Tipped into hyper on thyroxine?

[Bluemallers]

Hi - would really appreciate your verdicts on my latest blood test results. I had them done through finger prick test at Blue Horizon and finally had the whole shebang tested as I've never had antibodies or Free T3 tested before. I've been on 175mcg of thyroxine for about 18 months if not longer. Newest blood results show I'm hyper (although don't feel hyper, if anything hypo):-

SEPT 2015

TSH 0.20 (0.27 - 4.20)

Free T4 24.27 (12-22)

Free T3 5.57 (3.1 - 6.8)

T4 Total 120.3 (64.5 - 142.0)

Anti-Thyoidperoxidase abs 7.0 (<34)

Anti-Thyroglobulin Abs 14.5 (<115)

JUNE 2015

TSH 0.17 (0.35 - 5.00)

Free T4 16.3 (9.0 - 21.0)

MAR 2015

TSH 0.03 (0.35 - 5.00)

Free T4 19.0 (9.0 - 21.0)

OCT 2014

TSH 0.02 (0.35 - 5.00)

Free T4 18.6 (9.0 - 21.0)

I've had consistent low ferritin (hovering around 12) but am now supplementing every day. I also take B complex and Vit D. Any insights much appreciated. So it looks like I don't have Hashi's? Many thanks.

BM

[Angel_of_the_North]

How do you feel? Your results look good. Although your FT4 is slightly over range, your FT3 is only 2/3 of the way up the range. So unlikely to be hyper.

[Legion in reply to Angel_of_the_North]

I agree with the above. If you don't have hyper symptoms, then you're not hyper. Your T3 is well within range.

[Bluemallers in reply to Legion]

Hi Legion - yes I don't feel hyper but worry about whether it is damaging long term to have high free T4. the note from Blue Horizon stressed it was a hyper result and i should go and see my doctor but I don't want my doctor to reduce my dose. What I don't understand is why my T4 would have gone up so much - I've been on the same dose for ages?

Thanks for replying.

BM

[greygoose in reply to Bluemallers]

Because you're not converting it properly. You need to reduce it, but only if you can add in some T3 to bring up the FT3. You still have hypo symptoms because your T3 is too low for you. But you are in no way 'hyper' (over-medicated), your TSH isn't even suppressed. That was a stupid thing for Blue Horizon to have said. 'Hyper' is when your FT3 is over-range.

You're right about not wanting unconverted T4 slopping around in your blood, though. That can cause symptoms (but not permenant damage). But if you lower your Levo, your T3 will go down, and you will have even more symptoms. You need to take some T3.

[Bluemallers in reply to greygoose]

Hi GG - thanks for your advice. I'm querying Blue Horizon as I've just had my results back from the GP for thyroid tests which were done 3 weeks prior to the Blue Horizon one. My free T4 was only 16.2 on this test and I can't believe that within 3 weeks my free t4 has shot up to 24. I've been on the same dose for 2 years and the blood tests were both fasting and both at the same sort of time. Seems very odd to me. What do you think?

BM

[greygoose in reply to Bluemallers]

Well, it's not unusual for there to be a discrepancy between NHS tests and private tests, but that does seem a bit exaggerated. Best to query, I think.

[Bluemallers in reply to Angel_of_the_North]

Hi Angel - I didn't get a notification you had replied - so sorry if that looked rude! I feel ok-ish - I'm planning on changing to NDT if I can. It's weird my free T4 has shot up so much. I definitely don't want to drop my dose. It's hard to compare it to previous readings because I've never had Free T3 done before. I do feel that long term thyroxine isn't having a good effect on my body. My blood pressure is rising, and heart rate and cholesterol.

So is the free T3 a good result?

Thanks very much.

BM

[foreversummer]

Did you remember not to take your levo before the latest blood test? My FT4 went significantly higher when I had taken my levo a few hours before.

Foreversummer

[Bluemallers]

Hi Forever Summer,

I didn't take thyroxine before the test I always do it as a fasting blood test no meds. What is even stranger is I've just had my GP NHS thyroid blood test results back and they were only done a couple of weeks before and my Free T4 was 16.4 and TSH was 0.4?? I don't see how it could jumped so high in just a couple of weeks. I wonder if the finger prick test was a bit corrupted?

