Hi I was diagnosed with an underactive thyroid 13 years ago, and over these years I have put on 5 stone in weight going from a healthy 10 st to 15st, and suffer with all the other nasty ailments linked to it. I currently take 125mg Levothyroxine daily. My last test results taken in October 2017 were
Serum T4 level 13.8 pmol/L (11.0-26.0)
Serum TSH level (XaELV) 0.94 (0.27-4.2)
My GP states I am in the normal range, however after reading posts on this site I believe I am not at the optimum guide level. I am due to see an Endocrologist (finally) very soon, which I have never seen and been symptomatic. My test results in July 2017 were
Serum T4 level 18.3 (11-0-26.0)
Serum TSH level (XaELV) 1.08
Any advice from follower who be greatly appreciated.x
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Linzilou43
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Were your tests done at the same time of day, early morning after an overnifht fast and leaving off Levo for 24 hours? Making sure conditions are the same each time is the only way to compare results accurately.
There is quite a big difference in your FT4 but even so it's still less than half way through it's range. You really need FT3 testing also.
Have you had thyroid antibodies tested? What about vitamins and minerals - Vit D, B12, folate, ferritin? All part of the bigger picture.
Thanks SeasideSusie for your fast response. The bloods were taken in July/Oct 2017 1 hour difference in time in the afternoon. Not done the 24 hour fast off levothyroxine before, will try that on my next testing, and get them done early morning to see what reading I get. I have kept asking for free T3 to be checked, unfortunately it has not been done on these last two occasions, and I don't have any other test results other than these. To get copies of results is quite challenging in itself tbh. I will ask for all of the above to be done and post them, as I really want to get on top of these issues I am experiencing.
When we are on Levo and have tests, if we want to avoid a reduction in dose or want an increase then we need the highest possible TSH. TSH is highest early in the morning and lowers throughout the day so it's best to only ever have tests done at the earliest appointment your surgery offers, no later than 9am. Eating lowers TSH so fasting overnight will also ensure the highest possible TSH (water is allowed).
Taking Levo before a blood draw will give a higher FT4 which could also influence the GP to not increase Levo, so leaving it off for 24 and taking it after the blood draw is advised.
It's the lab that decides if FT3 will be tested, even when the GP requests it, and it tends to only be tested if TSH is suppressed. This is why many of us do our own tests with Blue Horizon or Medichecks fingerprick kits.
Here in the UK we are legally entitled to our results under the Data Protection Act. You should ask at reception, not your doctor, for a print out (don't accept hand written or verbal results). If they are difficult about it, just remind them that we are legally entitled to them and say you're sure no-one at the surgery would want to break the law.
Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.
All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results
If you have Hashimoto's then strictly gluten free diet is very likely to help or be essential
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, 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)."
You can obtain a copy of the articles from Thyroid UK email dionne.fulcher@thyroidUK.org. print it and highlight question 6 to show your doctor.
Thank you for your reply Slowdragon. I have requested a copy of the article from Dionne you have suggested. Do you think I may need T3 med or an increase in Levo currently on 125mg to start feeling well and lose the weight. I am doing SW healthy eating plan lots of veg, fruit ,lean meat, and having Gluten Free products instead of wheat?..
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