Help with test results please.

[dizzy864]

Hi, I've just got my latest blood results and they're very different to previously.

Free T4 15 ( 9 - 19 ), Free T3 13.9 ( 3.6 - 6.5 ), TSH < 0.01. I was told that in the past T3 and T4 were tested and not Free T3 and Free T4. I don't know what the difference is.

I was tested on 31/12/14 T4 11.7 (9.9 - 19.2 ), T3 6.27 ( 3.6 - 6.5 ), TSH < 0.01 and

14/02/14 T4 15.2 ( 9.9 - 19.2 ), T3 not tested, TSH < 0.01

Diabetes in the normal range, Glucose in the normal range

I was diagnosed Vitamin D deficient three years ago and on a daily supplement for that.

These results are the opposite way round to what I published before - there was a misunderstanding with the results line.

A little bit of my history may be helpful. I was diagnosed hypo approx 17 years ago and prescribed levothyroxine. After initial variations in dose, I have been on 100mg a day since.

My symptoms were not controlled and approx 11 years ago, I was prescribed 20mg liothyronine a day in addition to levo. My symptoms improved a bit but not completely. Eight years ago I was put on 3 x 20 mg liothyronine a day. I have remained on this dose since. I have seen various GPS, all of whom want me to reduce my liothyronin because my TSH has been suppressed for years. I don't understand why GP should be insistent on me reducing lio when my T3 result was in the normal range.

I have never been completely free of symptoms - I run on warm, very prone to head aches and problems with sudden drop in blood sugar and very dependent on eating every 3 1/2 hours. I took this as normal for someone hypo as I'd always been like this.

I was very unwell November through January. I'd had another letter from my GP telling me I was over medicated. I thought my being unwell could be due to this. I cut down to 8 tablets of liothyronine instead of 9 every three days. I became really ill. I then read there were problems with batches of liothyronine and I had been taking two of them. I resumed my previous dose of liothyronine and made sure I avoided the three problem batches.

I am not as ill as I was but have not got back to what I was prior to November. I have a constant head ache - it does not respond to pain killers. I've got no energy. I'm a lot more hungry. In spite of eating small amounts of food six times a day ( at least every 2 1/2 hours ), it's not enough. I've been suffering badly with water retention and puffy fingers. My memory is non existent and I'm not "with it" all the time. My husband talks to me, I know he's talking to me, but I've no idea what he's saying a lot of the time - He might as well be speaking double Dutch! I'm really spaced out. I just can't concentrate on anything.

I saw a new GP on the 8th. She agreed ( reluctantly ) to increase my levo to 125mg a day and I had a blood test. I've been taking 125mg levo since Monday - results are promising but it's too soon for a definite result.

I would really appreciate some help with understanding my results - I did not think T3 could increase so dramatically with no change in medications. I don't understand why T4 should go down and then up.

I've got a telephone consultation on Monday with the GP. I'm hoping she's not going to just look at my high free T3 and order me to reduce lio.

As far as I know I have not had any other tests done.

I'd be very grateful for any help or suggestions.

[Clutter]

Dizzy, Suppressed TSH doesn't indicate overmedication but over range FT3 does. Your FT3 is more than double the top of range. This may explain why you feel too warm, have headaches and need to eat frequently.

I think you should brace yourself for either a reduction in Levothyroxine or Liothyronine.

thyroid.about.com/od/thyroi...

Has vitD been retested since you started supplementing 3 years ago?

[dizzy864 in reply to Clutter]

Hi,

My vitamin D levels were checked in February. I was told they were in the normal range. I think this is the only test I've had since being diaganosed.

I last tried lowering levo about 10 years ago following a blood test. Two and a half weeks later, I had become really ill, I asked GP to put me back up - he refused. After 4 weeks, I had gained over a stone, had another blood test, saw a different doctor. I was told that my levels were now dangerously low and needed to be put up immediately. I have not lowered levo since.

I want to know first why my T3 has shot up. I've been on same dose for 8 years and don't believe this has happened before. I just read that It could be due to a problem with a particular batch of liothyronine or Levo being more potent than normal or just a change in brand. I get different makes of levo every time - something it says shouldn't happen. There are regular problems with liothyronine.

I have changed my diet a bit this year. My vitamin D deficiency went untreated for many years and as a result I have a lot of muscle wastage on my thighs and the top of my arms which causes me pain etc. I was advised in late March by my physio to increase my protein in-take to help with muscle regrowth. This I have done. Does anyone know if this can affect thyroid med absorption? I've read that a high fibre diet can affect this. I couldn't find anything on the affect of protein increase.

I am going to refuse to make any changes to my meds until I return from my German holiday. I am also going to ask for the blood test to be repeated. Although, unlikely it may be an error with the test or just a change in lab. I know my surgery uses more than one lab for it's testing.

[Clutter in reply to dizzy864]

Dizzy, Change of diet can certainly improve absorption of thyroid meds.

If your results were suboptimal 10 years ago reducing dose will have had the effects you describe. It shouldn't be the same now because dose will be adjusted to bring your FT3 into range which will be optimal.