Low FT4 With Normal FT3 and TSH?

[DanaScully]

Hi

I’ve had my most recent blood test results through, and I was surprised to see that my FT4 is so low in the range. Does anyone know why that might be? I take 2.5 grains of NDT and I skipped the morning of the test.

TSH <0.05

FT3: 6 (3.1-6.8)

FT4: 11 (11-22)

I am still experiencing Hypo symptoms, although I'm also diagnosed with ME so it's difficult to know what's down to the ME and what's down to the thyroid.

Can I top up my NDT with a small amount of Levothyroxine? The Endocrinologist who has recently discharged me because I chose to take NDT told me I shouldn't, but I would welcome any input from you.

Thanks for any replies.

[SeasideSusie Remembering]

FT4 is usually low when taking NDT. It's FT3 result that matters.

NDT should be left off for 12 hours before blood draw.

[DanaScully in reply to SeasideSusie]

Thanks, SeasideSusie.

[shaws Administrator]

The blood tests were introduced along with levothyroxine (T4) so if we add in other hormones, i.e. either adding T3 or taking NDT - results cannot correlate with T4 only. If you take NDT, and are having clinical symptoms you can add 1/4 of 1 gr tablet every two weeks until you are symptom-free.

I will say I am not medically qualified but had undiagnosed hypothyroidism.

[DanaScully in reply to shaws]

Thank you, shaws.

When you say add 1/4 of 1 gr tablet, do you mean NDT or T4?

I've been having some symptoms recently which are making me think I might be over-medicated, namely hand tremors/shakes and pulsatile tinnitus (a rhythmic pumping/whooshing in the ears in time to the heart). I'm still extremely fatigued, lethargic, and often have cold extremities. It's almost like I have symptoms of both hypo and hyper which is making things very confusing for me.

Thank you.

[shaws Administrator in reply to DanaScully]

I am only talking about NDT not levo. you've not had thyroid antibodies checked ask for these at next blood test if you haven't had them checked previously. It could be due to antibodies flooding out and making you feel hyperthyroid when you are really hypo. I shall give you a link re Hashi's which is an Autoimmune Thyroid Disease - the commonest and due to having thyroid antibodies.

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

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

[DanaScully in reply to shaws]

Thank you. Last year my TPO came back as 1017u/l, so I know my Hypo is autoimmune related. I haven't had it tested since as getting my Endo to agree to the initial test was a nightmare. When it came back so high, I asked him about it and he basically shrugged it off and didn't really comment.

I'll have a look at the links you've provided and I'll try adding another 1/4 of a grain of NDT to see how I get on. Thanks again.

[shaws Administrator in reply to DanaScully]

It is a struggle and they are so poorly trained and really aren't aware of how we feel, considering all of the different symptoms one can get and they know none. Once upon a time we got diagnosed due to our clinical symptoms alone, no blood tests or levothyroxine then. We were prescribed NDT and increased dose until we felt well with relief of symptoms. If pulse/temp rises drop to previous dose.

[shaws Administrator in reply to DanaScully]

The emphasis when taking thyroid hormones is all about how we 'feel' on a certain dose. The aim is to feel better with no clinical symptoms. Doctors seem to believe if we have a very low TSH we will have heart or bone problems but not if we are on an optimum for us individually and feel well.

[DanaScully in reply to shaws]

Thank you, shaws. You've been really helpful.

[Eddie83 in reply to DanaScully]

My condolences. Your endo is grossly ignorant.

[Eddie83 in reply to DanaScully]

Since your endo is ignorant, you might want to check out some of the people on youtube who talk about the causes of Hashimoto's. Also Izabella Wentz has several books; the "Root Cause" deals with things that can cause autoimmunity. In my case, that "thing" was gluten.

[shaws Administrator in reply to DanaScully]

This is a list of clinical symptoms of hypo:

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

This is about antibodies:

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

[Eddie83]

This is how I feel most comfortable: FT4 low in range (~20% up in range) and FT3 mid-range. FT3 is what matters. If you add levo to your NDT, several things could happen: (1) if you don't convert well, you could end up feeling anxiety, tremors, or other undesirable symptoms. (2) if you do convert well, then your FT3 might go up some, and maybe too much (depending on where you are now). (3) you notice no change in how you feel and your FT3 changes very little.

Hope you are aiming your FT3 for mid-range. It's a good idea to avoid readings low in the range, as those represent people in the defining population who were not fully well.

[Hidden]

You can hve symptoms like thar from other conditions, stop blame thyroid from everythink.