Opinions/Advice on recent blood results and vis... - Thyroid UK

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Opinions/Advice on recent blood results and visit to Dr Friday


Hi Everyone. I'm a 42 year old female who was diagnosed with Hashimoto's disease and hypothyroidism 3.5 years ago. Since that day my life has changed so much and I really want to do as much as I can to be as well as I can. I've recently started gentle swimming and doing daily meditation, as my anxiety gets crazy sometimes. I've gained 4 stone in the last 3 years and daily naps are a regular occurrence, as are 10/11 hours sleep at night. I feel so bad for my two children as their lives have changed too :(

Things have improved since first diagnosis and I currently take Levothyroxine doses as follows; Mon/Wed/Fri 100mcg Tue/Thur/Sat/Sun 75mcg.

My body seems to be particularly sensitive to the drug and every increase I make I have to do extremely slowly and build up over a period of time otherwise it makes me feel very unwell.

I'm currently under a different GP, who seems, on first meeting, to be quite understanding. The last time we met she requested lots of bloods and here are my results;

Serum free T4 level 13.2 pmol/L (12-22)

Serum free triiodothyronine level 3.7 pmol/L (3.95-6.8)

Serum TSH level 2.99 miu/L (0.2-4.2)

B12 798 pg/mL (197-866)

Serum folate 8.8 ng/mL (4.6-18.7)

My TSH result from 8 months ago was 0.94 (0.2-4.2) and I do recall having a little more energy.

I'm very confused. Would you say that from my recent results that I should request an increase in my meds? What confuses me is that my anxiety has got really bad lately, and it makes me wonder if I have symptoms of hyper?

I have an appointment Friday (tomorrow) and want to discuss this with my Dr, but would appreciate any comments/advice before I go as I feel apprehensive as to what I really want or need? Thank you so much x

16 Replies

You may have symptoms of hyper, but you most definately are not hyper. Your FT3 is under the range and it's T3 that make you hyper, not the T4 or the TSH. There are some symptoms that are of both hyper and hypo and it can be confusing, but not when you see the FT3 so low.

You are very hypo and I should think you do need an increase. But when did you have the last one? You're still on quite a low dose and there's plenty of room for manoeuvre in your blood results. I expect you did have more energy when your TSH was 0.94. Once one is on thyroid hormone replacement, the TSH should be below 1.

Hugs, Grey

ft4=23.9. ft3=9.7 tsh=0.02. doctor needs to see me. dont wont to increase dose of n.d.t. if not needed. very weak. pulse gone up today, keeping eye on this. temp dropped from 38.6 to 36.6 in 2 days. 4 days well when temp was 36.8. what do you think. thank you

Hi, erfathyroid, it is very important to give the ranges for the FT4 and 3, because ranges differ from lab to lab. If I use the ranges given by Wired, your results are way over the top. But your lab might use totally different ranges that make your results at the bottom.

Your TSH is suppressed, but that means nothing - although it has probably terrified your doctor which could be why he wants to see you! However, your temperature would suggest that you are hypo rather than hyper - which is why I said the TSH is meaningless.

Why do you say you don't want to increase your NDT? Although no-one would suggest you increase it if it isn't necessary, it isn't something to be afraid of.

sorry i should have said i do not wont them to decrease. increased my dose 10 days ago to 31/4m.g. from 3 m.g. morning temps went up t 36.8. for 4 days. pulse o.k. felt good. 2 days ago temp went to 37.1. pulse 85. today temp 36.6. pulse 93. 1pm pulse 85. temp36. not feeling great still weak. have been a lot worse. keep thinking i am getting there, then i drop. doctors just keep you ill. i was thinking my ft3 was to high. hope you are well. thank you.

Well, I really can't say if your FT3 is high without the range. Is your dose really mg? Or is it mcg? Or do you mean 3 1/4 grains?

3.1/4 grains no range on blood test.

