What makes T4 lower?

[Beckymarie1986]

My bloods 3 weeks ago showed I'm borderline as my T4 was 10.1 and TSH was 2.24. I need my T4 to be lower than 10 for the Dr to prescribe levo again. Is there anything I can do to make it lower such as fasting the night before? I felt so much better on levothyroxine and don't want to be left untreated. Thanks xx

[Scazzoh]

Hi Beckymarie, could you give us the ranges (the numbers in brackets after the results)? When did you stop taking levo and why if you felt so much better? Most doctors don't even test T4. He is lab-obsessed and presumably he is not concerned about your symptoms Your TSH needs to be below 1 and your T4 at the top of range when you are taking the right dose of levo. If you take T4 (levothyroxine), your T4 will go up and your TSH will go down. That's what your doctor needs to understand. He wants to make you iller before he starts treating you again. You can't lower your T4 if you are not taking anything, from what I know. It may have gone down anyway since you last blood tests are you are not taking any medication. Can you not see a different doctor at the surgery? There is always self medication if you get to the point where doctors aren't helping.

[Beckymarie1986 in reply to Scazzoh]

Thank you.

Bit long winded but basically.... I was put on levothyroxine around 6 months ago as my bloods were:

T4: 8 (10-25)

TSH: 2.68 (0.4-4)

TPOa: less than 28

Dr tested me 6 weeks after the levothyroxine treatment and my bloods were:

T4 9.1

TSH 2.2

The Dr then referred me to the Endo as my TSH wasn't high enough for me to be classed as hypothyroid . The Endo did a range of bloods which showed.

T4 12.7

TSH 0.77

This was after 2 months or so of levothyroxine and I felt a lot better. The Endo however,told me to come off the levothyroxine for at least 6 weeks and then have repeat blood tests. During this time I felt awful. 2 months later my bloods were

T4 10.1

TSH 2.27

I was told to take a multi vitamin and that I don't have hypothyroidism. Now they are testing my liver and kidneys functions and T4 again.

[Scazzoh in reply to Beckymarie1986]

Your doctor, rather than increasing the Levo to get your T4 up referred you to an endo. The endo was probably then panicking because your TSH had dropped to below range. If you feel better on Levo and awful when not on it then you are clearly hypothyroid. Your incompetent doctors are just looking at the figures. they keep testing but then make the wrong decision.

If you email Louise Roberts at Thyroid UK, ([e-mail]), ask for a copy of the Pulse article by Dr. Anthony Toft (who used to head the British Thyroid Association). Question six in that article states that TSH needs to be below 1 and T4 needs to be towards the top of the range. Take that to your doctor and tell him you need to start taking Levo again. Don't waste your money on a multi-vitamin. Most of them don't work.

[Beckymarie1986 in reply to Scazzoh]

Thanks so much. I will definitely email her. I have an appointment on Friday so want to go in prepared. I have every symptom going and I know that I'm hypothyroid xx

[Angel_of_the_North in reply to Beckymarie1986]

High TSH only appears with primary hypo. Low/normal TSH and low FT4 is secondary hypo. Crazy that 0.1 means you aren't hypo. Your bloods on levo were still not good.

[Beckymarie1986 in reply to Angel_of_the_North]

Are they not good? I don't know what they would have to be for me to feel more human but I was feeling a bit better on the levothyroxine. I felt like I could have done with an increase though. They are thinking there is something wrong with my liver or kidneys which is affecting the thyroid gland. xx

[Angel_of_the_North in reply to Beckymarie1986]

Nope. FT4 was way down the bottom of the range when it needs to be in the top quarter (21+ if the range was the same as the one you gave first), but it was early days so any increase in Ft4 was a good thing.

[Beckymarie1986 in reply to Angel_of_the_North]

I don't suppose you know what "sick euthyroid" or "hypothalamic effect" mean. They've queried this on my last letter? Do you know what could cause secondary hypothyroidism?xx

[Angel_of_the_North in reply to Beckymarie1986]

Secondary hypo is caused by damage to the pituitary gland - anthing from a head injury to a tumour to genetic defect. Central hypo is similar but the problem is with the hypothalamus. (Ideopathic means "unknown cause".)

ncbi.nlm.nih.gov/pmc/articl...

academic.oup.com/jcem/artic...

Euthyroid sick syndrome is a name given by some people to bloods in low normal range (esp low FT3 and inc low TSH) with hypo symptoms allegedly caused by other critical illnesses or very low food intake - could be confused with central hypo, but cortisol and rT3 levels are different. The underlying illness should be treated (and depression isn't one of them). Usually seen in patients in intensive care.

thyroidmanager.org/chapter/...

msdmanuals.com/en-gb/profes...

"Patients with central (hypopituitary) hypothyroidism manifest low serum T4, free T4, and low or "inappropriately normal' serum TSH levels, findings identical to patients with sick-euthyroid syndrome."

[Beckymarie1986 in reply to Angel_of_the_North]

Thank you

My cortisol,FSH and LH were low normal on last blood test so maybe it's something else going on with me too. They're not investigating that any further though as it's still low/normal. They are referring me back to my Dr as can't find anything wrong with me.xx

[Angel_of_the_North in reply to Beckymarie1986]

I'd get the list of doctors from [e-mail] and see if there is anyone in your area you could go to as it really looks like secondary hypo or if it it isn't, you have a serious illness that your GP isn't curing.