Any help to explain my results.

[hpfan123]

I have Hashimotos and was diagnosed with an under active thyroid two years ago. I just had my recent bloods back after increasing my levothyroxine to 75mg. My TSH was 8.5 (he told me the range is under 5) and my T4 is 21 (he said this was just above the range) These had both increased from when I had been taking 50mg. (my T4 was 18 and my TSH was 7) so i am just wondering why both my TSH and my T4 would be increasing. My doctor explained that everyone's bodies are different and therefore the ranges do not always fit so because my TSH is high I should increase my levothyroxine to 100mg. So that is what I am taking now.

Any help with these results would be much appreciated.

[shaws Administrator]

Yes everybody is different i.e. those people who don't have thyroid gland problems and those who do!

Your GP is another who appears ignorant of how to make his patient better. 50mcg is usually a starting dose and is increased gradually around every 6 weeks until clinical symptoms improve.

You are obviously undermedicated and he should have increased your dose of meds before now. Is he aiming to get your TSH down to 5? That is the top of the normal range although they are advised not to treat patients until 10 unless they have symptom. Patients on hypothyroid medication usually have to be lower than 5 to feel better.

When you put your blood test results it is advisable to put the ranges too (the figures in brackets) as labs differ and it makes it easier to comment.

You should have another blood test in 6 weeks to see how your new dose is working (get a print-out). If you haven't also had a Vitamin B12, Vit D, iron, ferritin and folate, ask for these to be done as well.

[galathea]

Had you taken your levothyroxine on the day of the test? Before the test? If so, this would account for the level of t4.

If you have good levels of t4 but the tsh is raised, it rather suggests that you have a lack of t3 in the cells. This could be be to non conversion of t4 to t3, or it could be cellular resistance. Firstt thing would be to get a free t3 test and see where you are with it.... Lack of t3 will push up the tsh.

Very convenient that the ranges don't suit everyone... Most doctors swear by them fanatically and we spend all our time arguing with the docs that they should be going by symptoms, and lab tests.

G x

[rosetrees]

Sounds to me like your doctor is clutching at straws. If your T4 is high then increasing your dose of T4 probably isn't going to help.

As Galathea says, it's possible that you have conversion issues. Some people can't convert T4 to T3 effectively.

You need to insist on a Free T3 test. This will help you work out of conversion is your problem.

There was an excellent presentation to the Scottish Parliament about this very issue. It's long, but well worth listening to all of it. youtube.com/watch?v=CVXvYrJ...(Not working as expected?)

[Heloise]

T4, if not converted to T3 becomes reverse T3, which is not usable for metabolic purposes. This answers questions regarding reverse T3. thyroid-rt3.com/backgrou.htm

[hpfan123]

Thank you for all your advice. I will ask my doctor for a T3 test as well for my next bloods and see what that comes back as.

Galathea- am I not meant to take my levothyroxine prior to the test?