Lab results - or not?

[mumcat2]

In a letter from my endo this morning (the copy sent to my GP, not to me) I have received some numbers...that's the only descriptor.

TSH 3.7

T4 17.4

T3 3.7

No reference ranges or even units. Needless to say, I've contacted the endo's secretary and asked for reference ranges and Free T4 and Free T3.

Given that I'm hypopituitary, I'd say that my pituitary is working like the clappers sending TSH, but the ratio of "bald" T4 to T3 is not right. The endo suggests upping my levo to 125mcg. These results were pre-going back to T3. I've been on the T3 a week and feel so much better. I remain to be convinced (until the Free results come back) that I need more levo, so intend to just swan along with what I'm taking (100 levo, 20 lio)

When I was a kid (many many moons ago) I'd have been slaughtered if I'd given in graph results without units, or a map without a scale and north pointer. The numbers might as well be tiles on the roof. So there - I'm feeling a bit stroppy!

Any feedback on the silly numbers would be welcome.

[helvella Administrator]

Many NHS labs have put up laboratory handbooks (or something similar) which often contain reference ranges, etc.

For example:

pathology.bsuh.nhs.uk/patho...

(I believe that failure to record reference ranges in notes should be regarded as poor record keeping. After all, whatever the person writing knows now, they might not know in years to come, and nor will anyone from outside the area ever know.)

See if you can find the one for the lab that did your tests. Might be easier for you than trying to go through the endo.

Rod

[mumcat2 in reply to helvella]

Thanks for the link. Looking at my numbers,they appear to be FT4 and FT3 anyway,but I will await confirmation. If they are free, it looks like my T4 is mid range,with the implication that the T3 ought to be somewhere in its own mid-\range,about 5.6 nmol/l. As it's only 3.7, adding T3 would,to me,be the treatment. Adding T4 is surely more likely to increase the shortfall of T3,or at best lift it but at the expense of pushing T4 out of a comfortable mid-range into borderline high?

If she wants my TSH to come down, my system needs to think it has enough thyroid hormones available. Not sure how or what that would register with physiologically!

.

[helvella Administrator in reply to mumcat2]

Did you find the numbers from your own lab? (The ones in the link would only apply if the test was done in that lab in Brighton.) They do vary from lab to lab.

Borderline high FT4 might not be much of an issue.

Did you take any thyroid hormone in the, say, 12 hours before having the blood drawn? That can make quite a difference.

Rod

[mumcat2]

Yes I'd taken my usual dose of 100 Levi about 3 hours previously. No-one had said anything about not taking any meds, and as I have to take so many tablets (40+ daily) that I need to have routine times for them. The list of my other conditions would make a med student pale!

[mumcat2]

Tiny addition to the test results from yesterday; I also had a 30 minute (very)short synacthen because my BP was so low (97/47)and was reassured that my peak cortisol was 850 so no adrenal insufficiency detected, though as usual I'm being hypercritical because I didn't receive baseline value! Bah humbug!