Results opinions please

[Greenwall]

Hi.

Bloods in March were:

TSH 7.9 mIU/L (0.3- 4.5)

FT4 14.6 pmol/L (11-22)

Now they are:

TSH 2.18 mU/L (NB slightly different letters for the units of whatever they are measured in - so not sure if it can be directly compared or not) range (0.34 - 5.6) ie goal posts moved slightly.

FT4 9.6 pmol/L (8-18) ie goal posts moved.

If the FT4 was 9.6 in March, would that have been underactive?

And if so, why isn't it now?

Thanks.

[SlowDragon Administrator]

How much Levo are you taking. How long on that dose

It looks like your ready for a dose increase. FT4 is low in range and most people need TSH around one or lower to feel better.

What about vitamin D, ferritin, folate and B12 levels

[Greenwall in reply to SlowDragon]

This person isn't on meds, and it was big enough job persuading doc to repeat tests, let alone add others to the list.

I do agree that the other tests are important, especially as there has been a history of low ferritin.

[humanbean]

Each test result you get, for any test at all, must be compared to the lab reference range given with the result at that time. You can't decide which reference range to use for yourself, and you can't just decide to use a previous reference range with a new result - it really would make no sense.

When you are comparing two results with different reference ranges and/or different units of measurement the easiest way to do that is to find out how far through the reference range a result is as a percentage.

FT4 14.6 pmol/L (11-22) - this result is 33% of the way through the ref range

FT4 9.6 pmol/L (8-18) - this result is 16% of the way through the ref range.

So, using percentages you can see that your Free T4 has dropped significantly, although even the first result is much too low for anyone on Levothyroxine only.

.

mIU/L = milli-international units per litre

mU/L = milli-units per litre

I've always assumed these were the same, but perhaps I assumed wrongly.

.

Your TSH is still too high and you need an increase in dose. For future reference you really need to know your Free T3 as well if you are going to get your health to the optimum possible. Sadly, the NHS rarely tests Free T3 for people who are hypothyroid, and so you would have to pay for the test yourself. Also, for people on Levo it is important to know Free T4 and Free T3 results which are done from the same sample. So, if the NHS tested your Free T4 you couldn't then go and get a test of your Free T3 and get any useful information from the result. Free T4 and Free T3 must be tested from the same blood sample to be of any use.

[Greenwall in reply to humanbean]

This person isn't on meds at present.

[shaws Administrator in reply to Greenwall]

I am not medically qualified but I'd say if someone has a TSH of TSH 7.9 mIU/L (0.3- 4.5) he/she would be hypothyroid. In other countries when it reaches 3+ people are diagnosed. FT4 was also low.

Also blood tests should always be at the very earliest possible, fasting (you can drink water). The TSH is variable throughout the day, highest a.m. and lower p.m.

B12, Vit D, iron, ferritin and folate and thyroid antibodies should be tested too.

I shall give you a link from TUK re interpretation of tests and symptoms.

Free T3 and Free T4 should be towards the upper part of the range. FT3 is important too. Any tests not done can be processed by one of our private labs.

thyroiduk.org.uk/tuk/testin...

thyroiduk.org.uk/tuk/about_...

[Greenwall]

Thanks for all the replies. It's back to persuading doc to repeat labs....