Latest test results

[TheCatsWhiskers]

Hi there,

I take a combination of Levothyroxine (75mcg) and Liothyronine (10mcg) daily. I've just had my latest test results back and my GP has requested I see him (I think to reduce my medication). I have had more energy of late (I suffer with M.E. aswell) and I don't want to reduce my medication unless it's really required (my GP is very much a traditionalist!). What do you folks think - these are my results;

TSH 0.09

FT4 14.8

FT3 (Fine - within range)

I don't have a problem reducing my medication if its needed, however.

Kind regards & thanks in advance,

[helvella Administrator Thyroid UK]

What is the reference range for FT4? That is something which varies considerably for one lab to another.

[Issy]

and what are the results for the T3? If T3 is within range, then there appears no reason to reduce thyroid meds

.

[TheCatsWhiskers]

Hi, at this stage, until I get the printout of the results when I visit the my GP, I have no idea of the reference range unfortunately ... I just have these results read out by the receptionist.

I wanted to go to my doc a bit informed and forearmed!

My FT3 is defo in range at 5.?

[shaws Administrator]

If you have been feeling well on your dose, there is no reason for him to adjust according to your TSH levels.

This is the recommendation from Dr Toft, ex President of the British Thyroid Association:-

The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range – 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This ‘exogenous subclinical hyperthyroidism’ is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).

Even while taking the slightly higher dose of levothyroxine a handful of patients continue to complain that a sense of wellbeing has not been restored. A trial of levothyroxine and tri-iodothyronine is not unreasonable. The dose of levothyroxine should be reduced by 50µg daily and tri iodothyronine in a dose of 10µg (half a tablet) daily added.

Dr Lowe states:-

Dr Lowe: Your observations don’t suggest to me that your pituitary gland isn’t functioning properly. In fact, your observations are consistent with what science tells us about a patient's T4 dose, her TSH level, and her metabolic health or lack of it. If the goal of a doctor is metabolic health for his patient, he has no scientific basis for adjusting her thyroid hormone dose by her TSH level. If the doctor is going to make the imprudent choice of treating the patient with T4 (rather than T3 or a T3/T4 combination), he should be aware of the relevant physiology and treat her on the basis of it. Otherwise, he's likely to ruin her health, as your doctor appears to be doing to yours

[shaws Administrator]

Have you had your B12 and Vit D tested and are they at optimum levels. These are two links re B12.

chriskresser.com/b12-defici...

and this is from the Pernicious Anaemia Society

thyroiduk.healthunlocked.co...

[TheCatsWhiskers]

That's brilliant help, thanks Shaws .... I'm going to print that out and take it along with me!

Also - I've not had my B12 and Vitamin D tested, but I do take supplements of both. I used to take bi-weekly B12 injections (via a private Dr), but they're so expensive I had to stop. I now take a sublingual 5000mcg supplement.