Can anyone make sense of my readings and explain normal?

[Monnty]

Hi, diagnosed under active thyroid 11 months ago. Symptoms were occasional muscle cramps, stomach problems and weight gain. After a large gap between tests due to a misunderstanding between my doctor an I, I finally got a follow up test last month after 8 month gap. Still no idea what they mean though?

I was on 50mg per day on the first test in March and on the back of the second my meds were increased to 125 per day. I am more curious what "normal" readings should be, i suspect i am still a little under dosed but would like more understanding for my next review in a week or 2.

March

Serum TSH level 74 mu/L (0.3-6)

Serum free T4 11.2 pmo/L (10-22)

October

Serum TSH level 78 mu/L (0.3 SR - 6)

Serum free T4 7.7 pmo/L (10 SR - 22)

Can anyone explain the readings please?

[helvella Administrator]

As your post actually has the reference ranges - the results should be expected to be within those ranges. TSH of 78 - and being even higher than in March - appears to be mismanagement of your health.

TSH doesn't always accurately reflect where you are, but if it is being any sort of a guide, you are under-dosed or have a problem in getting the levothyroxine to do what it should be doing.

The Serum free T4 numbers are low within range. Most people with thyroid disorders would expect them to be at least in the upper part of the range - maybe 18 to 22?

Did you avoid taking any levothyroxine in the hours before having your blood drawn for tests?

So it appears that you were very much under-dosed. And ignored. They should have had you back for another test at maybe six weeks after your 50 microgram dose was started. If you didn't realise that, they should have realised when you asked for repeat prescriptions.

No wonder you still feel unwell.

Rod

[Monnty in reply to helvella]

Thank you, the increase in TSH and drop in T4 threw me and it seemed i was getting worse not better.. but I was also concerned that I was increased from 50 to 125 in one go. On reading this site, that appears to be a large jump and was probably a little risky.

I must apologise though I miss typed and had to edit. My second T4 reading was actually 7.7 not 11.2. but you have helped put some of the info in to context.

Do you mean that the T4 should be medicated to reach the upper numbers as "normal" or with elevated TSH the T4 should also be high?

[helvella Administrator in reply to Monnty]

Many people feel best when the TSH has dropped (to at least the lower half of the range or even below the bottom of the range) AND FT4 is near the top of its range.

If you have FT4 near the top of the range but TSH is still very high, then something odd is happening. Something that needs to be properly investigated.

If your thyroid were responding to TSH in the way it should, then way before TSH reached anything like the heights you report, the FT4 level should have shot up.

Rod

[Issy]

Clearly hypothyroid. No questions

When well treated you should have no symptoms, tsh should ideally be around 1. T4 ideally in Upper quarter of the range.

[lesleywagg]

I would just like to say all my results were in the so called normal range and I was still ill no matter how much thyroxine I took. I eventually got t3 and feel great so I think I definitely had a conversion problem and couldn't turn the thyroxine t4 to t3. X

[anniekaren in reply to lesleywagg]

Hi how did you get your dr to give you t3 when your tests are normal as my husband tried today and his dr didn t want to know as his bloods are so called normal