New blood test. Some help please understand it.

[Haze1975]

Hi!

I was texted by the doctor for a blood test said it was due. So I went for the blood test Thursday. It came back on the same day? The test was run at 9.30 in the morning. I think I followed everyone comments from the last time. Don't take the tablets before the blood test, 24 hours after takening the last tablets from, no food, but had a apple juice as I don't like plain water.

Results were as follows:

Serum Tsh level <0.01 miu/l (0.35-4.94)

Serum free T4 level 19.4 Pmol/l (9.01-19.5)

Does anyone know what this means please.

[silverfox7]

Very quick turnaround I agree. Don't know specifically for thyroid tests but I once spent a day in a haematology lab getting info for a presentation for new medical students and for General bloods the test takes very little the time. What can take time is someone reading and checking the result and then it's emailed out to GP etc. doctors usually say check in a few days as the GP reads them before you do and of course once upon a time it was all snail mail! You must have dropped lucky with no holdups.

Would have been better though if they had tested FT3 as well. On paper your FT4 reading is high in the range and your TSH low. Many doctors are freaked out if TSH iS under range but of course you could be very low if you are getting enough medication. What it doesn't tell you though is if you are utilising this and. are correctly converting to T3. So the magic question, how do you feel and have you any symptoms?

If you aren't feeling good then you may have to rest privately as even if your doctor requests a FT3 reading most labs will refuse.

[Haze1975 in reply to silverfox7]

My doctor has already read them. And on the same day two. I can see my medical notes. But hasn't told me yet. My tsh levels are meant to be low as possible. I'd had thyroid cancer 2013. My whole thyroid has been removed.

I don't feel well at all today. My back and kneel have been playing me up a few days this week. And still doesn't feel right. Trying to drink but its saw to drinks at the moment. And my arms are pally again. Also Even know I went to bed at 10.30 last night. Still feeling tied thou. And normally when I finished work I full to sleep in the afternoon. I don't know what going.

Thanks for reply.

[4Alexandra]

I too have had a total thyroectomy in 2005 and struggled for years with Endo's putting my T4 medication down because the TSH was too low and every time I felt dreadful. It wasn't until a couple of years ago when I realised that my T3 had been on the floor whenever I felt really ill. Nobody can tell me if not having a thyroid effects the T4 conversion to T3 which is what we need. I believe the T4 is converted in the thyroid, the liver, the intestine and the brain but many of us do not convert well with the remaining organs. I finally started to self-medicate with T3 about two years ago and have had a significant improvement. Also good B12 levels are important and of course, D3 which I found much improved general aches and pains A blood test for FT3 and FT4 will tell you how much you are converting.

[helvella in reply to 4Alexandra]

I'd guess it is more that the thyroid manufactures both T4 and T3 - rather than it doing any significant amount of conversion.

[silverfox7]

You can help converting if Vit D, B12, folate and ferritin are optimum for you. That's usually high in the range and we are often very low so many of us supplement to get and keep things at a good level. Without a thyroid I would thing its usual to improve on something with T3 in it. Doctors seem to think that everything works normally in our thyroid and when the dose is right then we pick up quickly but how can it when we have faults or things missing. They wouldn't be dismissive if they suffered!

[blondpalomino]

If they think the blood test is abnormal they can get it back quickly! Maybe because of the low Tsh and the T4 being maximum.

As mentioned you really need the T3 tested to know what is going on.How much thyroxine are you taking? are you taking T3 as well?

I have no thyroid either and do not do well on thyroxine alone, I need some T3 as well.

With a normal thyroid a percentage of your T3 will come directly from the thyroid gland, so if you don't have one then most people will need to have T3 added as well,it can't all be converted from T4 alone.

Ask for a referral to an Endochrinologist, they are the ones who can prescribe T3.

[Haze1975 in reply to blondpalomino]

I only take levothyroxine 175mg a day, and have been taken that since December 2013 and only stopping for scan. But have taken t3 when I first started thou but haven't takened it since 2013. But also take cetirizine allergy and hay fever. Subtomol and a pink in haler. A Nassel spray. Because have really bad Seense as well, and problem breathing some times.

[blondpalomino in reply to Haze1975]

why did you stop the T3? Most people find they feel better with T3. Perhaps you didn't take it long enough to feel an improvement.

175 mcg thyroxine seems a largish dose, it's pushing you to the top level of the range, but you are still tired,so it's obviously not working. I wouldn't have thought the sprays would make any difference.

[Haze1975]

I didn't stop it the doctor stop giving it me when I started levothyroxine. Levothyroxine is I think is t3 I thought. ??

The spray avamys 27.5. It's to tried and keep my nose unblocked. It meant to help with seense problem.

[helvella in reply to Haze1975]

Levothyroxine is T4.

Liothyronine is T3.

[blondpalomino in reply to Haze1975]

levothyroxine(T4) needs to convert to T3 to be used by the body.If you have no thyroid then you will most likely need to be given additional T3 as well.

It's no point your doctor giving you more thyroxine,it's up to the maximum level now and is most likely not converting sufficient to T3. That is why you need to ask for a blood test to measure your T3 level. Doctors don't like to do the T3 test now unless you insist,but an endochrinologist will.

You need to ask your doctor for a referral to an endo as they are the ones who can prescribe T3.

[Haze1975 in reply to blondpalomino]

I go to see endo untill next year now. I've been cut down to one a point a year. I no longer see my cancer doctor.