Results please help. Thanks

[MaiteFrench]

Hi,

Could you help me understand the following especially the T4 which is too high.

Serum free T4 level26.9 pmol/L Range 10.8 - 25.5pmol/L

Serum TSH level0.02 mu/L < Range 0.27 - 4.2mu/L

Unfortunately I don't have the T3. I have no thyroid left and take 150mg of levothyroxin.

Thanks for your answers.

[SeasideSusie Remembering]

It depends on how you feel.

Dr Toft states in Pulse Magazine, "The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

So you really need FT3 testing, if that's in range and you feel well then all is OK. If it's over range you're overmedicated.

[MaiteFrench in reply to SeasideSusie]

Thanks for sharing your knowledge. I know I need my T3 tested but that is a fight in itself. Hopefully the endocrinologist will do it next week. Something is wrong thought as I am in hypo. I believe I am not transforming T4 in T3 as I should to feel well.

[bantam12]

Your doc will probably have a hissy fit same as mine did and he/she will say you are overmedicated, my results are almost the same TSH 0.03 and T4 25, my T3 is well within range so I know I'm not on too much, 125/150. If you feel ok that's fine but you do need a T3 result.

Good luck with the GP !

[MaiteFrench in reply to bantam12]

The GP said I was taking too much levo but I refused to be changed as long as I don't have a complete assessment since I have so many symptoms of hypo. I am not impressed by any hissy fit or otherwise. I really don't care about that. My health is more important than any GP's emotions. Thanks for your answer in any case.

[silverfox7]

With those results you could have a very low FT3 as not converting properly or you could have a very high one which shows over medication and could be dangerous. So it is essential to get your FT3 tested to see which end of the scale you are. Both scenarios could make you feel rough.

[MaiteFrench in reply to silverfox7]

I believe that I am not transforming T4 in T3 as I should hence all my problems. So I am definitely going to get my T3 results one way or the other. Thanks for your answer.