Latest blood results with ranges.

[zebady]

Got ranges now, but am still perplexed. Any help is gratefully recieved

To clarify thyroid stimulating hormone is 0.02. (0.3-5.5) mlu/l

Free thyroxine 28 (9-25) Pmol/l

Free tri -lodothronine. 5.6. (3.5-6.5) Pmol/l.

Again . Thankyou for your help

I Still feel ill.....

[gabkad]

Looks like your liver is doing its job. That's where T4 is primarily metabolized into T3. Your fT3 is fine but your Ft4 is high, over range. The T4 is stored in the kidneys so.....

At 300 mcg levothyroxine per day........reduce the dose. Skip all meds for 4 days and then go down to 250 mcg. Get checked out in 6 weeks. It's a slow blasted process to get to where a person feels good. YOu may need a lower dose than 250 mcg but changes need to be gradual or you could end up feeling worse than you are now.

You ought to feel better when fT4 is high in range (i.e. 18 to 20) and fT3 is where it is now.

[zebady in reply to gabkad]

Thankyou. Bless you. You are very kind.

[shaws Administrator]

Did you leave approx 24 hours between your dose of levothyroxine and the blood test. Was it the earliest appointment and did you fast?

[zebady]

To shaw. No, no and no I did not leave 24 hours . I did not fast. And it was around 1 o'clock. I had no direction from the endocrinologist, I had no instructions. Does that mean that these results are obsolete

[gabkad in reply to zebady]

Probably the TSH would be a bit higher, maybe. I've done the fasting first thing in the a.m. and not taking the thyroxine and on another occasion taking it. The only difference was 1 unit on the fT4. It was 18 when I took the thyroxine 4 hours before the blood was taken and 17 when I had not taken it since the previous morning. I don't think this is significant at all. fT3 was identical on both occasions. I think when someone is taking thyroxine, because it has such a long half life, it makes no significant difference taking it or not taking it before a blood test. I am a contrarian in this respect on this forum. But I've done it one way and the other. Seen it for myself. When taking Liothyronine, yes, timing does result in significant differences in fT3 levels.

For diagnostic purposes when someone is hypothyroid and not treated, then getting the TSH reading as early as possible in the morning is a good idea. TSH is highest in the a.m.

Someone taking only thyroxine (T4) would not have fluctuating fT3 levels.

Your results are not obsolete.

[Clutter in reply to gabkad]

Gabkad, I think you are an outlier, taking Levothyroxine a couple of hours before a blood test can cause a huge spike in FT4 and FT3. Clarebear's FT3 was 15 2 hours after taking 2.5 grains and 5 when she left 24 hours between last dose and blood draw.

[gabkad in reply to Clutter]

2.5 grains is NDT. Levothryoxine keeps fT3 steady state. That's what's it's known for.

I had fluctuations when I was also on T3. I figure my fT3 levels were going up and down daily from about 4.6 to 5.6.

No fluctuations of fT3 when on thyroxine only even if I skip a dose. Only the fT4 went down by one. I can't honestly remember what happened to the TSH but mine is sluggish anyway.

Based on that, I think it ought to be taken more than once a day but that's just my 'feeling' since if i only take it in the a.m., I get a major 3 p.m. slump in energy. Tried it for a week last week adding a small amount and nah, unless I take two doses per day, it's not for moi.

[Clutter in reply to gabkad]

Gabkad, doctors can tell when a normally non-compliant patient wolfs down T4 before a test because FT4 shoots up but TSH remains static ie high because it takes time to respond to fluctuating T4 and T3 levels.

[gabkad in reply to Clutter]

Clutter, I don't understand non-compliance especially when it comes to thyroid medication. So much depends on taking it every day.

[Clutter in reply to gabkad]

Me neither, Gabkad. I know some people can't seem to tolerate any thyroid hormone and can believe a lot don't feel well on Levothyroxine, but I can't believe that is why the majority are non-compliant.

[greygoose in reply to gabkad]

I think a lot of people Don't understand how important it is, because doctors just Don't explain. And if they Don't do any reading themselves, or find a support group, how are they supposed to know?

[Clutter]

Mike, In what way are you feeling unwell? FT3 5.6 is good so you shouldn't be feeling hypo.

FT4 is likely to be over range because you took Levothyroxine before your blood draw. You might mention it to your endo if FT4 is commented on. Take Levothyroxine after the blood draw in future. If I'm correct in thinking you had thyCa and TSH is to be kept suppressed, you don't have to worry about dose being decreased due to low TSH, so there's no need to worry about early morning fasting thyroid tests.

I recommend you ask GP or endo for ferritin, vitamin D, B12 and folate to be tested. I was severely vitD deficient, folate deficient, had low B12 and very high ferritin 15 months after thyroidectomy and RAI x 2. I'm half wondering as I type this whether RAI destroys nutrients as well as thyCa cells.