More Results via GP

[Jefner]

GP actually made a home visit to see me last week and ran yet another lot of bloods, why I don't know.

The nurse arrived unannounced the following morning quite early. I wasn't expecting her and had taken my 100mcg Levo and either 5mcg or 10mcg (can't remember) T3 around 6-7hrs earlier as I take mine at bedtime. The other bit of T3 I take is mid afternoon (15mcg in total)

Here are the results but I don't think they are going to be that accurate are they? That's certainly the highest my T3 has ever been. My TSH is now too low? Was also low on my 3rd April test? Looks like I am a little hyper? Do I cut back on my Levo a little? Have just read "Subclinical hyperthyroidism (SCH) is defined as a low thyroid-stimulating hormone (TSH) level with normal free T4 and free T3 levels in patients without specific symptoms of hyperthyroidism". I am certainly experiencing typical symptoms of hyper!

TSH 0.04 mU/L (L) - (0.27-4.20)

Free T4 17.2 pmol/L - (9.0-26.0)

Free T3 5.0 pmol/L (2.8-7.1)

Vitamin B12 - 827 ng/L (H) (191-663)

Folate 8.5 ug/L - (3.9-26.8)

Ferritin 64 ug/L - (15-350)

Sodium 149 mmol/L (H) 133-146)

25-hydroxy Vitamin D 102 nmol/L > 50

Previous results I did via Blue Horizon on 3rd April

***3rd April 2017****

CRP 0.10 <5.0

Ferritin 76 (20-150)

FT4 15.13 (12-22)

FT3 L2.95 (3.1 - 6.8)

TSH L0.13 (0.27 - 4.20)

T4 Total 90.3 (64.5 - 142.0)

B12 569 Deficient <140

Serum Folate 22.08 (8.83-60.8)

[greygoose]

You cannot have hyperthyroidism, subclinical or otherwise, because you are hypo. The thyroid doesn't jump around like that. When you are hypo, you're hypo for life.

You can, on the other hand, be over-medicated. But, you aren't. It doesn't matter how low the TSH goes, it doesn't mean anything. The TSH is irrelevant once you are on thyroid hormone replacement. All your low TSH means is that you are on thyroid hormone replacement.

[Jefner in reply to greygoose]

greygoose

Hi hon, but with Hashi's you can swing both way. I am certainly experiencing typical symptoms of hyper lately. When you say overmedicated, do you mean by the Levo or the T3?

[Jefner in reply to Jefner]

greygoose

fatigue or muscle weakness

hand tremors

mood swings

nervousness or anxiety

rapid heartbeat

heart palpitations or irregular heartbeat

skin dryness

trouble sleeping

weight loss

[greygoose in reply to Jefner]

Can all be hypo symptoms. Or high cortisol symptoms. You are not over-medicated, you took your T3 too near the test, that's why it's high.

[Jefner in reply to greygoose]

greygoose

It's splattered all over the net that a low TSH with normal T4 range usually means excessive thyroxine ingestion. You sure I don't need to drop my levo a little or even alternate between 100 and 75?

[greygoose in reply to Jefner]

Yes, but most of what is splattered all over the net is wrong.

If you think you are over-medicated, lower your dose a little, and see how you feel. If you feel better, well and good. If not, you can put it up again.

But, I stand by what I said, once you are on thyroid hormone replacement - whatever it is - the TSH is irrelevant unless it goes high. It does not matter how low it goes.

In any case, your FT4 is only about mid-range!

[Jefner in reply to greygoose]

Greygoose

Yeah my T4 looks better although I am still not convinced that the results are accurate due to having my meds so few hours before because my T3 has NEVER been that high. Think I might alternate, although my gut issues will be having an affect on my thyroid anyway

[greygoose in reply to Jefner]

Your FT3 is only just a smidgeon over mid-range. I would have thought you be happy!

Your FT4 isn't even mid-range!

But, be that as it may. I think your thinking is a bit twisted...

Taking your thyroid hormone 6/7 hours before the test is unlikely to have impacted your FT3. It might have had a slight impact on your FT4, giving you a false high.

A false high means that your FT4 is lower than that. Reducing your dose will lower it even further.

You would only need to lower your dose if you had a false low. Which you didn't.

I sincerely think you are over-reacting, the way you did before, when you stopped your T3 for two days before reducing it. Do you remember the disastrous effects that had? Do you really want to repeat that episode? If I were you, I would leave well alone. Or at least think about it a bit more.

