Normal tsh high ft4

[Melwise]

Hi, im new but wandering if anyone can help. Ive been on levothyroxine for nearly 2 years. In Feb I noticed a lot of symptoms similar to pre diagnosis so went for a check. All normal but gp suggested uping to 75mg see if it helped. I did this and it kind of did and didnt but continued. Its a long story but in may I got very ill, diagnosed with all sorts by gp, in June ended in hospital, diagnosed with different things, in July hospital again and again diagnosed with different things, one of which was very low iron. At this point I had all sorts of body issues going on and questioned about thyroxine as it had been upped probably for no reason as the low iron was probably causing initial symptoms, so dropped back to 50mg.

Im still having a lot of stuff going on, lots of symptoms, just had an mri and they are talking about fibromyalgia, but im still concerned they are missing something with thyroid.

I was only ever borderline and 50mg put me into normal ranges, but even since ive dropped my levothyroxine back to 50 my ft4 is going up? I get confused about this, but its now going out of normal ranges and gp saying its fine. I cant help thinking its not fine! He just says its fine as tsh is fine.

Tsh Feb: 0.67,increase meds July: 0.71 decrease meds Aug: 0.92

Ft4 Feb:11.3 increase meds July: 13.4 decrease meds Aug: 15.7

If anyone can explain to me what the increasing ft4 means id be grateful, or any thougjts on whats going on. Im not happy with GPS suggestion to wait 6 weeks and test again

[SlowDragon Administrator]

You quite probably have Hashimoto's also called autoimmune thyroid disease. Do you know if you had thyroid antibodies tested? If the result was high this is Hashimoto's

Very common with thyroid issues to have low vitamin levels due to gut being affected. Ask for vitamin D, folate, ferritin and B12 to be tested.

When you have results, including ranges come back with a new post

If vitamins are too low body struggles to use the thyroid hormones.

[Clutter]

Melwise,

Can you post the FT4 lab ref range please? Impossible to see whether FT4 results are high, low or normal without the ranges.

[RedApple]

Ft4 Feb:11.3 increase meds July: 13.4 decrease meds Aug: 15.7

Melwise, What time of day do you usually take your thyroxine? And what time of day were these bloods drawn? If levothyroxine is taken too close to the blood draw, this can give a misleading FT4 result.

Both FT4 and TSH levels naturally fluctuate throughout the day. So, to get anything like a sensible comparison between each blood test, the taking of thyroid hormone and timing of the blood draws needs to be consistent. Was that the case for the results you've posted here?

[Melwise]

I cant remember about times etc, one lot were taken in hospital when I was seriously ill, I dont even know if I took it that day. But yes it could possibly be that situation actually, though my last lot were drawn at 3pm in afternoon and I had levothyroxine at 7am, so I thought id read that false highs were often in first few hours?

Vit d, ferritin and b12 all good. Folic acid was a little low but corrected very quickly. Iron has now started to pick up.

I should add as its been mentioned about ranges that the bloods were done in different labs so have different ranges but why is that? So by one lab theyre out another they arent but gp not concerned at all.

[Angel_of_the_North in reply to Melwise]

The labs may use different machines so you can only measure the result using theranges from the lab that did the test. 3pm will give you low TSH - could raise FT4 if you took it that morning, too.

[Janhoppo]

I get high fT4 readings whilst TSH is within normal range. I was told it is because I am not converting T3 to T4, but unfortunately the high fT4 means I get symptoms of overmedication and have to cut down on the Thyroxine. My highest fT4 was 20. It is now 13.

[silverfox7]

It should be that if you aren't converting the T4 to the T3 but they should really be doing an FT3 test to find out what is really happening. If you are getting hyper symptoms that FT3 is high as well though your TSH would then be low