results help needed

[supahotchick]

Hi, I hope somebody may be able to offer advice.

My doctor tested my thyroid again last week, results are in but I am a little confused. This time I did the test on a fast and did not consume my thyroxin (5o microg).I wasn't tested for T3 even though I asked and the doctor who indicated he would approve my request.

Results indicate Free T4 12.7

TSH 3.5 ( which has risen significantly by my fasting Levothyroxin for the blood test). My Previous result in October without the fast showed TSH 1.4

( as an aside) I found my test results dating back to March 2002 ( I was not diagnosed with HypoThyroid till 2010) My results from 2002 are TSH - thyroid stim. hormone 1.860 T4 (Thyroxine) 14.700 I noticed the notes for T4 provide guidance " Normal = 50 - 151 nnmol. "My result of 14.7 ( in 2002) indicates abnormal T4 but this was never addressed at the time?

In summary I am trying to understand what my body is telling me with a rise from TSH 1.4 to TSH 3.5 when abstaining from Levothyroxin for the blood test? Golly I am so confused. Thanks for reading my post

[shaws Administrator]

Don't worry if you are a little confused. I think initially we all are when taking thyroid hormone replacements and still feel unwell. We don't realise and neither does doctor/endo tell us that we will be having it increased. Some don't when they look at the TSH and see it is low and 'suppose' the patient is taking sufficient. TSH is a pituitary hormone and it's job is to rise when thyroid gland is failing.

Before the blood tests were introduced and we were given another type of thyroid hormone replacement until we were well and doses were around 200 to 400mcg each day.

When you give results you have to also give the ranges. Ranges are in brackets after the results. The reason being that labs differ in their machines so ranges are different and it makes it easier to respond.

Some labs wont do other than the TSH if it is 'within range' even if top of range is 4 or 5 and GP suggested other results.

If you take levothyroxine daily i.e. usually a.m. when we get up and then get the earliest appointment for a blood test - it may only be a few hours gap. One dose of levo taken today will eventually diminish gradually over quite a number of weeks, so that's not the cause of your rising TSH.

The reason for your rising TSH is 50mcg is only a starting dose and is gradually increased by 25mcg each six to eight weeks till we feel well with a TSH of around 1 or lower. The above indicates you need a rise and dose increased.

Your quote from above:-

TSH 3.5 ( which has risen significantly by my fasting Levothyroxin for the blood test). My Previous result in October without the fast showed TSH 1.4

and that is the reason we recommend fasting and no hormones because there is now quite a big difference between a TSH of 3.5. fasting and early test and TSH of 1.4. later a.m. and non-fasting. with a TSH of 3.5 your GP should increase dose. With a TSH of 1.4 he wouldn't. Also if you had another coupleof blood tests later in the day it would be different each time as TSH fluctuates throughout the 24 hours. i.e. Highest early a.m.

Don't worry, it's a lot to take in but if we want to get well, onto an optimum dose it is a gradual increase each time - not until our TSH is 'somewhere in range' as most doctors believe but to 1 or lower and some need it suppressed but to bully us they threaten that we will get osteoporosis and/or heart problems but the fact is an optimum dose will protect us a low dose means our body struggles.

[silverfox7]

Thank you for posting and giving us the results after you have done the right thing before a blood test! It shows well that the TSH rises in those circumstances and this is good as so many doctors wrongly decide when it's low that it's too low. So you have sent brilliant results to prove the point which I'm sure will help others reading this thread. So thank you again.

[supahotchick]

Thanks everyone for taking the time to respond, and explain, the principles are much clearer in my head now. I definitely feel more educated.

Thanks again so much, armed with this info I can led discussions and prescribing decisions with my doctor