Low T4

[emilylouise]

any advice / opinions please im taking 100mcg levo

free T4 level 11.8 Low

TSH level 1.62

serum vit B12 1302

ferritin 14.6

[shaws Administrator]

If you could put the ranges please as labs differ and it makes it easier to comment when ranges are given

[emilylouise in reply to shaws]

yes i have now done x

[Phoenix605]

Hi Emily, you need to include the ranges for the results, they will be in brackets eg FT4 11.8 (12-22) as different labs use different ones. Your Doctors receptionist will be able to confirm the ranges if you dont have them (you are entitled to them)..

That ferritin looks very low for most of the ranges Ive seen used though as does your FT4. If your FT4 range is the same as the example it looks like you may have central hypo, ie you dont have enough hormone because the pituitary is not signaling TSH properly, you really need an FT3 test as if that is also low it would confirm it. GPs cannot use TSH as a guide with central but he likely does not know this. I am assuming you are not taking any T3 with your levo as that can give lower TSH and FT4 together.

[emilylouise in reply to Phoenix605]

thank you i will put the full results up x

[emilylouise]

June 2016 100mcg Levo

TSH: 0.02 (0.2-5.5)

FT4: 13.7 (10.3-24.5)

FT3: 4 (3.1-6.8)

GP reduced Levo to 75mcg on those results and now

July 2016

TSH: 0.49 (0.2-5.5)

FT4: 10.7 (10.3-24.5)

FT3: 3.1 (3.1-6.8)

there are the last results with the hosp fields in brackets

so the latest are ::

May 2017

TSH 1.62

FT4 11.8

Ferritin 14.6

--- so what is happening ???

[shaws Administrator in reply to emilylouise]

emilylouise

Copy and paste your last answer onto a new post. The reason being you began it two days ago and many will not read beyond the first day as we are getting very many questions You will get fresh responses as the ranges are also quoted.

Put an introductory sentence first.

[Phoenix605]

Hi Emily, I would say central hypo is highly likely, those July results are awful and to be frank am surprised you can get your head off your pillow. Your pituitary should have been screaming for more thyroid production and it wasnt. Here is a bit of a comparison of my frees at a TSH not much above yoursTSH 0.05 (0.3-4.2) FT4 21.8 (12-22) FT3 4.8 (3.1-6.8) !!!! My GP has a clue and knows I am not over medicated as my FT3 is well within range.

You need to sack your GP he is treating on TSH only and completely ignoring the fact that calling your FT3 and FT4 in range in July was a joke. You should have been given an immediate increase and a referal to an endo. Instead he has decided your first TSH meant you were over medicated without even looking at your low frees which say you definately were not. The fact that he hadn't noticed the fact your all your results were bottom of range is wrong and means the feedback loop is faulty means he is incapable of interpreting thyroid blood results or treating you correctly. The general feedback rules are simple when TSH goes down frees should go up and vice versa. yours are all near as dammit going up or down together so something else is broken most likely your pituitary but there are other possibilities.

Your last results were at the hospital, does that mean you have been refered? If so your GP is not quite such an idiot (but I would still consider ditching him) BUT i see they did not do FT3 probably because your TSH is back in range and I will bet it is lower than it should be with that TSH.

One last thing do you follow good testing rules? Overnight fasting test, ( water only no supplements til after test) earliest appt available, no levo for 24 hours before test? TSH rises through the day and after eating. Have you had antibodies tested for hashi etc?

Not many will see your results as they are on an 'old thread' I would copy them off with the answers to the above included and any relevant back story onto a new thread and you should get many more replies with advice (reallyfedup123 has personal experience of central hypo so is likely to be quite vocal if Im right that thats what your results indicate)

[Clutter in reply to Phoenix605]

Phoenix605,

If Emilylouise had central hypothyroidism her TSH would have been low-normal at diagnosis with low FT4 and FT3. If Emilylouise had high TSH at diagnosis and normal or low FT4 and FT3 she has primary hypothyroidism.

I agree that it is not desirable to dose according to TSH particularly when FT4 and FT3 are low in range and it would be preferable to increase dose to raise FT4 and FT3 even if it means TSH becomes suppressed as in June 2016 when she was taking 100mcg.

[Phoenix605 in reply to Clutter]

Hi Clutter, I could not find a diagnosis result but was going on those provided, as the TSH and frees do not seem to be moving as normal in relation to each other or her dosage changes. That is also why I suggested reposting so she could get advice from a wider audience

[emilylouise]

thank you both very much i will repost x i just went up Hosp for bloods wen i felt fit enough to do so - they wont refer me to an endo & dont want to give me any more levo - cos il get bulging eyes etc !!! i picture Marty Feldman !!! they say its all my other meds for fibromyalgia & arthriris im 54 yrs & feel 84 !