Hey, I am looking for some advice regarding my recent thyroid blood test results. I have been hypothyroid for over 13 years after a partial thyroidectomy for a hot nodule. I have always had my T4 range in the higher range even before my thyroid issues, so that seems to be were my body functions well.
My new endocrinologist wants me to decrease my T4 by 125mg per week to improve my TSH levels even though I am saying I don't feel great. I finally got them to test for T3 (reluctantly). Could someone let me know, if with the below results, I would feel worse if I were to reduce T4 by 125mg per week?
My recent bloods were:-
TSH 0.06 (0.27-4.2)
Free T4 20.9 (11-22)
Free T3 3.6 (3.1-6.8)
They also tested my bone profile which is was within range but my haematinics results had higher than normal ferritin and B12.
I am aware that my TSH is low but is it suppressed? Surely if it were suppressed my T4 would be higher than 22. Any help would be much appreciated.
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Fitkid
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Sorry to hear you're feeling unwell and stressed, I feel the same at the moment.
I can't give any good advice really, but I can tell you that when my levels are like yours, I feel really, really unwell. Everyone is different, and is affected differently.
Thanks for your response, I am currently taking 100mg x 5 days and 75mg at weekends. They reduced to 75mg at weekends last year. My TSH slightly improved to 0.05 and my T4 came down to 21. They were happy with that but now this new endo wants me to reduce further even though I don't feel great because he feels my TSH is still too low.
If 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
I usually get tested in the afternoon (as that's usually the only appointment available) but I get it done in a fasted state. I take my T4 at night before bed 3 plus hours after eating. I have always found that to be better for me. So when I have the blood test around 3-4pm there has been a gap of around 18 hours since taking it.
When I remember to take my vitamins, I take Vitd, Bvits, multi, minerals, omega3, electrolytes, iodine, selenium. Although I hadn't take any for around 1 month before these bloods so I could get a good idea of what my real levels were like.
B12 - 891.0 ng/l (197-7771 range)
Folate - 13.3 ug/l (4.5-99999 range)
Ferritin - 168.8 ug/l (13 - 150 range)
Vitamin D - couldn't see this on my result unless this was the bone profile. Result from those were:
Alkaline Phosphatase 59 (30-130)
Total protein 69 (60-80)
albumin 47 (35-50)
calcium 2.41 (2.2-2.6)
phosphate 0.83 (0.8-1.5)
Thanks for the info on private testing. I would like to see what my reverse T3 is doing and the NHS will not test this. They reluctantly tested my T3 but I had to push for it.
It’s never recommended to supplement iodine when taking levothyroxine. You get all the iodine you need in levothyroxine.
Folate low ….but you stopped B complex too long before test
In days before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg)
Free T4 (fT4) 20.9 pmol/L (12 - 22)
Ft4 89.0% through range
Free T3 (fT3) 3.6 pmol/L (3.1 - 6.7)
Ft3 only 13.9% through range
Ft4 would have been lower after 24 hour interval
TSH would have been higher at 8-9am
Suggest you get private test done testing early morning and last dose levothyroxine 24 hours before test
Also including BOTH thyroid antibodies
Randox FULL thyroid test including both thyroid antibodies just £31
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
Also test vitamin D ideally twice a year, certainly annually
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Blood Test advice required please 
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