What's better high tsh or FT4?: Dropped my.meds... - Thyroid UK

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What's better high tsh or FT4?

vickyabp profile image
15 Replies

Dropped my.meds from 150 to 125mg and I am cold, depressed and grumpy.

On 150mg TSH is 0.4 and FT4 is 26.1 that was October's reading.

On 125mg TSH 2.95 and FT4 20.7.

I told doctor I felt better on 150mg and he doesn't see how.

Any advice please

Vicky

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vickyabp
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15 Replies
SeasideSusie profile image
SeasideSusieRemembering

vickyabp Were both of those tests done at the same time of day and under the same conditions for complete accuracy of comparison?

It's always recommended to book the earliest appointment of the day for the blood draw, fast overnight (water only) and leave off Levo for 24 hours.

If conditions were the same, then maybe try alternating 150/125 to average 137.5mcg daily and see how that feels.

But really, an FT3 test should be done, that's the important one. If your FT3 is in range when on 150mcg then there's no problem.

Dr Toft article, past president of the British Thyroid Association and leading endocrinologist, wrote in Pulse Online magazine:

"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)."

If you email louise.roberts@thyroiduk.org.uk she will let you have a copy of the article which you can print out and show your GP.

vickyabp profile image
vickyabp in reply to SeasideSusie

They were dine pretty much firdt thing in the morning. He pretty much thinks I should be on 125mg. I will have another test in march and I will ask for T3 as well.

Thanks for your response

Vicky

SeasideSusie profile image
SeasideSusieRemembering in reply to vickyabp

Had you eaten and/or taken your levo before the blood draws?

You may not get FT3 done unless there is something drastically wrong with TSH or FT4. Your GP may request it but it's the lab that makes the decision on whether to do it.

vickyabp profile image
vickyabp in reply to SeasideSusie

Yes had eaten and had taken meds.

Well I will chat to GP but they have never done my T3 before. But I am shocked at the difference in tsh

SeasideSusie profile image
SeasideSusieRemembering in reply to vickyabp

If you ate and had taken meds before blood draw both times then they're comparable. If you ate and took meds one time but not the other then they're not comparable and it would account for the difference.

Have you ever had antibodies tested? If you have autoimmune thyroid disease aka Hashimoto's, then results fluctuate as and when antibodies attack your thyroid.

vickyabp profile image
vickyabp in reply to SeasideSusie

They are comparable. I have autoimmune disease. I looked at.my TSH on the last few tests and they ranged from 0.4 to 0.15..

I will take 125 tomorrow and alternate between 150 and see what results I get then

SeasideSusie profile image
SeasideSusieRemembering in reply to vickyabp

So you have Hashimoto's then. Your results could be fluctuating because of the antibody attacks.

Are you addressing the Hashi's by being strictly gluten free and supplementing with selenium? Both are supposed to help reduce the antibodies.

vickyabp profile image
vickyabp in reply to SeasideSusie

Oh heck gluten free no not done that. I shall have to read up about that.

Thank you

SeasideSusie profile image
SeasideSusieRemembering in reply to vickyabp

A bit of reading to get you started:

Gluten/Thyroid connection -

chriskresser.com/the-gluten...

Lots of members find it helps enormously, not necessarily a quick fix, some people benefit straight away, others it takes longer.

Hashi's info if you haven't already seen it -

thyroidpharmacist.com

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

thyroiduk.org.uk/tuk/about_...

Supplement selenium L-selenomethionine 200mcg daily

greygoose profile image
greygoose

The TSH is totally irrelevant when you are on thyroid hormone replacement, unless it goes high. At 2.95, yours is too high for someone on thyroid hormone replacement. And I think that's born out by the fact that you felt better when it was 0.4.

You don't give a range for the FT4, but they look high. A high FT4, coupled with a highish TSH, could indicate that you are not converting that T4 to T3 very well, so, as SeasideSusie says, you really need your FT3 tested to find out.

If you ate before the test, your TSH will not have been at its maximum. TSH drops after eating. If you took your T4 before the test, you will only be testing the dose you took. So, that could account for the highish levels, and is possibly why your doctor lowered your dose. Best not to take it, next time. :)

vickyabp profile image
vickyabp in reply to greygoose

So I would be better to take 150mg then?

This has cost.me my relationship

greygoose profile image
greygoose in reply to vickyabp

If you felt better on it, then yes. You would. It's just as much about how you feel, as about blood tests. It's just that doctors have no understanding of that.

vickyabp profile image
vickyabp in reply to greygoose

Thank you.

What is FT4 then?

greygoose profile image
greygoose in reply to vickyabp

FT4 is the blood test that measures the level of T4 in your blood. T4 is a thyroid hormone. It is the storage hormone that has to be converted into T3 to be active. T3 is needed by every cell in your body, and when it is low, the cells can't function properly, and that's what causes symptoms. TSH is a pituitary hormone which stimulates the thyroid to make hormones. :)

SlowDragon profile image
SlowDragonAdministrator

ask GP to check levels of vitamin d, b12, folate and ferratin. These all need to at good (not just average) levels for thyroid hormones (our own or replacement ones) to work in our cells.

Common to be low when we have Hashimoto's. Especially as you are not on gluten free diet. Going gluten free may really help reduce symptoms and lower antibodies.

ALWAYS Make sure you get the actual figures from tests (including ranges - figures in brackets). You are entitled to copies of your own results. Some surgeries make nominal charge for printing out. Alternatively you can now ask for online access to your own medical records. Though not all surgeries can do this yet, or may not have blood test results available yet online.

When you get results suggest you make a new post on here and members can offer advice on any vitamin supplements needed

If you can not get GP to do these tests, then like many of us, you can get them done privately

thyroiduk.org.uk/tuk/testin...

Blue Horizon - Thyroid plus eleven tests all these. £99

This is an easy to do fingerprick test you do at home, post back and they email results to you couple of days later.

Usual advice on ALL thyroid tests, (home one or on NHS) is to do early in morning, ideally before 9am. No food or drink beforehand (other than water) If you are taking Levo, then don't take it in 24 hours before (take straight after). This way your tests are always consistent, and it will show highest TSH, and as this is mainly all the medics decide dose on, best idea is to keep result as high as possible

hypothyroidmom.com/92-of-ha...

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