Blood Results Query

[Eoperez]

Hi, just new here so apologies if this has been asked before.

I was eventually diagnosed as hypothyroid back in 1994! I have had enough of feeling like crap and want my life back! I am sick of being tired and sick of all of my other symptoms and sick of getting fobbed off by GP and even the so called specialist obstetrician who I was under in my last pregnancy, who reduced my dose and then tried to do it again when I knew that wasn't correct in pregnancy! And after 5 years of trying for a baby I wasn't going to let her put my baby's health at risk. I wanted a referral to an Endocrinologist as haven't seen one since I was about 15,but they wouldn't refer me.

Anyway, just had bloods done earlier this week and got my usual phonecall from GP telling me I was overtreated even though I still have loads of symptoms. Spoke to the GP who didn't want to know and told me to speak to the GP who looked after me in my pregnancy. She is on holiday for 2 weeks but when I see her I want to be armed with as much information as possible.

I have my last 2 blood results and they are as follows:

21/08/2017

TSH <0.05 (range 0.35 - 5.5)

Free T4 17 (range 9-23)

22/08/2016

TSH <0.05 (range 0.35 - 5.5)

Free T4 17 (range 9-23)

Free T3 5.1 (range 3.5 - 6.5)

Now after being hypothyroid for so long you'd think I'd understand these results but I don't fully. All I know is TSH is outside the reference range and thus GP looks at this and says I'm overtreated. I know free T3 & free T4 are also massively important but don't know what I'm looking for!

I don't know if my thyroid is an autoimmune disease and if so I've read about cutting out gluten and perhaps dairy.

Thanks in advance, sorry for long post!

[greygoose]

Once you are on thyroid hormone replacement, it doesn't matter how low the TSH goes - as long as it doesn't go high, because that would mean you're under-medicated. But, it can go as low as it likes, and it goes low because the pituitary senses there is enough thyroid hormone in the blood, so it doesn't need to stimulate the thyroid anymore. It goes low because you don't need it.

The most important number is the FT3. T3 is the active hormone, and it's low T3 that causes symptoms. So, you need to know that you have enough active hormone in your system. Doctors think the FT3 is unimportant/unreliable because it fluctuates throughout the day (and they don't know how to interpret it!). But if you always have your blood draw at the same time of day, you can compare the tests and see if the level is going up or down or staying steady. It may be a rough guide but it's an important guide.

Your FT3 in 2016, was just slightly over mid-range - mid-range being 5.0. That is good for some people, but, there is plenty of room to increase if you feel the need - according your your FT3, you are nowhere near being over-medicated, despite the low TSH. So, you can see there, how unreliable the TSH is to dose by. Had you reduced your dose there, because of the low TSH, you would have become grossly under-medicated.

T4 is the storage hormone, which has to convert to T3 - I take it you are on T4 only, you don't say, and it is important to know that in order to interpret the results. Your FT3 is only just over mid-range, too - mid-range being 16.0. Which is good, shows you have enough T4 to convert to T3. And, if we compare the FT4 with the FT3, it shows that your conversion is OK. But, there's room to increase if you feel the need. However, you don't want your FT4 too high, because it will stop converting to T3 and start converting to rT3, which your body can't use.

To know if you have autoimmune hypo, you would have to have your antibodies tested : TPO and Tg antibodies. They are not on either of those two test you posted, so unless you have them somewhere else, you would need to ask your doctor to test them. Although she will probably only do the TPOab.

I think that just about explains it, but if you have any questions, don't hesitate to ask them, to make things clearer.

[Nanaedake in reply to greygoose]

greygoose, Do you know why doctors only do TPOab?

[greygoose in reply to Nanaedake]

Because - ta da! - they think it's rare to have high TgAB and low TPOab! And, it's another case of 'if you don't test for it, of course it's rare'!

[Nanaedake in reply to greygoose]

Haha!!

[Eoperez in reply to greygoose]

Thank you so much for your in-depth reply. I forgot to say that I take 175mcg Levothyroxine. I have PCOS also and just been diagnosed with Raynauds.

How would I increase my FT3?

Whilst pregnant the obstetrician reduced my dose to 150mcg and then tried to reduce it further to 125mcg. I had to fight to stop her reducing it further and to get it back up to 175mcg.

[greygoose in reply to Eoperez]

Try increasing your levo by 25 mcg.

[Clutter]

Eoperez,

TSH 0.05 is suppressed but FT4 is only just over halfway through range so you are not overmedicated. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email [e-mail] if you would like a copy of the Pulse article to show your GP.

[Eoperez in reply to Clutter]

Thank you Clutter I will read that and also request the article.