 alternate days. I already have a GP blood test booked for 13th March with GP review towards the end of March and have requested that T3 be included and will add vitamins to the list. I won't hold my breath!
Any thoughts/insights would be welcome! Thanks.
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I took the MMH test to primarily check T3 as it is never checked at GP, and also Vitamins as recommended here. TSH 0.01 (range 0.27-4.2) T4 28.1 (range 12-22) T3 4.6 (range 3.1-6.8).
Yes propranolol will lower uptake and conversion…..
Free T3 (fT3) 4.6 pmol/L (3.1 - 6.8)
Ft3 only 40.5% through range
TSH takes weeks or months to respond to reducing Levo
Alway dose by Ft4 and Ft3
Was test done as recommended, testing early morning and last dose Levo 24 hours before test
Which brand of levothyroxine are you taking
Do you always get same brand at each prescription
What were vitamin results and exactly what vitamin supplements are you taking
You MUST ONLY reduce propranolol very slowly
Get GP to give you 4 x 10mg tablets per day instead of 40mg slow release…..then you can start slowly reducing by 5mg ….wait 4-6 weeks…..reduce by another 5mg etc
Thanks SlowDragon. I followed all protocols as suggested on the forum, which I was sure would result in a reduction in T4 as my Jan blood test was done after taking meds in morning. The only vitamin result I have is Vit D @ 78 as MMH could not process B12, folate and ferritin. I take VitD supplement and more recently B12. Brands of Levo are mixed - Accord and Teva. Advice on Propanolol noted - I'll follow up with GP.
Many patients do NOT get on well with Teva brand of Levothyroxine.
Teva is lactose free, but contains mannitol as a filler instead of lactose, which seems to be possible cause of problems. Mannitol seems to upset many people, it changes gut biome
If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient.
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
Do share your MMH vitamin results with us Lowbattery and look to optimise if required, as advised by forum members
Your FT3 is low, indicating conversion issues. Right now though, I’d focus on getting FT4 in range through a slow & steady reduction of Levo. I like to reduce by 12.5mcg and find a pill cutter useful for this…. You could try 112.5mcg per day instead of alternating 100/125mcg (for same results). Also go steady reducing the proprananol- think ‘tortoise’ not ‘hare’ when adjusting your dose, as larger steps can spike adverse symptoms.
Thanks Buddy195. I only have Vit D @78 as MMH were unable to process folate, ferritin and B12. Will try to have them included with next GP test later this month. Yes, I was wondering about T3 conversion - at least I now have a baseline to monitor going forward. Advice about Levo and Propanolol noted thank you. Unfortunately, I think we all get used to being a tortoise, frustrating as it is!
I have recorded a note in my personal health journal that ‘propranolol can reduce T3 serum 25-30%’, I think bisoprolol wasn’t thought to do this, but there are other hypertensives too if it was just for lowering BP. I’m on 4 now, and beta blocker removed, as a result of Long Covid.
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Blood results.. please help
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