T3 & t4 over range

[Beau66]

Hello everyone

Does having over range t4 & t3 mean under active? The same as tsh when being over range meaning under active?

Would appreciate any comments

Beau x

[SeasideSusie Remembering]

It depends on whether you are taking thyroid meds for hypothyroidism. If so then you are overmedicated to have FT4 and FT3 over range.

[Beau66 in reply to SeasideSusie]

Thank you for reply

I’m not over was just wondering if it’s the same principle?

T4 17 10-18.71

T3 6.3. 3.5-6.5

Tsh 4.94. 0.55-4.78

I’m on 50 mcg levo

Many thanks

[SeasideSusie Remembering in reply to Beau66]

Those are very strange results. Normally with a high or over range TSH you'd see low FT4 and FT3 and that would indicate undermedication/hypothyroidism.

The aim of a treated hypo patient generally is for TSH to be 1 or below with FT4 and FT3 in the upper part of their ranges if that is where you feel best. Your free Ts are very good and would suggest your dose is correct; however, your TSH is saying you are undermedicated.

[shaws Administrator in reply to Beau66]

Do you always have your blood tests at the very earliest, fasting (you can drink water) and allow a gap of 24 hours between last dose and test?

[Beau66 in reply to shaws]

Yes do all that

[shaws Administrator in reply to Beau66]

I will say your dose of 50mcg is so very low so I've no idea why your FT4 and FT3 are so high. It is a puzzle. Also your TSH at nearly 5 when the aim is 1 or lower.

How many clinical symptoms do you have and are you feeling well - despite the strange results?

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

[Beau66 in reply to shaws]

Hi thank you so much for reply

It’s a very long story. Was diagnosed with cfs/me many years ago and was virtually bed ridden for a number of years. Through my own hard work and Determination I managed to get well through nutrition.

Had a head injury two year ago and I’ve been bed ridden for the last year. Through research have found out about pituitary problem through head injury. Also had head injury when I was seven and fractured my scull when I was 25 playing rugby. Been fighting with drs this last year to get appropriate testing., but he blames everything on cfs. So many symptoms to mention I feel like I’m dying every minute of every day. Not strong enough now to fight for my health anymore

[Beau66 in reply to shaws]

Also had a positive ana test recently I had done privately. So another twist to put in the mix

[Angel_of_the_North in reply to shaws]

I have read that thyroid hormone resistance can cause high in range Free t4 and free t3 with high in range TSH.

[diogenes Remembering in reply to Beau66]

With these strange TSH figures, I'd ask for a repeat using a different measuring method. There might be interference in the test from antibodies.

[StelAnd in reply to SeasideSusie]

Hi Susie

I had the medichecks blood test results last week. These are them

ENDOCRINOLOGYThyroid FunctionTHYROID STIMULATING HORMONE 0.85 mIU/L 0.27 - 4.20 FREE THYROXINE 17.8 pmol/L 12.00 - 22.00 TOTAL THYROXINE(T4) 86.6 nmol/L 59.00 - 154.00 FREE T3 *3.03 pmol/L 3.10 - 6.80 THYROGLOBULIN ANTIBODY 12.100 IU/mL 0.00 - 115.00 THYROID PEROXIDASE ANTIBODIES*47.5 IU/mL 0.00 - 34.00

[SeasideSusie Remembering in reply to StelAnd]

StelAnd

Can you please post this in a new thread of your own and I will be happy to reply. It gets confusing when you jump in on someone else's thread and it a bit rude

[StelAnd in reply to SeasideSusie]

Sorry I’ll consider myself admonished 😊

[SeasideSusie Remembering in reply to StelAnd]

No, didn't mean it as a telling off , it's just that it is a bit unfair to jump on the back of someone else's thread that's discussing a different subject, but if you post your own thread more people will see it and respond (and correct me if I give some wrong information )

[greygoose]

Hypothyroidism is high TSH and low thyroid hormones - FT4/3.

Hyperthyroidism is low TSH and high thyroid hormones. Except that it's not as simple as that. If you have high antibodies, and therefore Hashi's, you thyroid hormone levels can sometimes rise, and therefore your TSH will drop. But, that doesn't mean you are truly hyper, just that you are having a Hashi's 'hyper' swing.

Your Free levels are extremely high for someone with a TSH of 4.94 and on only 50 mcg levo. I would therefore suspect you have high antibodies and are starting a Hashi's 'hyper' swing - aka Hashi's flare. The TSH takes a while to catch up with the levels of the Frees. Have you had your antibodies tested?

[Beau66 in reply to greygoose]

Thank you so much for your reply

Sorry for my ignorance but would Levo reduce t3 t4 numbers or make them higher? My gp knows nothing which concerns me.

