My recent Thyroid function test results. Not improving apart from having lower TSH.

My recent test results from 22nd of March are as follow:

( I discontinued my NDT for 24 hours prior blood test, so not result are unlikely to be skewed this time)

TSH - 1.7 ---------------- ref ( 0.3 - 5)

LOW:

Free T4 -11---------------- ref ( 9-22)

Free T3 - 4.4--------------- ref( 3.5 - 6.5)

After taking ERFA for 7 weeks, nothing improved apart from TSH

Before I started treatment my TSH was 7.6, FT4 11, and Free T3 - 4.9 ( so even higher than after I started to take NDT!!)

My thyroid output probably decreased with the amount of NDT provided, if that is not the case does NDT do something here?? My T3 level was higher without medications, and that is slightly worrying.

I feel crap. Maybe slightly better some days..it is hard to tell.

I had some brighter days when my brain fog lifted and I was able to study but I quickly found out that the lift was temporary and my hopes for passing my exam are shattered again. Such a cruel illness that is..

I take selenium , iron, b complex +b12, vit d3, zinc+copper, vitamin C, cod liver oil ( thats for omega 6 fatty acids).... lots

I for the last for weeks my dosage was as follow

1 week - 1 grain/ day

1 week - 1 1/4 grain/ day

1 week - 1 grain/ day

1 week - grain/day

before I was on 1/2 grain for 3 weeks ( but that was at the beginning of therapy)

Shall I increase the dose?

I am worried that my blood results did not improved.( T3 even dropped slightly)

I wish you a very happy Easter!!

My erfa stuck in the post so I am facing a minimum 4 days of being without medication... how great is that.

warm wishes to all

Exxx

[Jackie]

Hi If not well, then the dose is too low. Good to start low.Your TSH will drop on armour or Erfa etc as they contain T3, T3 in a drug or on its own does lower the tSH. We find the T4 and Free T3 much more important. Why did you go on Erfa as a first choice and not first try T4 ( levo) and T3. It is the prefered medical option.? I cannot take Levo so have armour and T3 , that is unusual. My endo prefers T4 , then adds T3, only if that does not work is it armour etc. If that no good just T3, but that shows the bloods a bit haywire.Normal dose is around 2 grains, but everyone varies. I used to need 7 before T3 existed in a drug form.

You need retests and to have a dose where you feel well. If GP will not test all 3 , then are you able to pay for them. Get back to me if you want those details, I pay £61 for the 3, no doc involved!Good treatment for thyroid should be gradually increased on the blood results until well. Also there are other tests you need, but sort the T4 and FT3 levels out first. Glucose and vit d, B12 and Folic acid, feritin/iron ,some of these are autoimmune and hormonal. If your Hypo is autoimmune ( a lot is ) then you may well need other things. Low D is very common, but if low be sure to have a calcium test first before treatment as D may make the calcium go above range.

I hope this helps.

Jackie

[marram in reply to Jackie]

Jackie, I think Edysia has really tried almost everything but with no result. and takes all and any supplements her poor tummy can stand

[Hidden]

Dont worry about the low FT4, It will be low when you are taking T3.

Your FT3 will also drop a bit, as your body starts working again having been semi dormant for years, it will start using more and needing more. You have still been on the ERFA quite a short time, it can take several months or even a year for the body to get back to running properly and for the required dosage to even out.

[Clarebear]

Also you need to be on a stable (same) dose for 6 weeks to get a true reflection of how that dose will look in the blood tests. What is your current dose as I think that number is missing from your blog?

If I was you I would be feeling quite pleased with these results as it looks like you will need an increase and will hopefully feel better when you get to the right level for you. I have recently discovered that I feel we'll with midrange Ft4 and top 1/4 of the range ft3 - pretty much as STTM suggests - you still have a way to go to get to this level. Fingers crossed that this will be the same for you Xxx

[shaws]

Before the thyroid gland blood test came into use, patients were dosed by clinical symptoms and the usual dose was between 200mcg and 400mcg' These are a couple links which may be helpful (some of the links questions may not work) and am very sorry your meds are stuck in the post.

web.archive.org/web/2010122... 200mcg and 400mcg.

and one on NDT.

web.archive.org/web/2010122...

[PinkNinja]

It is likely just because you are still on a very low dose.

Are you crunching your Erfa? You will likely absorb it much better if you crunch it.

