Thyroid

[Tldg45]

I'm confused about my blood results

Serum free t3 3.7

Serum tsh 3.2

Serum free t4 12

No matter what diet I do or how much exercise I am still gaining weight. My doctors say my results are normal. Any advice would be gratefully received.

[SeasideSusie Remembering]

Tldg45 Have you got the reference ranges for your results please (might be in brackets after the results).

TSH is too high and it's very unlikely that your free Ts are at the upper part of their ranges, so you are probably very under medicated. You are not going to loose weight with results like those by either dieting or exercising. In fact, hard exercise depletes T3 and if you're not getting enough thyroid hormone then you don't have enough T4 to convert to T3 to replace what has been depleted by exercise. You need to be optimally medicated and you seem to be far from it.

Your GP is saying your results are normal because they fall within the range but they are not optimal.

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

[Tldg45 in reply to SeasideSusie]

Reference ranges are

serum free t3 3.5 - 6.5

Serum tsh 0.55 - 4.8

Serum free t4 9 -23

[SeasideSusie Remembering in reply to Tldg45]

serum free t3 - 3.7 (3.5 - 6.5)

Serum tsh - 3.2 (0.55 - 4.8)

Serum free t4 - 12 (9 -23)

So there you have it, TSH far too high and free Ts far too low. Everything I said in my previous reply is relevant.

Dr Toft, leading endocrinologist and past president of the British Thyroid Association, states in Pulse 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)."

Email Louise as Clutter has mentioned for a copy of the article to print off and discuss with your GP.

You will not be able to successfully lose weight until you are optimally medicated and your FT3 is in the upper part of it's range.

[Clutter]

Tldg45,

You are under medicated. The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 1.0 or lower with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email [e-mail] if you would like a copy of the Pulse article to show your GP.

[Tldg45]

Thank you, the weight gain is reallly getting me down and I don't seem to get any help from my doctors.

[Tldg45]

I've been to see my doctor to discuss my bloods and he's told me that my bloods are within the normal range. I'm so frustrated as I know that how I'm feeling and the weight gain is not normal. I've asked for a referral to a private endocrinologist.