TSH still high even on T4? Also High MHCH

[mlc2009]

I had my bloodtest as I'm on lamisil at moment and wanted to monitor my liver. I also take 100mcg of T4, however, my TSH is still quite high. Does anyone know what a high MHCH mean? My iron is fine, my liver is fine.. do my platelets look quite low? worried.. but I'm a worrier

FULL BLOOD COUNT HAEMOGLOBIN (g/L) 158 g/L 130 - 170

HCT 0.432 - 0.37 - 0.50

RED CELL COUNT 5.14 - 4.40 - 5.80

MCV 84.0 fL 80 - 99

MCH 30.7 pg 26.0 - 33.5

MCHC (g/L) 366 g/L 300 - 350

HRDW 12.7 - 11.5 - 15.0

<b>PLATELET COUNT 151 - 150 - 400 </b>

MPV 10.9 fL 7 - 13

WHITE CELL COUNT 3.98 - 3.0 - 10.0

Neutrophils 58.7% 2.34 - 2.0 - 7.5

Lymphocytes 30.7% 1.22 - 1.2 - 3.65

Monocytes 7.3% 0.29 - 0.2 - 1.0

Eosinophils 2.5% 0.10 - 0.0 - 0.4

Basophils 0.8% 0.03 - 0.0 - 0.1

ERYTHROCYTE SEDIMENT RATE ESR 2 mm/hr 1 - 10

ELECTROLYTES. SODIUM 143 mmol/L 135 - 145

POTASSIUM 3.6 mmol/L 3.5 - 5.1

CHLORIDE 99 mmol/L 98 - 107

BICARBONATE 25 mmol/l 22 - 29

UREA 7.0 mmol/L 1.7 - 8.3

CREATININE 97 umol/L 66 - 112

BILIRUBIN 9 umol/L 0 - 20

ALKALINE PHOSPHATASE 60 IU/L 40 - 129

ASPARTATE TRANSFERASE 19 IU/L 0 - 37

ALANINE TRANSFERASE 22 IU/L 10 - 50

LDH 154 IU/L 135 - 225

CK 63 IU/L 38 - 204

GAMMA GT 28 IU/L 10 - 71

TOTAL PROTEIN 75 g/L 63 - 83

ALBUMIN 50 g/L 34 - 50

GLOBULIN 25 g/L 19 - 35

CALCIUM 2.58 mmol/L 2.20 - 2.60

PHOSPHATE 1.06 mmol/L 0.87 - 1.45

URIC ACID 326 umol/L 266 - 474

RANDOM BLOOD GLUCOSE (FL) 5.1 mmol/L 3.5 - 7.9

TRIGLYCERIDES 1.3 mmol/L < 2.3

CHOLESTEROL 4.9 mmol/L Optimum <5.0

IRON 14.5 umol/L 10.6 - 28.3

T.I.B.C 51 umol/L 41 - 77

TRANSFERRIN SATURATION 28 % 20 - 55

CORRECTED CALCIUM Corrected Calcium 2.50 mmol/L 2.20 - 2.60

HDL CHOLESTEROL HDL CHOLESTEROL 1.0 mmol/L 0.9 - 1.5 HDL % of total 20 % 20 and over

LDL CHOLESTEROL 3.3 mmol/L Up to 3.0

THYROID STIMULATING HORMONE 5.57 mIU/L 0.27 - 4.2

FREE T4 FREE THYROXINE 23.5 pmol/l 12.0 - 22.0 H

[Clutter]

Mic2009, Your FT4 is mildly elevated and not dangerous but it's not common to have high TSH too. High TSH and high FT4 can indicate resistance to thyroid hormone or TSHoma which is a benign pituitary adenoma. I think FT4 would be higher if it were the latter and some resistance is more likely. Ask your GP for a referral to endocrinology. You can email [e-mail] for a list of member recommended endos.

MCHC is mldly elevated and a one-off abnormal result is unlikely to be significant when other red blood cell count is within range. Platelets are within range and may be low if you had a virus at the time of testing.

This link explains possible causes of low/high values in a full blood count. They tend to report possible causes for significantly high/low values so you shouldn't worry about your results.

labtestsonline.org/understa...

[mlc2009 in reply to Clutter]

Thank you Clutter. I stopped taking the T4 3 days before the test actually as I didn't want to skew the results, could that explain the high TSH ( rebound ) and high free t4 result?

[Clutter in reply to mlc2009]

Mic, 24 hours between last dose and blood draw is ample time to get a measurement of normal circulating levels. I think you may have slightly skewed the TSH result, and high TSH will stimulate T4 production which may be enough to push FT4 over range. I doubt 3 days off T4 will account for such high TSH though when FT4 is high in range.

[mlc2009 in reply to Clutter]

I have battled with my thyroid for many years, my past posts show multiple lab work. I usually have slightly over range TSH, in range FREE T4 AND FREE T3. I tested reverse T3 once and that was high too, perhaps it explains. However, sourcing legit T3 to clear the reverse t3 is a hassle, and as you know, uk doctors.. no help

[Clutter in reply to mlc2009]

Mlc, rT3 may result in high or low FT3 but I don't think it makes TSH high. It can take up to 3 months to clear high rT3 on T3 only. The smaller the dose you can manage on will speed up clearance.

100mcg T4 is equivalent to 33.33mcg T3 if you switch. It may be better to start on 18.75mcg T3 for a week to see how you tolerate it and let the T4 wash out to avoid feeling overmedicated. You can then increase to 31.25mcg if necessary.

[mlc2009 in reply to Clutter]

I have tried t3 only in the past, it doesn't make me feel any different. I have sourced it from a popular mexican drug store, but its like sugar pills

[Clutter in reply to mlc2009]

Mlc, when I had a build up of T4, which I know now is likely to be high rT3, I felt no different on 120mcg or 60mcg T3. Theory is the high rT3 blocks T3 from receptors and it isn't until the rT3 clears that T3 will hit the receptors. It is borne out by people taking very high doses of T3 without feeling hyper. However, rT3 can clear suddenly and people will feel hyper and need to reduce T3 dose by as much as two-thirds.

Grossman appear to have ceased production of Mexican Cynomel.

[mlc2009 in reply to Clutter]

do you have any suggestions for sources of T3?

[Clutter in reply to mlc2009]

mlc, I sent you a PM 30 minutes ago.

[mlc2009 in reply to Clutter]

Thank you

I see my LDL is slightly elevated, will thyroid medication help with this?

[Clutter in reply to mlc2009]

Mlc, it should if it is elevated due to undermedication. If you Google Dr. McKendrick you'll see why there's no reason to worry about cholesterol levels.

[faith63 in reply to Clutter]

Thank you for the info on Dr. McK..very reassuring.

[Clutter in reply to faith63]

Faith, I'm surprised you haven't come across Dr. Kendrick's blogs before. I think you'll like this drmalcolmkendrick.org/2015/...

[faith63 in reply to Clutter]

No, i have never seen them! You do learn something new every day, don't you?

Thanks..i will check it out.