low ft4, high ft3

Hi guys,

My mom recently did blood test and her results are quite strange for me, hence why asking you for an advice. Her TSH is 1.2, ft4 only 11.69% but ft3 53.33%. AntiTPO and antiTG are slightly above the range. She has some symptoms of hypo like feeling cold, swelly face, hair loss, weight gain, muscle pain etc., but gp said everything is all good (sic!). She's on vit D3 2000 units a day, ferritin is in rage, wit b12 just under the range (not much). What you think?

28 Replies

  • Hi Ziel,

    The following reference is the only mechanistic, biochemical connection between the misnamed (prohormone) "vit D" and thyroid hormones postulated I'm aware of ( - of any detail; are there others ? ? ?):

    autoimmunityresearch.org/pr... - hope its useful for your Mum's case. Abstract rather technical, so may be worth starting with the introduction !

    I have to wonder whether the 50mcg (2000IU)/day intake is causing blood T3 levels to elevate, . . . . rather than being taken up by cells ? ? ?

    Feed back in due course appreciated, but do not be surprised if UK medics know nothing about this !

    Best wishes,

    Sid A.

  • Sid,

    Test results were done before she started taking vit D! I have no idea what to do now.

  • Consider the paper cited, . . . . . and clarify what her calcidiol level ( - the standard "vit D" blood test) result was before she started supplementing ?

  • The cited body's opinion is that advising on supplementing on "vit D" or increasing sun-exposure is NOT possible in EVERY/any case, based on the result of the calcidiol test result ALONE ( - as sadly is the current UK practice !)

  • It was 11,7 and the range was 10-100. Her reumatologist precribed it, because her whole body is swelling, specially knees and hips, he said it's because of low vit d...

  • That range (of 10-100 . . . nmol/L) is looking a little ODD for the "vit D", calcidiol or 25(OH)D test result. Would you mind double checking it ?

    Your Mum MAY have an inflammation-causing illness, . . . . which are KNOWN to deplete calcidiol levels . . . . and in this case, taking more is said NOT to be helpful in the longer term especially.

    The "fail-safe" position (conceptually) would be for such an illness to be properly EXCLUDED before Mum the recommended "vit D" supplements is continued.

    Hope that's OK, as information to consider ( - certainly not medical advise).

    An introductory article to this "vit D/VDR dysfunction":

    fearlessparent.org/suppleme... - again, (sadly) UK medics are not (at present) recognising this KNOWN body of biochemistry/medical knowledge, . . . . . as far as I can see.

  • I checked - that was a range from the lab. She is treated by rheumatologist for few years now and they still don't know what's going on with her. They tried number of medications but nothing helped her.

  • Am intrigued by that lab range !

    Is it a recent result . . . . and does it actually state: nmol/L ?

  • I assume that is for the T4? The only thing I can think of with low T4 and low TSH is that perhaps this has something to do with the pituitary gland. High T3 can be affected by either low or high TGB (Thyroid Binding Globulin). This can be tested for.

    If your mother is taking Vitamin D, ideally this should be taken with some magnesium.

  • Do you have any reference ranges you could post?

  • Tsh 1,2 range 0,27-4,2

    Ft4 1,02 range 0,93-1,7

    Ft3 3,28 range 2,0-4,4

  • Ft3 is not high, more mid range. Ft4 is lower in range. So really your mum is not showing she is hypothyroid by the blood tests, but she has many symptoms. What country are you in by the way ?

    A trial of T4 may be useful, but can you get the doctor to do this ?

  • I agree Maraday, blood tests do not show a problem with the thyroid.

  • "b12 just under the range"???

    Her thyroid results look pretty normal. A B12 result that's just under the range - not normal at all. What was it exactly?

    Pernicious anaemia (B12 deficiency) has very similar symptoms to hypothyroidism. Would be worth getting more tests done to see what's going on.

  • Test was done privately in Poland because GP in UK is not willing to do any tests for her unfortunately..

  • Why on earth not? If her B12 was below range that makes no sense. Would be worth complaining to the practice manager.

  • When she showed the results from polish lab her gp said she won't even look at it because it was done privately and then she refused to do tests here. You imagine?

  • I'm sorry, but I Don't understand why you're worried. If she's converting well, that's the way it's supposed to be. T4 should be lower than T3 in their respective ranges. FT3 should perhaps, be a little higher than 53.33%, but otherwise, her thyroid labs seem good to me. And I fail to see why the vit D3 would be stopping the T3 getting into the cells.

    However, her B12 should not be Under-range. It should be around 1000. Low B12 will cause a lot of symptoms that mimic hypo. She should be tested for Pernicious Anemia, with a low B12 like that. But, failing that, it needs supplementing. Any level Under 500 can cause irrepairable neurological damage. But doctors know nothing about that!

    Where is the ferritin? In range is not the same as optimal. It should be at least mid-range to 100.

  • Completely agree with you Greygoose....was posting a reply then it suddenly disappeared ....Grrrr but in the meantime you had posted it all 😊😊 save me re-writing. Thanks!!

  • Totally agree with GG. There is no puzzle here, the B12 is an enormous problem and should be treated immediately. From what you've said ferritin is also very low, the rule of thumb is these things should be at least 50% up their ranges.

  • Yep. GG, WLs, SA, I totally agree.

  • I just recently was diagnosed with a malfunctioning pituitary gland and am heading in for an MRI shortly. It was a regular tsh but very low free t4 and normal/high t3 that set off further tests etc. I hope this helps.

  • Hi - i have recently had problems with my pituitary (symptoms are similar to your mums), and my bloods were very similar as well. The endo mentioned it was central hypothyroidism and has prescribed 25 mg levo. Feel a lot better, not quite there yet, but better. All the best.

  • The thing is that her gp doesn't want to do any tests and she refused the results from Poland. Well, my mom changed the practice now and I hope new doctors will be more useful :P

  • Fingers crossed for you. I did a private test from Blue Horizons and took it to my GP. After initally being pretty dismissive about the results, I finally got the GP to agree to re-test under the NHS. And I have never looked back. It has taken 6 years to get this diagnosis, and even now not all Doctors agree that I should have levo. But now that I have it I feel really good and can start to live my life on my terms again! Good luck and once you find that GP that will listen, I'm sure life will get easier.

  • Ziel, you do not need a doctors permission to supplement B12. Just buy some and start her on it quickly. If her new doctor is more amenable, then ask for tests for the Pernicious Anemia antibodies, but she needs to take something now.

  • Reg dr don't fallow same guide lines as an indo dr will ... has she been having strange heart beats ?

  • T3 is the active thyroid hormone which regulated the metabolism and the symptoms. Your mother's free T3 is mid range so she should not have any hypothyroid symptoms.

    One possible cause of her symptoms is thyroid hormone resistance, also known as impaired sensitivity to thyroid hormone. This is a genetic condition and as you also have a thyroid problem this may be the cause. If there are others in your family with fibromyalgia, chronic fatigue, depression or thyroid issues this would support this possibility.

    With this condition the body needs very high levels of T3 to feel well. Your mother's body is trying to achieve this by converting as much T4 as possible to T3, giving the low T4 value.

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