BM

[greygoose in reply to Bluemallers]

Bluemallers, you should click on the orange 'Reply' button Under the comment, to reply to someone, and they will get notification that you have replied. If you just leave a reply in the comment box at the bottom, they won't know you've posted.

[Bluemallers in reply to greygoose]

Wah - I get really confused with this forum. I have been hitting reply under their comments? Often I'm not notified if someone has responded. All very strange. I've just replied to you.

BM

[greygoose in reply to Bluemallers]

Yup! You've just replied to me. Twice. And I was notified. But you didn't do the same for foreversummer. lol I know, it can be very confusing. Plus things often go wrong, and responses disappear... Gremlins, I suspect!

[Bluemallers in reply to greygoose]

Thanks - I'll get the hang of it. I've queried result at Blue Horizon so will see what they say about discrepancy in Free T4 result.

BM

[greygoose in reply to Bluemallers]

Great! Let us know what they say.

[Bluemallers in reply to greygoose]

I will do

[Bluemallers in reply to greygoose]

So I've heard back from BH - I'm still not convinced as to the explanation for very high free T4. What do you think? They first came back to me and said that the TSH was suppressed as well and that showed that i was producing too much thyroxine. I emailed back saying that my TSH has been suppressed for a long time like this and my free T4 has never been that high. So they responded with this:-

''If the TSH has not changed much, that is important, as TSH is a more reliable indicator of overall thyroid function than T4. T4 (and T3 levels even more so) are more likely to vary in the short term than TSH levels.

Sampling error is always a possibility - but if the TSH is similar that would be a less likely possibility.''

I just want to be assured that there blood tests are accurate and that the blood collection through finger prick is adequate. Otherwise there's no point in doing them.

I'm not knocking BH, I think it's great what they do, as we could have very little chance of getting these tests done anywhere else for the price. But I do query that particular result.

BM

[greygoose in reply to Bluemallers]

Well, I find that very doubious. We all know that the TSH is in no way a more reliable indicator of overall thyroid function. And it varies all the time. So, for me, that BS from BH!

[Bluemallers in reply to greygoose]

Yes I agree - odd choice of words and just wrong. I can see why they would say that the test is unlikely to be skewed because the THS is roughly the same as my NHS result from a few weeks ago. However I still find it very weird the Free T4 has shot up so much.

I suppose I'll never know! It's all so hit-and-miss. It feels like you just take your chances out there in every respect

[Legion in reply to Bluemallers]

Interesting that you did the finger prick test, and it will be interesting to hear what BH have to say. I couldn't get the finger prick test to work. I just wouldn't bleed!

[Bluemallers in reply to Legion]

I know the finger prick test is a real pain. I get the sweats every time I do them. They are really hard to do. I tend to drink lots of water before doing them, then dunk my hands in warm water to get blood flow going and then do the test standing up. It takes at least half an hour to milk enough blood from a couple of fingers. Ergh it's pretty horrible.

I'm really sceptical about my Free T4 result being right and not a lab error. I was getting a bit frustrated with Blue horizon yesterday as I queried why my NHS results had free T4 much the same as it has been over past year and the BH one was so high. They came back saying that as TSH was suppressed it wasn't unusual to have high free T4 as the results show I might have started producing too much thyroxine. The doctor who responded said that if the 'trend' had changed in my blood test then it's unlikely to be a lab error. However, as I'd pointed out to them my TSH has been suppressed for a long time on the same dose of thyroxine - so I already have a 'trend' in my levels. The free T4 result was the weird anomaly that I'm querying. I don't think they quite understand my point - do you think I'm being clear?

BM

[Legion in reply to Bluemallers]

That seems clear to me. Did you phrase it like that? I've generally had a good experience dealing with BH, but I do find that some people are more sympathetic/understanding than others. I had one lady who did her best to find me a phlebotomist locally (no joy, hence trying the fingerprick method) but the chap I spoke to the next time certainly didn't go out of his way.

[Bluemallers in reply to Legion]

I'm not entirely satisfied with their last word on the results TBH. I don't see how my Free T4 could be that high when it's a matter of weeks apart from my NHS test and done under the same time and circumstances. Seems very odd to me. Why would Free T4 suddenly shoot that high after being the same for a long time on the same dose?