I didn’t realise how complex all this is

[greygoose in reply to Beau66]

Levo would increase FT4 numbers, certainly. But, how much it would increase your FT3 numbers depends on how well you convert.

So, you've had your TPO antibodies tested, right? 31 (0.00 - 60.00) Which is negative. But, that doesn't 100% mean you don't have Hashi's. There are two types of Hashi's antibodies, but the NHS only tests one - the other is Tg antibodies. And that could be high when the TPOab is low, and still mean you have Hashi's. Or, you could be one of those Hashi's people that never develops Hashi's.

I do wonder if there wasn't some mistake at the lab to give you those weird numbers. I think I would be inclined to ask for a retest. Because those labs don't make sense. The TSH should be much lower with high Frees like that.

[Beau66 in reply to greygoose]

Thank you so much that is so very helpful

Why do gps not have this knowledge and lots of endos as well I expect

[greygoose in reply to Beau66]

Because they don't learn it in med school. And the reason they don't learn it in med school is that Big Pharma doesn't want them to know how to make hypos better, because BP are making a fortune out of treating our symptoms : antidepressants, statins, PPIs, beta blockers, etc. etc. etc. If we were well, we wouldn't need all that!

[Beau66 in reply to greygoose]

That makes my blood boil!!!

It’s so wrong as I know from bitter experience how ill you can be from this!!

Thanks again for in-depth information it’s very appreciated x

[greygoose in reply to Beau66]

You're very welcome.

[JS33 in reply to greygoose]

yes , well said.

And I agree about the antibodies , I've seen this sort of misleading blood numbers on my own journey.

To the OP , I just take my time and paid for frequent blood tests . It's quite possible , if you stay on the 50 levo and have a blood test in a few months , your levels will be totally different .

[Hidden in reply to greygoose]

I’m fed up of reading that GP’s don’t learn about the Thyroid in med school ... they do ! What they do with that knowledge , how they use it, how good they are at keeping up to date and how much exposure they’ve had to thyroid issues prior to and during their GP training are all factors that can influence along with their individual personalities of course.

[greygoose in reply to Hidden]

From what I've heard, they have one afternoon to cover the whole endocrine system. How much can they possibly learn about the thyroid in that time? Some of them don't even seem to know where it is! And even endos don't seem to know much more, and they're supposed to know about all hormones. All they know about is diabetes, for the most part.

[Hidden in reply to greygoose]

One afternoon in five years of med school and another five plus years of hospital based training with relevant exams and assessments along the way before they branch out into a specialty such as GP practice and then low and behold they are expected to be experts in every ailment and disease going ! Really. That’s why there are Consultant specialists such as Endocrinologists to refer into when appropriate to do so. But even then those specialists of the endocrine system have to have knowledge of the whole system and then individually they will have their own specialist interests such as the thyroid or diabetes etc. There are bad eggs in all areas of employment. Those that give 110%, those that give just enough and those who are so stressed and brow beaten they’ve stopped caring and unfortunately it’s always the bad ones that ppl remember and then assumptions are made about them all. I’m sorry to rant but I spent 27years working in the NHS before having to retire because of my health. It’s not a perfect system. The people working in the NHS are not perfect and are only human. But the majority try as much as possible to give the best care they can within the restrictions and guidelines they are tasked with working to. I’ve now had experience on both sides of the fence and the advice I give is that doctors nurses specialists etc are only as good as the information you give them and the response you get is often as good as how you present that information to them. So work collaboratively with your healthcare provider , don’t lock horns with them , accept that you won’t always here what you want to hear but what you need to hear and if you are not happy see another GP or a second opinion from a specialist. No one intentionally wants to keep you or make you ill

[greygoose in reply to Hidden]

another five plus years of hospital based training

Well, that's part of the problem, isn't it. They don't tend to see hypos in hospital. Hypothyroidism is never connected to the reasons people end up in hospital, so they don't get exposure to thyroid there.

they branch out into a specialty such as GP practice and then low and behold they are expected to be experts in every ailment and disease going

No, not at all. I don't think people do expect them to be experts in everything. But what people do expect is to be referred to the relevant experts, but GPs refuse to refer. And, a very important question is, do these GPs realise they're not experts in everything? I would say they don't, for the most part. They are ready and willing to pronounce on just about everything, even if they do have to make it up as they go along, and spout rubbish! It's very rare to hear a GP say 'I don't know'! And they're very fond of 'diagnosing' people with psychiatric problems, which they are definitely not experts in! If the general public is going to realise that GPs aren't experts in everything, GPs should stop behaving as if they are.

it’s always the bad ones that ppl remember

Well I've seen a hell of a lot of doctors, and there's not one I would class as good. And I've never met one - well, perhaps one - that wanted to work collaboratively with me. They all wanted to dictate, withhold information, and treat me as a moron. And that no matter how I approached them. Despite what you might think, I don't barge into a doctor's surgery and 'lock horns' with them, but I do give as good as I get. I'm not going to tolerate being insulted, looked at like a piece of trash, talked down to, laughed at and just generally mocked, which most doctors seem to think they're entitled to do because they are god, and I'm just a stupid patient. I don't know about intentionally wanting to keep me sick, my impression is that for the most part, they just don't care.

