Low TSH - Low Serum Free T3 and normal Serum free T4

[norfolkgirl99]

Hi - My GP has been tweaking my Thryoxine (currently 125mg per day) and Levothroxine - 10mg 3 x a week) but my results are now all over the place.

Just had blood tests plus thyroid peroxidase and some iron tests

Serum TSH - 0.04 mu/L (0.35-3.50mu/L)

Serum free T3 - 3.2 pmol/L (3/80 - 6.00pmol/L)

Serum free T4 - 14 pool/L (8.00 - 21.00pmol/L)

Se thryoid peroxidase - 8.9 ku/L (0.00 - 34.00ku/L)

Serum Iron level - 36.7 ump/L (11.50 - 30.00umol/L)

Transferrin saturation - 66% (16.00-45.00%)

Serum ferritin - 55ug/L (23.00 - 300ug/L)

Does anyone have any advice / suggestions?

My GP was away all last week so trying to see her this week.

The blood test print out says acceptable for TSH & T3 - no action required

And Normal for the Iron status even though the saturation level seems a bit high.

Thanks

[Clutter]

Norfolkgirl99,

Do you mean you are taking 10mcg Liothyronine (T3) 3 times a week?

Can you check the FT3 range. Should it be 3.1 or 3.8 - 6.0?

[norfolkgirl99 in reply to Clutter]

Apologies typo - it is 20mcg three times a week. It was only twice a week and she put it up two months ago.

Serum T3 is 3.2 pmol/L and range is (3.80 - 6.00pmol/L)

[Clutter in reply to norfolkgirl99]

Norfolkgirl99,

Liothyronine has a short half life and will be out the blood around 6 hours after last dose. It should be taken daily not alternate days. You would do better to buy a pillcutter and halve the tablets and take 10mcg with your Levothyroxine dose daily.

FT3 is below range so either the alternate day dosing is not working or 20mcg x 3 per weeks is insufficient dose. I would switch to daily dosing as I advised above and ask your GP to retest in 6 weeks. Take Levothyroxine and Liothyronine doses after your blood test.

TSH is suppressed but you are not overmedicated because FT4 is halfway through range and FT3 is below range.

Thyroid peroxidase result is negative for autoimmune thyroiditis (Hashimoto's) but it can't be conclusively excluded without a negative thyroglobulin antibody test which you will probably have to order privately.

Iron and transferrin saturation are high which indicates iron overload (haemochromatosis). Discuss with your GP because you may need to arrange to donate blood to reduce iron.

[norfolkgirl99]

Thank you so much for your reply. That is a good idea re cutting the pills. I have one I used to use for my cat! The iron & transferrin tests are the first ones I have had taken and when I researched it online it did seem to suggest that I would need to give blood. An iridologist told me 25 years ago that I must never take iron supplements as I don't process it properly so guess he saw something then. I never take iron supplements or multi vits as they usually have iron in them. I did not know that about the thyroglobulin antibody test. If GP can't do it I will get one privately. She would like to refer me to an endocrinologist as she is under pressure to stop prescribing Liothyronine. Will get more tests done. Thanks again.