Can anyone explain please.

[beaton]

Further to last post about return of symptoms, I had a blood test and got the results today.

I'm on 60 mcg. T3 only.

June results marked as ok :-

TSH 0.139 (0.35-4.5 )

T4 0.3 (11-24 )

T3 5.2 (4 - 6.8) Felt fine at this point.

Sept. results :-

TSH 0.354

T3 3.9

No T4

So why are the results "normal" now that the symptoms have returned while I was feeling fine on "abnormal" results.

I have been refered back to the endo.

[shaws Administrator]

Its always best to go by how we feel, rather than the blood tests.

Did you get the blood tests as early as possible, fast and have the last dose of thyroid hormones about 24 hours before the test?

The fact that your T3 is much lower in Sept is a puzzle so I would have thought you needed an increase in T3.

The first answer might be helpful:

web.archive.org/web/2010103...

[beaton in reply to shaws]

Hi Shaws, thanks for responding.

I did not take meds. on the day of the test. I had an appointment with Dr/Nurse and hoped she would agree to test. I had my bloods done at our drop in hub in the evening, having had to explain yet again. So I had not had meds. and nothing to eat since lunch. (7hrs. )

At the hub they told me the Dr/Nurse had already asked for a referral back to endo.

[shaws Administrator in reply to beaton]

The best time to have a blood test is to have the earliest in the morning.

When they tell us that our bloods are 'normal' it is meaningless. For instance the range used by your lab is (0.35-4.5 ) so even if your TSH was 4.5 it is 'normal'. The TSH is lowest in the morning and changes throughout the day. They don't take into consideration the patients remaining symptoms.

Before the blood tests were introduced around the late 50's I believe they had taken blood from a mixture of people and they didn't exclude those who might have been hypo so the result is mixed.

By reducing your levo it made your T3 drop (whereas the test before it was higher and you felt well and T4 is supposed to convert to sufficient T3 to eradicate symptoms. T3 is the Active thyroid hormone that goes into our cells and T4 is really a pro-hormone - if it doesn't convert sufficiently to T3 we will have symptoms.

If your TSH is low or very low they will usually reduce levo to bring your TSH higher. Dr Toft says some of us need a low or suppressed TSH but doctors are unaware of this.

For those of us who have been diagnosed they still use the same blood tests and adjust the TSH according to the normal range even if it is at a high point (around 5 with symptoms) even though we are already hypothyroid. If someone has awful clinical symptoms of hypo the doctors wont prescribe until the TSH reaches 10 - if it ever does.

[beaton in reply to shaws]

Thanks Shaws.x

[Clutter]

Beaton, your June results weren't abnormal. FT3 was good and TSH low because pituitary detected sufficient T3. FT4 was low because you are taking T3 only and don't need T4 for conversion when you take T3 direct.

September FT3 is low which is why you feel unwell now, and TSH has risen because pituitary isn't detecting sufficient T3 and is stimulating the thyroid gland to produce more hormone. You need to increase T3 dose until FT3 is back to 5.2.

[beaton in reply to Clutter]

Thanks Clutter. The June results were marked as ok when they came back, with a note from the biochemist saying T4 would be low as she remembered I was on T3 only. The new Dr/Nurse was working from them and has made a referral to endo. but refused a blood test, so I went for one anyway, not only for my own peace of mind but also because I thought she would refer me.

Just to add, today when I explained my low night temp. (34.5) she said, "Your body temp. doesn't change, you just feel cold."

Perhaps it's as well she referred me.

[Clutter in reply to beaton]

Beaton, she won't have been trained to use temperature to make a clinical diagnosis. Stupid comment though, on that basis a patient with a raging fever has normal temperature but feels hot.

[beaton in reply to Clutter]