Blue Horizon test results

[Angie7]

Hi I'd be really grateful if someone could help me interpret these results. I'm currently on 100 levothyroxine but still feel ill and I have had half my thyroid removed previously due to nodules and I have a small nodule on the remaining half.

ENDOCRINOLOGY

THYROID PROFILE 2

TOTAL THYROXINE(T4) 101 nmol/L 59 - 154

THYROID STIMULATING HORMONE 1.41 mIU/L 0.27 - 4.2

FREE THYROXINE 17.7 pmol/l 12.0 - 22.0

FREE T3 4.8 pmol/L 3.1 - 6.8

IMMUNOLOGY

THYROID ANTIBODIES

Thyroglobulin Antibody 11.5 IU/mL 0-115(Negative)

Method used for Anti-Tg: Roche Modular

Thyroid Peroxidase Antibodies 6.8 IU/mL 0 - 34

Method used for Anti-TPO: Roche Modular

[PinkNinja]

For someone who is already on treatment, the TSH is often better below 1 with T4 at the top of the range or even slightly above in order to get your T3 to a good level. There was a paper in Pulse magazine about that some time ago. Louise Warvill may have a copy of it if you need backup.

Although you still have half a thyroid, there is a good chance it is no longer doing very much which will mean that you may need just as much thyroxine as someone with little or no thyroid. An increase may well be what you need to feel better.

It is important to make sure that everything else is in order and it would be worth testing serum iron, ferritin (aiming for 70-90 is advisable), folate (above 12 is good), vitamin B12 (optimally above 500), vitamin D and cortisol. The cortisol is of limited use as it is a random sample but it can be an indication of whether further investigation is required. Optimal levels of all of the above will help with your body's ability to convert and use thyroxine.

I hope that helps a little.

Carolyn x

[Angie7 in reply to PinkNinja]

Thanks Carolyn. I dont know what the top of the range is for T4, i cant find the ranges anywhere. Its a familiar story with my gp i asked for full thyroid profile and blood count and ferratin/iron. They just did tsh no ferratin. They told me my thyroid is fine based on that test, which is why i went and got one privately. They did tell me i have vit d deficiency though and i am on vit d tabs for 8 wks. I also have bladder probs interstitial cystitis and fibro but i feel its all related to my thyroid, but i cant convince my gp of that no matter which one i see they cant be bothered

[PinkNinja in reply to Angie7]

I agree with you. I personally, in my non-expert opinion, think you would benefit from trying a higher dose of thyroxine. The guidelines from the British Thyroid Association (which are generally pretty useless) do state that some patients may need fine tuning of dose whilst keeping the TSH within range. As yours is above 1, an increase may help. There is plenty of room for an increase whilst keeping your TSH in range.

Vitamin D deficiency can make you feel very rough. If you have fibromyalgia, the vitamin D deficiency is probably making the pain worse. It also makes you more prone to viral infections and probably bacterial infections too.

It may be worth asking for a referral to a thyroid specialist. After all, your thyroxine isn't helping so he should be referring you. Unfortunately some endocrinologists are even worse than the GPs but it's got to be worth a try. Or it may be worth asking for a trial increase of 25mcg followed by another blood test 6 weeks later to make sure your TSH hasn't dropped too far.

You still have symptoms and it is your doctor's duty to find out the cause of them, whether they be thyroid related or not. A trial increase is one way to find out if thyroid is the cause. Another way is for him to do the flippin' tests you asked him for! If he is convinced it isn't your thyroid he should be testing the other common causes of thyroid-type symptoms such as vitamin B12, folate, ferritin etc. If he won't do that, he's not doing his job.

Sorry your GP is so unhelpful.

Carolyn x

[Angie7 in reply to PinkNinja]

Thanks Carolyn. I dont know what the top of the range is for T4, i cant find the ranges anywhere. Its a familiar story with my gp i asked for full thyroid profile and blood count and ferratin/iron. They just did tsh no ferratin. They told me my thyroid is fine based on that test, which is why i went and got one privately. They did tell me i have vit d deficiency though and i am on vit d tabs for 8 wks. I also have bladder probs interstitial cystitis and fibro but i feel its all related to my thyroid, but i cant convince my gp of that no matter which one i see they cant be bothered