And, forget the TSH! When you are taking T3, the only important result is the FT3. Surely, that too is plastered all over the net. It certainly is on here.

[Jefner in reply to greygoose]

greygoose

thanks hon, I am going to stay at my original dose, not messing with my thyroid meds whilst I have other stuff to sort out. I don't think my T3 is a smidge too high hon, I think it's a false reading due to having my T3 only a few hours before

[greygoose in reply to Jefner]

False reading or not, it's not high!

[Angel_of_the_North in reply to greygoose]

Or low cortisol symptoms esp hand tremors and weight loss if combined with appetite loss.

Others can be hypo or low iron.

[greygoose in reply to Angel_of_the_North]

Jefner has high cortisol.

[Angel_of_the_North in reply to greygoose]

Symptoms are more like low, though. So it is high all day?

[Jefner in reply to Angel_of_the_North]

I have symptoms for high cortisol not low

[Angel_of_the_North in reply to Jefner]

The ones that you describe are what I had when my cortisol was a couple of points above Addisons level - I also had nausea and vomiting with headaches, though. But the shakes, palpitations, anxiety, mood swings and weight loss are all low. You tend to get weight gain with high cortisol - some symptoms are common to both. You might have cortisol that is too low during the day and too high at night.

[Jefner in reply to Angel_of_the_North]

I have tested and am high all day. I had a DUTCH test a couple of weeks ago so will have up to date results soon

[Angel_of_the_North in reply to Jefner]

In that case, I'd wonder about low T3 causing your brain to pump out adrenaline to make up for it, but your latest FT3 is way better than mine.

[Jefner in reply to Angel_of_the_North]

my latest result won't be that accurate due to having my thyroid meds only a few hrs before the nurse came round to take my bloods

[JS33 in reply to greygoose]

Am I missing something with those more recent labs , T3 of 5 (2.8 -7.1) if that's not long after taking a dose of T3 you have room for some more meds , especially if you are having symptoms. And those previous results with a T3 of 2.9 would have me laid up in bed.

[greygoose in reply to JS33]

Yes, we know jefner has low FT3. The problem is convincing her.

[JS33 in reply to greygoose]

No wonder the doctor and nurse called round , they probably thought you would be collapsed on the floor .

[Jefner in reply to JS33]

I dont know what my symptoms relate to, i have so much going on

[JS33 in reply to Jefner]

Take it easy , listen to what your body tells you. Get an Omron basic blood pressure and pulse monitor , and a glass thermometer. If don't have a decent pulse and blood pressure and a temp of 37 or near that in the afternoon, don't consider yourself over medicated, because if you reduce the dose instead you'll be worse.

Either stay on the dose your on and give it more time , or raise a little and keep an eye on your temp and BP.

Those labs are no where near high enough for most people, so would explain you feeling poor and confused . Good luck.

[Jefner in reply to JS33]

my temp is 35.9 at the moment and I have a blood pressure monitor and thermometer

which lab results are you referring to, my recent one or the one before?

[JS33 in reply to Jefner]

both. the more rent one looked better , but if i were still having symptoms , especially with a temp of 35.9 , I would be looking to go up not down.

It's 5 30 pm and my temp is bang on 37 , my blood pressure is 115/80 and my pulse 76 - while smoking a fag. I got on the scales this morning 1/2 a pound lighter than yesterday, taking the total weight loss from 83kg to 76kg about 4 or 5 weeks. I no longer crave sugary snacks , and have recently on occasion nearly bust a rib with laughter. My eyebrow hair is growing and the hair on my head does not feel as dry.

My T3 was 6.8 bang on top of the range at 4.5 grains , but my blood pressure and pulse was still quite low , pulse occasionally dropping into the 50s, and my temp struggled to get over 36.5. I would wake up in the middle of the night many times hungry , was putting weight on and looked and felt a mess .That's why I disregarded the blood levels and believed what my body was telling me.

I am on 6 grains thyroid-s but my temperature started hitting 37 in the afternoon and evening at around the 5 grain mark , i may end up coming back down a bit but don't really feel the need to at the moment .

I expect my blood results would show quite high T3, they're only numbers.