Ah, ok. Well 3 1/4 grains is an average sort of dose. Although when I was on Armour (then Nature-Throid, then Thiroyd) I was on six grains. So, I don't know about the FT3, then, but even if it's high, your temps are rather low. Blood tests are only meant to be a guide. The doctor should take symptoms into account, too.

Thank you Greygoose. I didn't realise it was the T3 that makes you hyper (something to remember when reviewing blood results). My last increase was over 4 months ago and yet my TSH level has gone UP since then. Would this indicate that my thyroid is in further decline since then?

How much do the levels change on a day to day basis? Do you know? I guess you can have a blood test done one day but your body changes the following week. Is that why you sometimes have varying systems? Does it ever become consistent? Whereby you are generally stable or do I need to accept the fact that I will have some bad days/weeks?

I really appreciate your help.

Wired in reply to Wired

sorry typo *varying symptoms* not systems! ha ha

greygoose in reply to Wired

I think most people have good days and bad days - I certainly do! I have no idea how levels change from day to day, but I know that they change during the day. Therefore it is best to have your bloods done as early in the morning as possible when the TSH is at it's highest. Variations could be caused by having bloods done at different times in the day.

Having Hashi's would account for your TSH going up, as Hashi's slowly destroys the thyroid. As the thyroid is destroyed, it makes less and less hormone, so it is perfectly normal that your TSH rises and you need to take more hormone replacement.

As to whether the TSH ever becomes consistent, it probably will once your thyroid is completely destroyed. However, a lot of people find that they are better off, and the Hashi's swings are lessened, if they have their TSH suppressed. Unfortunately, finding a doctor who would be willing to allow your TSH to be suppressed is a whole other problem. It scares them rigid! lol

Wired in reply to greygoose

That makes a lot of sense and I can understand what you say regarding the decline of the thyroid. With that in mind, I can tell myself that there isn't really an "ending point" at the moment and it's going to be an ongoing changing process for a while yet.

It's frustrating when I read success stories and how people are running Marathon's etc with the same condition. I sit there in amazement thinking ... how????

greygoose in reply to Wired

Oh, I know exactly what you mean! lol I have never been capable of running a Marathon in my whole life! In fact, I've never been capable of running, even as a child. Beginnings of peripheral neurpathy? I don't know, but when I tried to run I always had the feeling that I was going to fall flat on my face. Completely uncoordinated. Also my breathing has always been difficult. So running is just a dream for me. But I tell myself I have other talents. lol And if I had to run for my life? Well, I just wouldn't make it, that's all. Survival of the fitest and all that. Ho hum.

Wired in reply to greygoose

Well, I visited my Dr today. At first she tried to tell me my results were "within range". When I sat stuck in the chair, not looking like I was going with that idea she added "however, I don't want you to walk around feeling unwell". So we decided that I would increase to another day of 100mcg for 2 weeks and see how that feels with another increase if necessary. I have to do it very slowly or I feel really ill with too much of a change.

Thanks for your input and knowledge. I hope YOU are having a good day today :)

greygoose in reply to Wired

Glad to hear you got some action!

Take care, Grey


This is an extract from Dr Lowe and some of the links within many not work as it is archived but you can still get a lot of info. This is from the 1st question and there are other topics at the top of the page.

Dr. Lowe: With most patients, I use thyroid function tests (TSH, free T3, and free T4) and thyroid antibodies only for a patient’s initial diagnosis. Afterward, I follow the practice, in principal, of Dr. Broda Barnes—that is, measuring tissue effects of particular dosages of thyroid hormone rather than remeasuring TSH, free T3, and free T4 levels.

My reason for this different protocol is simple: the TSH, free T3, and free T4 tell us only how the pituitary and thyroid glands are interacting. Of course, the test levels may also tell us something of the influence of thyroid hormone over the hypothalamus in its secretion of TRH, another hormone that influences the pituitary gland's secretion of TSH.


Wired in reply to shaws

Thank you Shaws. I did have a read, but blows my mind a little at the moment! I appreciate your response.

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