[Hidden in reply to greygoose]

I’m sorry you’ve had such a bad experience as it would appear to have clouded your outlook ! and that’s as dangerous as as a bad healthcare professional who doesn’t listen explain or refer appropriately. Not everyone with Hypothyroidism or hyper etc needs to be referred

We are going to have to agree to disagree on a lot of things. Just remember that we become an ‘expert’ on our own health conditions but that doesn’t mean that we are experts about others

[greygoose in reply to Hidden]

Well, I just speak as I find. But, I have never pretended to be an expert on anything. I, at least, am capable of saying I don't know, when I don't know something.

Aplogies to Beau66 for hi-jacking her thread.

[Hidden in reply to greygoose]

Yes apologies to Beau66. I will also hold my hand up and say I don’t know. My GP when presented with my neurological diagnosis of NMO which is rare did just that. Asked me about it and then of his own accord went and googled it to get more information and then told me at my next appt what he had done. He was a senior Registrar in orthopaedics before becoming a GP. While I accept that there are some who will not take the time to do that or are not prepared to say when they need to find out more about an ailment there are those that do as I’ve just demonstrated. So like I said we need to agree to disagree.

[waveylines in reply to Hidden]

Snow I have had excellant treatment on the nhs for other conditions & am extremely grateful for the hard work & dedication of nhs staff who work under terrible pressures but hypothyroidism is like some big black hole where the nhs is concerned.

I ask you if the nhs is doing such a fantastic job on treating those patients with that condition why is this forum so incredibly busy & active? Could it be that where this condition is concerned they are not doing well at all....their intentions may be honourable & well intended but with all due respect most are not well informed on this subject.

After nearly 15 years living with this conditons Ive heard all sorts of from various GPs without locking horns with them which is mind blowing ignorant at best & punitive at worst - the truth is the effective treatment am now on is no thanks to them....& they know it!! My GPs now respect me for that & do now back me....but its through my efforts, persistence, proactiveness not theirs but despite them that Im now well. Isnt that just a tadge back to front?

There is no doubt the nhs should feel ashamed about how they treat patients suffering with hypothyroidism.....the nhs should also consider it would actually save them money if they treated us patients optimally as we would need less other medications to offset symptoms due to under treatment. When I finally was optimally treated I no longer needed four other medications. My GPs saw that & admitted it. My oh my...,, how can one defend lack or under treatment of patients?......I do wonder...my GPs didn't do it intentionally....it was through sheer ignorance & lack of understanding. As one GP put it.....we havent done much for you at all have we. Nope not at all....not on hypothyroidism!!

[helvella Administrator in reply to Hidden]

Perhaps you could write a new post with a proper description of the education in thyroid they typically receive? Most of us have little connection with doctor training so someone who knows could be helpful in letting us all understand.

[Beau66]

Hi

Only peroxidase ab conc PBD

31. 0.00-60.00

[SKnud]

Are you obese by any chance? I recently saw an endo privately with elevated TSH (4.34) and normal thyroid values (FT4 14.8 [11.0-26.0], FT3 5.8 [3.90-6.80] along with negative antibody testing. I had some other key findings as well, like hypogonadal total testosterone (8.20 [8.64-29.00] - 29 years old at the time) and high uric acid (431 [200-430]). He didn't think I was hypothyroid even though I could tick most of the boxes of symptoms with crippling fatigue being the worst of the lot, but rather I have metabolic syndrome and insulin resistance, which can often be seen in these sorts of numbers and my body composition. Maybe some food for thought.

[ShootingStars]

Hi Beau. Is there any chance you’re taking iodine supplements?

[StelAnd]

ENDOCRINOLOGYThyroid FunctionTHYROID STIMULATING HORMONE 0.85 mIU/L 0.27 - 4.20 FREE THYROXINE 17.8 pmol/L 12.00 - 22.00 TOTAL THYROXINE(T4) 86.6 nmol/L 59.00 - 154.00 FREE T3 *3.03 pmol/L 3.10 - 6.80 THYROGLOBULIN ANTIBODY 12.100 IU/mL 0.00 - 115.00 THYROID PEROXIDASE ANTIBODIES*47.5 IU/mL 0.00 - 34.00

Hi all these are my results from last week

[Angel_of_the_North]

No, it means Overactive or temporarily overactive from a Hashi flare or overmedication.