Hi guys after a tt in december 2016 because of lots of complications with graves. I still feel terrible I have my blood results sadly it's not an in-depth one just the basics. My Dr has upped my Levo to 150 and repeat bloods ....
TSH 22.18. FREE T4. 12.6
T3. 2.1. THANKS IN ADVANCE X
If you add the reference ranges then your results can be interpreted accurately (ranges vary from lab to lab) but your TSH is way too high, it needs to come back down to the lower part of it's range, and free Ts should be in the upper part of their ranges, which is where most people feel well. You probably have a few more tests/increases to go to achieve the correct levels for you to feel well, and it's possible that you might need T3 added to your Levo if your FT3 remains low with a high end FT4.
That's all I have it is just a copy letter to my Dr to explain the increase in Levo. I'm in the UK x
You can ask your GP or the hospital lab what the ranges are, as I said your results can't be interpreted accurately without ranges for FT4 and FT3.
TSH 22.18 - this is very definitely way over range. A typical range would be something like 0.2-4.2 or 0.5-4.5, I don't think we've seen one with a top limit of more than 5. So you will need to get this down to the lower part of your range, as mentioned.
FREE T4. 12.6 - this is almost impossible to comment on. My lab's range is 7-17, we see 9-19 and 12-22, so you could be mid-range or you could be at the very bottom. My guess is you're at the bottom because of your very high TSH. So you need to get nearer the upper end of whatever the range is.
T3. 2.1 - again impossibe to say. My lab is 3.5-6.5 and we often see 3.1-6.8 so, guessing again, if this is FREE T3 (FT3) [rather than TOTAL T3] then you may be below range, which I guess you probably are, again because of your very high TSH, and it needs to come up nearer to the upper end of the range.
As mentioned, increases and repeating tests need to be carried out every 6-8 weeks until you achieve the levels needed to feel well, usually we feel best with TSH 1 or below and free Ts in the upper part of their ranges. As also mentioned, if your FT3 remains low with a high end FT4 then the addition of T3 is a distinct possibility to help you feel well.
You were very under medicated. Bloods should be retested in 6-8 weeks
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 print it and highlight question 6 to show your doctor please email Dionne at
tukadmin@thyroiduk.org
Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine
(After TT you are likely to need it nearer 0.2 than 2.0)
See box
Thyroxine replacement in primary hypothyroidism
pathology.leedsth.nhs.uk/pa...
Professor Toft recent article saying, T3 may be necessary for many. Note especially his comments on current inadequate treatment for patients following RAI or thyroidectomy
rcpe.ac.uk/sites/default/fi...
Increasing Levo dose in 25mcg steps, retesting each time, until TSH is low in range and FT4 towards top of range.
If FT3 remains low p, then you may need addition of small dose of T3
NHSoften refuses to test FT3 so you may, like hundreds on here have to test privately
For full Thyroid evaluation TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies. Plus vitamin D, folate, ferritin and B12.
Essential to test vitamins
Private tests are available
thyroiduk.org.uk/tuk/testin...
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 ideally be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)
Thyroid results still feel bad 
New results - good/bad news
Stopping my thyroxine - a bad idea?
Print out of my results 
