Recent Labs

[RenKat]

Current medications are: Levoxyl 75mcg and Cytomel, 5 mcg x 5 daily (3 in am, 2 in pm)
Current labs with ranges:
TSH: 0.005 L
T4, Free: 0.74 L.        Range-0.76-1.46 pg/dL
T3; Free: 2.86.           Range 2.18-3.98 pg/mL
B12 488.                    Range 193-986
Vit D. 54.40.               Range 30-100
Serum Iron. 89 mcg   Range 50-170
Bun Creat and Chloride are high 35 and 108

Symptomatically, I’m tired, depressed and holding weight. However, I’m stressed, and under medication for a UTI.
Should there be medication adjustments here?

And regarding Euthyral, my answer was it is NOT available in the UK, but is in France at 32€, without insurance.
I have also learned, since Cytomel was unavailable in 25 mcg pills, and only the 5 mcg, (which is how I have been taking them since 2018, to equate 25 mcg daily) the cost has skyrocketed. it’s unlikely now, to be written in the UK, even if paying out of pocket over which is  £300 a month!
Any input on labs, most welcome! Thanks

[Barb135]

Both your FT4 and FT3 are too low, as is your Vitamin B-12.  Did you have any other iron related tests done, such as Ferritin, and the rest of the iron panel?  It looks as though your iron level could stand to be a bit higher.   Ferritin is the iron storage hormone and that's low, it means you have no iron in storage, either.

Have you considered increasing your T4 dosage?  If you increase your T4 dosage for a few weeks, then retest to see if it brings up your FT4 level, you might also need to increase your T3 dosage, but it's best to make only change at a time.

Fatigue can be caused by, either, low thyroid hormones or low B-12.  Most of us have to keep B-12 levels at/near the top of the range in order to prevent symptoms.  Both hypothyroidism and low B-12 can cause depression as well.  Adequate B-12 is also necessary for thyroid hormones to work properly.

Iron is necessary for the conversion of T4 to T3.  It's also necessary for red blood cell production, energy, etc.

It's typically not necessary to adjust medication dosage for the short time (assuming about 10 days?) one is on antibiotics for a UTI, but an infection can also cause fatigue and other symptoms.

Not all medications are available in all countries.  According to Pfizer's website, cytomel comes in 5, 25 and 50 mcg dosages.  It used to come in 10 mcg dosage as well, but they must have discontinued that.  T3 is best split into multiple dosages/day, which is easier to do with the 5 mcg tablets.  Larger dosage pills would have to be cut  in half in order to take multiple doses/day.

Again, perhaps not all dosages are available in all countries/areas.  There are doctors in UK that prescribe T3 med so perhaps you'll be lucky enough to find one.  If the price of cytomel is increasing so much, perhaps, you might want to look into taking the generic Liothyronine.