I've had two sets of results today, one from 19 January from the NHS endocrinologist and one from the private doctor I visited on 6 February.
19 January NHS Results
TSH 0.64 (0.30-6.00)
Free T4 25.3 (10.0-22.0)
6 February Private Tests
TSH 3.18 (0.27-4.2)
Free T4 19.0 (12.0-22.0)
Total T4 96 (59-154)
Free T3 3.7 (3.1-6.8)
25 OH Vitamin D 60 (50-200)
Thyroglobulin antibodies <10 (0-115)
Thyroid Peroxidase Antibodies 114.3 (0-34)
Reverse T3 26(10-24)
I also had a urine test done to identify cellular uptake of hormones:
T3 860 (610-3380)
T4 1390 (1030-8240)
T3:T4 ratio 0.62 (0.50-2.00)
I'm livid because the endocrinologist has instructed my GP to reduce my thyroxine to 100mcg from 125mcg based on the January NHS results even though I told him I've already done that recently and tsh shot up and I became very ill I gave him a list of the severe hypothyroid symptoms I've still got as a result of that episode. I'm going to GP tomorrow morning to complain. I also told him my tsh had been yoyoing up and down for 4 years!
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Venicefan
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Venicefan Your TSH has been yo-yoing because you have autoimmune thyroid disease aka Hashimoto's, as confirmed by your high Thyroid Peroxidase antibodies. This is where antibodies attack the thyroid and gradually destroy it. It's nature is to wax and wane causing fluctuations in symptoms and test results. There is no treatment for Hashi's, it's the resulting Hypothyroidism that is treated.
You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members enormously. Gluten contains gliadin which is a protein thought to trigger antibody attacks.
FT4 is at the top third of the range, FT3 is in the bottom quarter of it's range. You are not converting T4 to T3 very well. This is also confirmed by your FT4: FT3 ratio being 5.13 : 1 whereas good conversion takes place when the ratio is 4:1 or less (according to member Diogenes who is an advisor to ThyroidUK). Adding T3 to your Levo would help.
Your urine test shows that not much T4 or T3 is a getting through to the cells. However, neither your GP nor your endo will probably take any notice of the urine test.
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Your RT3 is slightly over range. Do you have the FT3:RT3 ratio? That should be over 20.
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Vit D is on the low side. Recommended level is 100-150nmol/L. You could buy some D3 softgels 5000iu and take one daily and re-test in 3 months. When you've reached the recommended level reduce dose to 5000iu alternate days as a maintenance dose.
D3's important co-factors K2-MK7 and magnesium are also needed. Take D3 and K2 with the fattiest meal of the day as they are both fat soluble. Magnesium is calming and best taken in the evening.
I don't know what they are but according to the report they're normal. I've got some results from April 2016 for ferritin, folate and B12 but not in the latest ones
Folate 9.8 (4.60-18.70)
Ferritin 104(13.00-150.00)
B12 471 (200.00-770.00)
I also had a cortisol saliva test with the private doctor that showed an abnormal profile so he's treating that first.
Sample 1(post awakening) 35.56 (7.45-32.56)
Sample 2 (+4-5 hours) 11.04 (2.76-11.31)
Sample 3 (+4-5 hours) 8.06 (1.38-7.45)
Sample 4 (before sleep) 5.72 (0.83-3.86)
DHEA mean 0.31
DHEA: cortisol ratio 0.012 (0.015-0.150)
Basically the endocrinologists were looking for low cortisol when they did their tests and it wasn't low so they said I was fine. I've actually got low DHEA and high cortisol!!
If you say you've gone to a private doctor, an NHS GP can refuse to treat that condition. Better to just say you had tests done.
Too much free T4 can cause issues with multiple hormones. The right strategy here would be the 100mcg of Thyroxine and some added Thyronine (T3) you are converting very badly.
Add 100mcg Selenomethionine and 100mcg SelenoCysteine collectively they should help conversion to T3 and reduce the conversion to rT3.
Thanks Leoopard. I did say to the Gp that I had private tests done. I didn't mention the dr but his name is on the test results.
I always suspected that I had a problem with conversion but NHS doctors wouldn't check it out.
GP has agreed not to drop my thyroxine dose, but when this happened before, a different doctor went into my record and changed it anyway. Took ages to sort it out!
I feel frustrated with the endocrinologist too because he hasn't read the BTA guidelines so didn't know what they say and he's put in his letter that NDT is unlicensed in the U.K. and so is T4/T3 combination therapy! Then he asks if the GP is willing to provide the combination therapy!
It was only semi-truthful. NDT was in widespread use before licensing came in. As such it was given 'Grandfathered Status' meaning it came be prescribed without a license, doctors use a lot of drugs on the same basis.
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New results, anyone's thoughts please.
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