Blood test results in (finally)

[puncturedbicycle]

Results in from last week. I'm on 37.5 t3 and 75 t4. I understand that I'm seeing some of the t3 implications here (low tsh and t4) but is the t3 high enough? I left out my morning dose of meds, which would make it about 24 hours between last dose and blood draw.

Ft3 5.7 pmol/L (3.8 - 6.8)

Ft4 7 pmol/L (7.5 - 21.1)

Tsh 0.05 mlU/L (0.34 - 5.6)

These results look okay to me. Feeling PANTS though. Recent b12 and ferritin results are low, so maybe that's why I'm not well?

When I felt really well in Oct, my results looked like this (note different ranges as test was done by a different lab):

Ft3 5.7pg/mL (2.0 - 4.4)

Ft4 8.5 ug/dL (4.5-12.0)

Tsh <0.005 (no units specified) (0.45 - 4.5)

Also worth noting that if I remember correctly, the latter test had to be taken unexpectedly when I had already taken my morning dose of meds, thus the high/low results. I was taking 125 t4 and 25 t3. Later that month I returned to the UK from a long trip abroad and seemed to go hypo again (constipated and tired), and I haven't felt well since.

Any thoughts? All contributions welcome. x

[shaws]

Maybe you feel better with a suppressed TSH? Dr Toft says some of us feel better with a suppressed TSH.

[puncturedbicycle in reply to shaws]

Thanks for your reply shaws.

Can I ask what is considered a suppressed tsh? Is that when it barely shows up at all? Cos my current tsh is quite low (too low for gp, I've been asked to make an appt, bleurgh) but maybe it doesn't qualify as suppressed - ?

Gp appt will give me the opportunity to grill a new locum, so maybe I should be glad of it.

[shaws in reply to puncturedbicycle]

I believe it when it has < in front of the numbers.

thyroiduk.org.uk/tuk/thyroi...

[Hennerton]

Maybe try a tweak on the T3 as you are still below the top of the range. Try 40 mcg? Have you ever tried Armour? I am currently on a mixture of all three meds. Would never have dared try such a cocktail but for dear Dr Skinner but am beginning, dare I sat it, to feel as though something is working. Hair still very thin though. No hope there!

[puncturedbicycle in reply to Hennerton]

Thanks Hennerton. Gosh, that is quite a combination. Good luck to you. I do hope it makes you feel better.

No I haven't tried ndt but my mum feels very well on Armour. Maybe I'll tweak the t3 a tiny bit, add in another quarter of a tablet. I don't have any hyper symptoms (not even borderline diarrhoea, which is my telltale sign) so I feel pretty safe giving it a go. I've been taking it all at once in the morning which is working pretty well. I do get tired in the afternoon, but I don't have the ups and downs all day so I don't second-guess my dose every day, which I kind of did when I took a split dose.

Don't despair - my hair got quite thin and came back brilliantly on levo alone once the dose was high enough, so it can be done (it's virtually the only thing levo ever did for me). Once you find a good combo of meds you might get lucky. I continue to lose too much hair, but it seems to be growing in like billy-o so my scalp isn't showing. I have loads of tiny baby hairs in my hairline, esp at my temples, but hey, it's hair, so as long as it keeps coming in I am grateful.

[Aurealis]

I've never had a TSH that high on T3 /T4 combo, so GP should be grateful!. Your results don't matter more than how you feel. What time of day did you have your test as TSH is highest earlier in morning? Looking at the numbers, perhaps your T3 is a bit high, especially as there was 24 hours since your last dose. T4 may be too low even though you're on T3. So balance could be out. I would advise you against changing both at the same time as it makes me feel that the world has gone upside down. The tests are of limited help aren't they? Follow your instinct pb xx

[puncturedbicycle in reply to Aurealis]

My blood was drawn around 10am. Their earliest appointment is 9:30; mine was 9:35.

Thanks for your input. T3 was so good for me when I started taking it that I'm often inclined to take more to feel better but it doesn't work that way. I had wondered if I needed a little more t4 as it had been virtually halved last time meds were adjusted, but I began to tweak it upward and haven't noticed a difference. I used to feel very anxious when my t4 was reduced but I don't feel a lot of generalised anxiety now. My agoraphobia is pretty bad, but it waxes and wanes so it's hard to know whether or not it's my meds.

My pulse doesn't react to subtle changes so it's hard to know when I'm on too much or too little meds. It is already generally 80ish bpm and I worry about it being much higher. My gut is a pretty reliable barometer and so far no diarrhoea, so that's something.

The thing is, I feel so bad now, if I raise my dose and still feel bad - or eventually feel worse - I will worry that I've overdosed, even if that's not the case.

I do hate the way t3 makes the tests so difficult to read. I'm really confused.

[Hennerton in reply to puncturedbicycle]

Do you ever take your temperature? For me, it is the best guide as to whether I need more of anything. I was on T3 only last year, using Paul Robinson's book and he advocates checking temp regularly, especially when changing a dose. Mine is much more stable now that I have added Armour to the mix. It might help you decide...just wish I could get my basal temp up but apparently in some people it never become normal again.

[T3sortedme in reply to Hennerton]

Puncturedbicycle - the above from Hennerton shows how we are all a bit different and so have to try things over a period to find what works for us. I was on T4 and that did not work at all even when TSH was 0.05. I added T3 and reduced T4 and felt a lot better (mentally especially) but still not right. I went to T3 only and was very quickly well. It seems that my body made reverse T3 (rT3) from the T4 which blocked access of normal T3 from getting to the cells to generate energy. T3 is a big discipline though - same doses at exactly the same time every day without variation. So that worked for me. But that did not work best for Hennerton who is better with some T4 and is just as likely the case for you.

It does take time to work out the best for each of us. I just described 4 years work in my case! When you change a dose, take at least 3 or 4 weeks before the next step as everything takes time to settle and the body's other cycles to adjust. If you move too quickly you will get confused as to what works. You need long enough each step to know if on average it made you feel better or worse (or it had no effect). I go entirely from how I feel over a period and not from blood results as T3 messes all that and it does not really tell you what is in the cells in any case. If you get a virus e.g. cold ignore how you feel for a few days before the cold shows and a few days after. Also stress and high activity levels can make us feel more hypo.

If you were abroad for a while, have you considered if you have picked up anything e.g. amoebic stuff from water etc. If you were well before and not now, it is worth considering

[Aurealis]

I find that my brain is the best guide. If I can sit and read and concentrate it's not too high. If I fall asleep reading or struggle to read, then it's too low. But I get lots of other signs too - anxiety depression insomnia, chest pain, breathing difficulties, constipation etc etc

[jeanniex in reply to Aurealis]

Hi do you get those signs when you're low (anxiety insomnia etc etc ... I'm 'suffering' with some of those now is it the T3 or T4 that's too low that causes your symptons I'm on combination 100/20 daily

[sazzyb]

Hi PB, I remember reading somewhere (I think it could have been Dr Lowe) that a supressed TSH is NOT the same as a low TSH. It stuck in my mind because mine is always low and often below range. Thankfully my GPs ignore it because the lower mine is the better I feel.