Blood test results - not happy!

[marigold22]

I had a thyroid blood test one week ago and knew the GP would consider me over medicated. I stopped T3 about 30 hours before the test. I have been taking 40mcg daily which the Endo prescribed plus half of a 25mcg from ‘elsewhere’. I’ve felt well on that dose at long last.

The GP has phoned me this morning (telephone appointment) to discuss the results.

She said my TSH is 0.05 (range 0.4 to 4), T4 is less than 1.3 (range 10.6 to 21), T3 is 1.4 (range 3.2 to 5.9). Then she said all of them show I’m over medicated.

I said TSH doesn't show the complete picture and there's no T4 in me because I take T3 - she went quiet.

I said to her that I now think I could well have Hashimoto’s after reading medical stuff on the internet, and would therefore like to have blood tests for thyroid antibodies. She instantly agreed to that. Then she said “Oh, if it’s autoimmune disease we had better also do B12 and folate”.

I’ve never been offered B12 blood test and only got one a year ago when I pushed for it. This shows to me that an autoimmune problem makes them take different action.

Any views please. Also thoughts on my blood results. Thanks

[galathea]

T3 under range certainly doesnt show you are over medicated..... In fact with low t4 and low t3 i bet you feel like you are at deaths door.

How are you feeling?

[marigold22 in reply to galathea]

I'm used to feeling at death's door !

[marigold22 in reply to galathea]

I've had this inability by doctors of all ilks to read my blood results for 35 years now. Have felt ill all that time. Exasperated

[Clutter]

Marigold22,

You've skewed your FT3 result by leaving 30 hours between last dose and blood draw which means there is no Liothyronine (T3) in your serum to measure. You'll get a realistic estimate of normal FT3 levels if you leave 12 hours between last dose and blood draw and add 10% to the result.

Your GP is patently only concerned with TSH otherwise she wouldn't stupidly tell you you are overmedicated when your FT4 and FT3 are below range.

TSH 0.05 is good and low. I think it makes it clear you are NOT overmedicated otherwise it would be suppressed much lower.

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I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

[marigold22 in reply to Clutter]

Yes I agree, I shouldn't have left 30 hours but was so worried about taking the extra T3 from abroad and got paranoid the GP would try to cut my T3 med.

[lc1973 in reply to Clutter]

Hi Clutter

I leave 26 hours between last taking T3 before a blood test, how long does it take for T3 to wash out of your system before a blood draw? Should i be splitting my T3 throughout the day to facilitate this do you think?

[Clutter in reply to lc1973]

Lc1973,

Most T3 is out of your serum 6-8 hours after last dose. 12 hours between last T3 dose and blood draw is sufficient.

I split my T3 into morning and night time doses to even out the peaks and troughs of once daily dosing. When I was taking T3 only I split dose into 3 x daily doses.

[marigold22 in reply to Clutter]

Would low T3 late evening cause insomnia? I take my full dose when I wake up. And have great difficulty going to sleep at night.

[Clutter in reply to marigold22]

Marigold22,

Some people sleep better when they take T3 at bedtime. Perhaps you should try taking T3 at night or splitting dose and taking morning an bedtime.

[lc1973 in reply to Clutter]

Sorry Marigold22, i think i hijacked your post! Not sure if anyone has replied re the insomnia but a couple of times a month i suffer with insomnia usually around the time of my period and i think this may be due to the fact i have or had low morning cortisol and low progesterone one or both of which are still a problem, i think and i might be wrong is that T3 might make insomnia worse but im hoping someone will come along and say to the contrary!

[lc1973 in reply to Clutter]

Hi Clutter

Please forgive my ignorance but does that mean if you mostly or only take T3 say at 6am in one single dose that come the afternoon you are flagging due to no serum T3? Does the T3 not store anywhere so that you can build up your T3 if its not needed?

[Clutter in reply to lc1973]

Lc1973,

After T3 leaves the serum it moves to the cells 48-72 hours after dose. T3 has a short half life so it is out of your system in 3-3.5 days after last dose.

If you flag during the afternoon you are either undermedicated or need to split the dose so that the second dose is taken 60-90 minutes before the slump.

[lc1973 in reply to Clutter]

Ahh, i get what you are saying now so as it is a serum T3 test it doesnt show total T3. Im flagging most of the day Clutter..still trying to get the dose right but the slight increase is helping, im not falling asleep anymore in the evening thank goodness! But i have taken on board your suggestion of splitting the dose and i might see if this helps.

[Clutter in reply to lc1973]

lc1973,

What is your FT3 result and range?

[lc1973 in reply to Clutter]

FT3 3.9 Range 3.9 - 6.7

[Clutter in reply to lc1973]

lc1973,

You need to gradually increase dose until FT3 is >5.0.

[lc1973 in reply to Clutter]

Thanks Clutter. Im taking 30mcg T3 now and 150mcg levo, have a blood test 6 weeks after last one, think it may be some time before i get anywhere near 5 or more but im sure the iron im taking will help.

[Clutter in reply to lc1973]

Lc1973,

That's a large combined dose. I'm surprised your FT3 is so low. Make sure you take iron at least 4 hours away from Levothyroxine and T3.

[lc1973 in reply to Clutter]

I know! Yes, i take iron well away from thyroid meds!! im not sure which way to turn in investigating why FT3 is so low.

[Clutter in reply to lc1973]

Lc1973,

It's because you are a lousy converter I reckon you can probably increase dose by 20mcg without over medicating. Might be best to do it in 10mcg increments every couple of weeks.