normal blood results

[thyroidnodules]

waiting on doc to phone back.  he says my results are normal.  tsh 3.7  t3 1.2 and t413.00.  Since my last results my tsh has improved slightly but my t3 seems to low to me and my t4 while slightly better than last time is still low.  my consultant at hospital seemed to think that I should be taking 75levo instead of the 50 I am currently taking.  my  doc says I amnormal however and he is calling me in the next 30 mins to discuss - any comments as soon as possible would be grateful for - thanks

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Hi, I'm still a newbie here, and you need to put the ranges too. However, if these where my results and based on my laboratory ranges, then my tsh would be too high, my t4 low and my t3 very low, indicating a need for an increase in levo. Others who know more than me will comment better. Not normal for me. Your consultant is more the expert not the gp. Good luck

[shaws Administrator]

Hi thyroidnodules,

There's no thyroid history in your Profile but I know you have been diagnosed with something as you are on thyroid hormones.

I'm sorry the reply is late as I assume your GP phoned you to discuss your results.

Your GP says your results  are 'normal' and they may well be for a healthy person without a thyroid gland dysfunction. If we are hypo we need our TSH to be around 1 or lower, certainly not 3.7 bordering 4!

If you've already had your conversation, either phone the surgery and tell/leave message for him. Tell him that you understand that Dr Toft, ex President of the British Thyroid Association, recommends in his Pulse Online(and you can email part of the article and the whole article next week) that:-

"6 What is the correct dose of thyroxine and is there any rationale for adding in tri-iodothyronine? 

The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range – 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This ‘exogenous subclinical hyperthyroidism’ is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).

Even while taking the slightly higher dose of levothyroxine a handful of patients complain that a sense of wellbeing has not been restored. A trial of levothyroxine and tri-iodothyronine is not unreasonable. The dose of levothyroxine should be reduced by 50µg daily and tri iodothyronine in a dose of 10µg (half a tablet) daily added.continue to complain that a sense of wellbeing has not been restored. "

Please note TSH to the lower part of the reference range – 0.2-0.5mU/l.

Say that if he would like the whole article you can email it to him

on Tuesday. Email [e-mail] for the whole article.

In some countries patients are prescribed when TSH is around 3. What's happened to your TSH. That's the mistake most doctors in the UK make - keeping a patients dose too low, resulting in a highish TSH with continuing disabling symptoms. Why do we, who may not even have any qualifications can suss out something's wrong but those who are 'qualified' don't understand the very basic. TSH is variable. 

Ask for an increase of 25mcg of levo and have another blood test in six weeks and another increase if you've not reached around 1. Unless of course your symptoms miraculously disappear and you don't even feel hypo any more. (sorry cannot do a smiley face).

[thyroidnodules in reply to shaws]

thanks for this Shaws.  I have been waiting on call from dr since 2.15 and so far he hasn't bothered to call- has until 6.00pm to call so I at least have the info to give him.  I just wanted to make sure that I understood my readings and that the t4 and t3 were low.  I have only 2 levo tablets left and the doc simply said my readings were normal and that was it.  I told the receptionist I had to speak to the doc re my new prescription based on my readings which in my opinion are not normal and she said she didn't understand it all just that my readings were normal.  I shall wait he calls me and if he doesn't I will complain and fight all the way tomorrow

[shaws Administrator in reply to thyroidnodules]

He should take notice of Dr Toft, who is the physician to the Queen when she's in Scotland (look how healthy she is - no doubt she's not hypo).

[Clutter in reply to thyroidnodules]

Thyroidnodules,

Ring your surgery now, to get more Levothyroxine or you may not be able to speak to a doctor and get a prescription until Tuesday.

If you can't get a prescription tonight ask the pharmacist who usually dispenses your Levothyroxine to give you a few tablets 'on account' until you can get a prescription next week.  It will be better to take 50mcg for a few more days and to press for a dose increase next week if necessary.

[thyroidnodules in reply to shaws]

hi shaws and clutter - well waited in all day for doc to phone and he finally did at 6.10.  he wanted to know what I wanted.  I told him 75 levo - after a pause he said "but your results are normal"  I replied while they were better they were far from  normal and if he did nt give me a new script I would get  worse again.  I told him I had to drop working from 5 days to 2 and did want to get ill again.      Anyway after a bit of humphing and hawing and me mentioning my consultant agreed with me he agreed to fax a script of 75 levo to the chemist so that I could pick it up on Saturday - result!!

[Clutter]

Thyroidnodules,

Ask your GP why he won't be guided by your endo.  TSH 0.35 is also 'normal' in most ranges, and FT4 and FT3 high in range is also 'normal'.