New blood results

[tterrygill]

Just got thyroid function test from doctore I am presently taking 125 m of levothyrovine results Serum TSH 7- 67 can someone tell me what the results mean got to have repeat bloods in four week.NHS

[SeasideSusie Remembering]

tterrygill Is that TSH 7.67? You haven't given the reference range but going by the ones we normally see you are probably over range and under medicated.

If you give more information members can possibly comment further.

[tterrygill in reply to SeasideSusie]

SeasideSusie thankyou for your swift reply .The only figures I have been given are TSH 7-67.Really feeling quite ill at the moment.

[SeasideSusie Remembering in reply to tterrygill]

Normally we don't see a TSH range go much higher than about 5ish, so I'm certain that you are quite a way over range meaning that you are definitely under medicated and you feel ill because you have symptoms of hypothyroidism still.

What has your GP said? You need an increase in your dose.

The aim of a treated hypo patient is for TSH to be 1 or below and FT4 and FT3 to be in the upper part of their respective reference ranges.

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

"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)."

You can get a copy of this article by emailing [e-mail] and show it to your GP.

It would be worth asking for a print out of your results, you are legally entitled to them under the Data Protection Act 1998 so your surgery can't refuse but may make a small charge for printing.

It would be worth getting FT4 and FT3 tested, although the NHS rarely do FT3.

Also, ask if you've ever had antibodies tested as this rules out, or in, autoimmune thyroid disease aka Hashimoto's which is the most common cause of hypothyroidism. If they've not been tested then you could ask for them to be done. Thyroid Peroxidase (TPO) is generally the one done by the NHS but there are also Thyroglobulin antibodies but rarely tested. You can get a fingerprick blood test to do at home that will cover antibodies and the free Ts if you can't get them done at the surgery.

[Hidden in reply to SeasideSusie]

Very good and detailed reply, and useful info for others as well, thank you

I have found it impossible to achieve FT levels in range, but in the upper part of respective reference ranges, when on NDT. FT3 levels tend to go too high when FT4 levels are optimal, and FT4 levels to drop dramatically when FT3 levels normalise. Some say FT4 is unimportant when on meds containing T3 but, as discussed in another thread, I have found FT4 levels to be important, too. I don't know if it's true what I read that pigs' thyroids produce 80% T4 and 20% T3, whereas humans tend to produce 95% T4 and 5% T3, which could explain why some feel overmedicated on NDT when their FT4 levels are good (too much T3). That could also explain why some feel good when they add some T4 to NDT, instead of raising NDT.

[SeasideSusie Remembering in reply to Hidden]

Hidden Dr Toft's quote appertains only to medicating with Levothyroxine.

I think we're all different in what we need. Getting on for 20 years ago I spent a couple of years on NDT, NDT plus T3, T3 alone, through the popular private doctors often mentioned here, and I never felt well, and my results were pretty crazy looking. Probably they weren't all done at the same time of day with all the right conditions we mention now when testing, there just wasn't the information back then (and no forum!). I ended up back on Levo and have never been well.

I'm now on a combo of Levo and T3, at the moment 100mcg Levo/25mcg T3 - still experimenting though so probably not reached my optimum dose.

I too have read that FT4 and TSH are not the important results, it's the FT3 that is, and I think it's here that people can differ. We all have our own needs in that department and I think it's important to go by how we feel rather than trying to fit into somebody's idea of where our numbers should be, bearing in mind that it's always cautioned that FT3 shouldn't go too high, especially not for prolong periods.

[Hidden in reply to SeasideSusie]

I couldn't agree more! I hope you end up finding the right dose and combination of drugs for you.

[tterrygill in reply to SeasideSusie]

Asked the nurse for my blood results she gave me

TSH 7.67 miu/L 0.38-5.5

Free T4 13.8 pmol/L 10.0-18.7.

I also have a low blood count but didn't get reading for that.

[SeasideSusie Remembering in reply to tterrygill]

tterrygill So your TSH is over range and you need an increase in your Levo.

Most doctors tend to dose by TSH only so I'm surprised that you haven't been given a raised dose based on that result.

When you book your blood test, always book the very first appointment of the day, fast overnight (water only) and leave off Levo for 24 hours. This gives the highest possible TSH which is necessary when looking for an increase in dose or to avoid a reduction.

The comments made in my previous post regarding where levels should be, Dr Toft's article, and other tests are still relevant.

You can make a new post with your new test results for comment. If your GP does give you a dose increase then you should have a retest 6-8 weeks later to check your level and to see whether another increase is necessary.

Always ask for a print out of your results, keep a record for future reference and comparison.

[tterrygill in reply to SeasideSusie]

Thank you .Your support is invaluable.

[SeasideSusie Remembering in reply to tterrygill]

You're welcome, I hope you get the increase you need