Help understanding my blood results!!??

[jayles182]

My GP referred me to a endo on my first diagnosis due to my age/size/severity of condition and was declined, fortunately he sends my bloods to an endo to look at and advise what action should be taken.

I suffer from under-active thyroid and was previously on Levothyroxine (175mg maybe slightly more i think) for several months however it disagreed with me so requested Liothyronine and have been on that (and feeling pretty damn good) for 3-4 months now.

Sadly, i am new to the blood test game and 80% of the time am clueless as to what they mean!! I request them to be printed off religiously so i can have a look myself.. but googling medicinal things always seems to come out with a much more scientific or acedemic answer than my mind can handle. Any explanations (literally just the bare bones of what it means and whether things are good/bad/improving) and i wouldl be enormously grateful!

So here goes:

Serum TSH level >100/mu/L (normal range 0.35-5.0)

Serum free T4 level <3.2 pmol/L (normal range 7.0-20.0)

note beside this from endo- very raised TSH indicates under-replacement, I see that her TSH was 0.9 in June.

Mean corpuscular volume (MCV) 76.9 fL (normal range 80-100)

Mean corpuscular haemoglobin (MCH) 25.6pg (normal range 27-32)

Red blood cell distribut width 22 (normal range 11-14.5)

These are the ones that were flagged up anyway, just seeing if anyone can go some way to clarify all this, a- because i have over a week and a half before i can actually see my GP and b- because i like to have some knowledge myself and learn to understand it all!

Thanks!

[Clutter]

Jayles, When were the thyroid tests done? TSH>100 and FT4 <3.2 is overtly hypothyroid. Was this at initial diagnosis? TSH 0.9 suggests you are optimally medicated but it would have been useful to see FT4 too.

I think, but I'm not sure, that low MCV and low MCHC may indicate iron deficiency anaemia and large RDW may indicate B12 and folate anaemia or pernicious anaemia. If you don't get more infomed replies here on TUK post the results on the HU PAS forum and they'll advise.

labtestsonline.org/understa...

[helvella Administrator Thyroid UK in reply to Clutter]

High RDW often means having BOTH iron deficiency AND low B12 / folate at the same time.

[Clutter in reply to helvella]

Thanks, Rod

[jayles182 in reply to Clutter]

the ones i just wrote up were a blood test from last month, when i was unmedicated my first blood test showed TSH>100, then on levo it went to 0.9 which i'm told its normal. now i am on Lio its showing 100 again.. does this mean i am taking too much?

[Clutter in reply to jayles182]

Jayles, no it means you are very under medicated. What dose Levothyroxine were you on when TSH was 0.9 and what dose Liothyronine are you taking?

[jayles182 in reply to Clutter]

How strange! I have lost a lot of weight and am feeling super energetic, thought I might've been over medicated before I got these results! I think 125 or 175 Levo.. Now I take 20mcg of lio

[Clutter in reply to jayles182]

Jayles, 20mcg Liothyronine (T3) is equivalent to 60mcg Levothyroxine (T4) so you would need 40mcg T3 if you were on 125mcg T4, or 60mcg T3 if you were on 175mcg T4.

I'm surprised you have any energy at all and that you've lost weight with your TSH so high. It's not good as it can put a strain on your heart so please see your GP and get your dose increased even though you appear to be feeling well. TSH over 20 has also been shown to impair driving reactions more than being over the drink drive limit so please be cautious.

[jayles182 in reply to Clutter]

Thankfully I do not drive! But thank you so much for clearing this up I have a doctors appointment booking for week after next and should sort it then. God knows why I hadn't been on a higher dose months ago if those are the equivilent measurements between the two drugs...!

[Clutter in reply to jayles182]

Jayles, equivalences have varied considerably over the years but latest research estimates T3 is 3 x stronger than T4.

ncbi.nlm.nih.gov/pubmed/204...

[galathea]

So, it looks like you need iron and b12 and maybe some more thyroid meds. However with low iron and b12 you can't make use of your thyroid meds... This might be the reason for the raised t s h. The thyroid stimulating hormone ( tsh) is rising to try and get your thyroid to make more hormones.

How much Liothyronine are you taking and has the free t3 been tested? If not your doc should request it and write "taking Liothyronine" on the test request slip.

G x

[Glynisrose]

What do you mean 'declined' by whom? You can make an appointment at the endo's clinic with a referral from a GP.

[jayles182]

GP referred me, endo decline because they have to many patients. My GP does his best and sends my results to an endo for advice if needed

[trevg]

Jayles- good advice given here. Is there another Endo you can get referred to? If your GP is supportive that's good but it can't just hang there. You need an Endo to suggest the right T3 dosage.

There's obviously something adrift -though you're a big way to fixing it by the sounds of it.

Check the Thyroid UK list of helpful endos in your area [if you contact the admin there] and push GP for one as near as you can get.