[Jefner in reply to JS33]

my latest one was inaccurate because I had had my meds only 6hrs before testing

[JS33 in reply to Jefner]

Going by those labs you are neither hyper or over medicated

[Clutter]

Jefner,

As you took your T4 and T3 6-7 hours before the blood test it is very unlikely that T3 was still peaking and your results will be accurate. They're the best results of yours I've seen.

Low TSH doesn't make you feel hyper or hypo. As long as FT4 and FT3 are within range you are not biochemically over medicated.

Perhaps it is high cortisol which is making you feel hyper.

[Jefner in reply to Clutter]

Clutter

Yeah, I have never had a T3 that high before. But's it's normal practice to lay off the meds for at least 12-24hrs before testing so they can't be that accurate surely?

The high cortisol and more likely the baddies in my gut that can cause a lot of nasty symptoms which I get. I still don't understand about the TSH. Normal is around 1 so surely anything much lower like mine should indicate something. My quack says I am "over thyroided"!!! And don't forget it's not always about the numbers, it's how we feel!

[Clutter in reply to Jefner]

Jefner,

Your results will be a lot more accurate than if you left them 12-24 hours.

TSH 0.27 is in normal range too. Suppressed TSH simply indicates your pituitary has identified sufficient circulating T4 and T3 and doesn't need to stimulate the thyroid to produce more.

What does your quack mean by "over thyroided"?

Are you saying you felt better on a lower dose with lower FT4 and FT3 and higher TSH?

[Jefner in reply to Clutter]

Clutter

My TSH is TSH 0.04. Range is 0.27. My quack means I have gone slightly hyper and need to lower my T4 a little bit. I can't say how I feel with changed doses hon. I have felt crap every day now since I crashed in 2015 when I went hyper

[Clutter in reply to Jefner]

Jefner,

I disagree with your doctor. As Greygoose said, you cannot be slightly hyper and you are not over medicated just because your TSH is low. Your FT4 and FT3 would have to be over range before you were over medicated. If you reduce dose to raise TSH your FT4 and FT3 will drop.

It might be helpful to keep a symptoms diary to note how symptoms improve or get worse after a dose adjustment.

[DoubleM]

Clutter and GG are right, as someone who is hyper I can say that suppressed TSH isn't the indicator it's free T4 and free T3 levels. Please be careful before changing your meds dosage as it may make you feel worse than you already do.

[Phoenix605]

Hi Jefner, this might help:

EXCERPT FROM BMA BOOK UNDERSTANDING THYROID DISORDERS BY DR ANTHONY TOFT (Endocrinologist and ex-president of Thyroid UK)

Question:

I feel better taking a higher dose of thyroxine than recommended by my doctor. Is this safe?

There is considerable debate about the correct dose of thyroxine. The consensus is that enough should be given to ensure that levels of T4 in the blood are at the upper limit of normal or slightly elevated and those of TSH at the lower limit of normal, or in some patients undetectable.....

Also if you look at the TUK hypo symptoms checklist you will see that a lot of the symptoms appear - granted things like weight loss may be less common but you mention gut issues.

My TSH is only 0.05 and my FT4 is right at the top of the range, my GP started making lowering noises til I produced my matching medichecks results which included FT3. She took one look at the midrange FT3 and agreed could not be over medicated (Im lucky to have one that has a clue and doesnt rely on TSH) and left well alone. Granted I feel well at these levels which you dont, but I dont have other health issues to muddy the waters either.

I would agree that if you genuinely feel you would do better on a lower levo dose then keep a symptom diary with scores out of 10 so you can quantify any improvement or otherwise especially if you get a bit foggy. Dont forget it will take 6-8 weeks to feel the full effects of a levo change even a small one and the same to put it back again if no improvement so it could take nearly 4 months to get back where you are now. Dont change just because your GP thinks you should unless he can justify it in light of your other health complications - even then I would run it past the forum incase he is 'confused' again!!

[Joesmum]

How is your menopause?

It can cause hellish symptoms especially when thyroid hormones are low?

Have you tried HRT?

[Jefner in reply to Joesmum]

Joesmum

I have been on hrt since November but only up to 3/4 patch at the moment as I had my hormones tested again to see what my levels are via a DUTCH test. Should hear from my meno specialist at the end of the week to see what to do. I don't know whether most of my symptoms are caused by the meno because I have Candida gut overgrowth and gut dysbiosis too

[Joesmum in reply to Jefner]

Many of the symptoms you have listed can be the result of low estrogen.

I know you are post menopausal but you could still be experiencing dreadful symptoms.