Clinically euthyroid?

[AngleX]

Just been going over my endo results via Hospital as my thyroid medication been reduced and I’m feeling dreadful with it.

The letter states I am clinically euthyroid and I have t a clue what this means. Letter from December bloods from Dec also

I’ll add some details from his letter and see anyone can help? 🙏🏻

Diagnosis hypothyroidism

Vitamin d deficiency

Levothyroxin reduced to 175 from 200 mcg

Cholecalciferol 800 iu od

TSH = 0.07 mIU/L

Free T4 = 25.8 pmoI/L

Free T3 = 4.5 pmoI/L

Clinical surgery. Clinically euthyroid although TSH on lower side suggesting we are slightly over treating her. Rescues levo and are her again in 4 months time then to discharge. Asked GP to refer to rhyematology for checks in fibromyalgia or chronic fatigue.

Bloods from prior tests in September were

AM cortisol 166 nmoI/L

Prolactin 347 mIU/L normal

TSH 0.05 mIU/L

FT4 20.7 pmoI/L

FT3 4.7 pmoI/L

Thanks in advance

[Marz]

Happy to help - so please post the ranges - the figures in brackets after the results Think you may have a problem converting T4 into T3.

B12 - Folate - Ferritin - have they been tested ? Doubt if 800 IU's of VitD will raise your level - what was the result ?

[AngleX in reply to Marz]

I’m useless with thus sorry. There’s no other numbers other than the numbers I added on here from his letter. Vit D doesn’t seem to have helped a lot but slight I’d say.

[Marz in reply to AngleX]

OK - then maybe ask the Surgery for more details next time you are there. You are legally entitled to have copies of results - that are YOURS ! It is important to check tests done - so you can pick up on anything missed. Also helps with posting here. The Surgery should be able to give you the VitD result as well. Your result needs to be around 100 if you are in the UK. Meanwhile I would take the 800 IU's x 3 per day until you know your result. I take 10,000 IU's in the winter months - and living in Crete I get plenty of sunshine !

Please ensure you have B12 - Folate - Ferritin tested - this is key for you to feel well and for the thyroid hormones to work well in your body.

Your dose has been reduced as the FT4 could well be over range - that is why the ranges are important for posting as lab ranges do very GP's and Endos do over-react to a Low in range TSH like yours.

Do you have Hashimotos ? If your anti-bodies have not been tested it may be worth asking for those to be done too - Anti-TPO and Anti-Tg.

[AngleX in reply to Marz]

Thanks so much. I’ll make an appointment and will get them. X

[Marz in reply to AngleX]

Don't forget the additional tests I have mentioned above ....

[Clutter]

AngleX,

Euthyroid means your thyroid levels are normal ie neither hypothyroid nor hyperthyroid on your current dose.

TSH 0.07 is suppressed and FT4 25.8 is usually over range and FT3 4.5 within range but one would have to see the ranges to be certain. Dose has been reduced because your endo feels TSH 0.07 and FT4 25.8 indicates slight overmedication. Some people do need high FT4 which will suppress TSH to feel well and it isn't necessarily a problem as long as FT3 remains within range. 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.

You should find out what your vitamin D level is. 800iu will not correct vitamin D deficiency. 800iu is a maintenance dose once deficiency has been corrected ie >75. Your endo or GP should refer to the cks.nice.org.uk/vitamin-d-d... re dosing.

It would be a good idea to ask GP or endo check ferritin, B12 and folate in addition to vitD as they are often low or deficient in hypothyroid patients.

[greygoose]

'Euthyroid' is just another way of saying 'she doesn't have a thyroid problem, her labs are normal'. All rubbish, of course, because they don't know how to interpret the results. But, because the results are all within the ranges, they consider them to be normal. But, on here, we know that if you still have symptoms, then they aren't normal at all! As Marz says, you would appear to have a conversion problem, and whilst your FT4 is on the high side, your FT3 is still too low. And, it's low T3 that causes symptoms.

[Angel_of_the_North]

You are probably a poor converter of T4 to T3 and so need over range free t4 and very low TSH in order to make enough T3. Get a copy of the Dr Toft Pulse article that states that case and show it to your doctor.