Until you get near your optimal dose, your blood tests are not likely to improve very much. You really need to keep increasing based on how you feel. While you are on such a low dose you may find increasing every two weeks is necessary if you can tolerate it (but only 1/4 grain at a time as I know you are quite sensitive to increases).

Hopefully your Erfa arrives soon! Keep going with it. It will take time, especially if you are sensitive to increases.

Don't forget that TSH isn't a very good reflection of what is going on. TSH can be affected by so many things, including the time of day the blood is drawn, B12 deficiency or adrenal issues.

Take care

Carolyn x

[Hidden]

You don't sound as if you are taking enough. You have to build up the dose slowly. In many cases the TSH is almost entirely suppressed. Mine is now 0.13 and I would say I am almost better after having been on treatment for adrenals and thyroid for around nine months. My symptoms were hellish. If your adrenal glands are stressed you may not be able to metabolise the Erfa as well. Have you taken adrenal support? My doctor (private and more knowledgeable than the average endocrinologist) told me it took around one year to one and a half years to get better, with adrenal support, if the adrenal glands have been badly affected. Everyone is different, but synthetic thyroxine only seems to work for relatively mild cases of hypothyroidism. It's synthetic, not bioidentical, so the body finds it more difficult to process it and you aren't getting the full range of hormones, only T4, but I expect you know that, which is why you are taking Erfa in the first place.

[marram]

Dear Edysia, I can see a tiny change in you. It may be small, but it is there. As the others are saying, your dose clearly has a way to go, but the sicker you are the more carefully it has to be done.

It's interesting what fedupsusie says, that your FT3 will drop slightly as your body starts to work and utilise it. I suppose that is logical, and after all, we'd prefer the T3 to be used up than floating around the bloodstream.

So sorry that you are going to be without meds for a few days, that is going to set you back a bit. It will still be a while but even a few good days are better than none, here's hoping that there will bee more and more good days and less and less bad days.

Marie XXX

[Heloise]

Hi Edysia, So the four weeks you posted above are starting from the top as the most recent? You decided to reduce your dose?

That IS troubling about the FT3 going down even slightly. I can't think of why that would happen. I wonder if some of it is now turning into reverse T3. Or maybe it's just the way your body is still adjusting to the NDT. And maybe you are one of those who should be on more T3 and less T4. You WERE taking T4 first, right? I hope your doctor will allow you a reverse T3 test if that IS a possibility.

I see where Europe Genova will do all the thyroid tests plus the two antibody tests for 126 pounds.

I'm so sorry about the exams. You really need some good news for a change!

[MaryMary]

HI Edysia

A few thoughts for you|

Maybe the t3 is lower because on stopping the meds earlier combined with its shorter half life , maybe this affected the result? next time, you will be able to make a better comparison if the timings are similitude?

Also have you considered supplementing with magnesium? My Dr says it's very important and you can't overdo it?

If you've had a short time feeling a bit better then something is changing. If I overdo it one day, then I suffer the next. So, we have to learn to pace ourselves, all very frustrating.

Well done, Edysia. I know from your blogs that you are having a really tough time, but it isn't a condition with a quick fix!

Mary x

[MaryMary]

Sorry for poor spelling! 'Similar'

[Hidden]

thank you so much to everyone who replied. I do apologize but i really cannot reply at the moment to everyone separately. i do feel much, much worse. i do not know if that is ndt that is making me worse. i woke up so so low and suicidal. it is such weird feeling, I cannot shake it off.

E xx

[Jackie in reply to Hidden]

Hi I am sorry you are feeling so ill. Do make sure it is not diabetes as the symptoms are very similar to thyroid disease and very common with auto immune conditions. You do not have to meet the criteria, I am thin, underweight etc. Also I cannot remember who is looking after you? You need to be seeing someone you are happy with., and feel confident in and asking them , whenever you have a problem.You will get better but it sounds as if you are going to be quite a while yet, Fight to get better, even though a terrible effort.

best wishes,

Jackie

[Maddie]

I noticed from a previous question that you had low serum ferritin in February this year. Low iron levels slows down the conversion of T4 to T3.

I had very low iron which caused me to also have low haemoglobin and low haematocrit. I did not start to feel better until my serum iron levels increased even though I was taking T3.

Just having low iron, without thyroid disease, can cause fatigue in women. See this info from Dr Briffa;

tinyurl.com/cfell4x

Maddie

[Hidden in reply to Maddie]

Thank you Maddie. I do take iron supplements from the moment I have realised that my ferritin level is low. Thank you for the link.

E x