Help with Interpretation of Results required please?

[RobynSM]

Dear All,

I switched from WP to NP Thyroid at the start of November, I switched exact equivalent drainage but NP per total grainage gives me a higher T3 & T4 dosage.

I have been symptomatic of what felt like hypo but have had a headache now for last couple of weeks and feeling edgy and irritable as I can get!

Basic thyroid panel indicates that my TSH is maybe a little too suppressed (I like to keep it slight suppressed as find it helps my antibodies and Hashi's symptoms), and both FT4 & FT3 outside of normal range... wondering how much I should decrease dosage without a plunge (don't know what's worse, feeling hyper, hypo or a Hashi's flare up!).

Feedback on results and recommendations warmly welcomed,

THYROID STIMULATING HORMONE *<0.005 mIU/L 0.27 - 4.20

FREE THYROXINE 21.3 pmol/L 12.00 - 22.00

FREE T3 *11.5 pmol/L 3.10 - 6.80

Many TIA

RobynSM

[Clutter]

RobynSM,

How long did you leave between last dose and blood draw?

[RobynSM in reply to Clutter]

I took my morning dose at 7am and then tested at 10.30am?

[Clutter in reply to RobynSM]

RobynSM,

In future leave 8-12 hours between last dose and blood draw. T3 in NDT can peak in the blood for up to six hours. That may be why FT3 is so high. I suspect you may be a little overmedicated to have such suppressed TSH and it is unusual to have FT4 high in range when taking NDT.

Your symptoms sound as though you are overmedicated so you could reduce dose by 1/2 grain now, and if symptoms don't improve, another 1/2 grain in 2 weeks, then hold for 6 weeks and retest before making more adjustments.

[RobynSM in reply to Clutter]

Thanks Clutter

Interesting.... I do my bloods early because I like to send them first thing when post office opens to make sure they get to labs fresh for next day delivery (I get quite panicked at blood prick time - just because I don't want to miss the next day window). Wondering about all my past test results now and questioning the accuracy. Anyway, thanks for that.

A half grain drop? I was going to do a 1/4 to see if symptoms shift, do you think a half instead?

As always very grateful to you for your support Clutter, thank you!

RobynSM

[Clutter in reply to RobynSM]

RobynSM,

Thyroid results are a snapshot in time so they are always "accurate" but by taking T3 before the blood test you will have a result for the peak level when what you want is the normal circulating FT3 level.

I'm not even sure 1/2 grain will be sufficient dose reduction which is why I suggested a further 1/2 grain in 2 weeks if symptoms don't improve.

[RobynSM]

Wow, that's quite a drop from my WP dose!

OK, will follow your suggestion and watch Clutter, thank you Much gratitude

[silverfox7]

I think it over medication it's easier to go low and flush out the extra then titrate back up or you might miss where you need to be.

When taking any form of T3 the results are read differently so TSH should be suppressed, FT4 can fall but FT 3 should be high but in range. So I'm suspecting on a Lowe dose both FT3 and FT4 will fall but like Clutter I thing with such a high reading you may well need to reduce again. If our are unsure at that point I would drop down again as Clutter suggests as it's easier to work up and o don't want to to miss your sweet spot.