Are these results ok?

[squiddie82]

Just had my results my TSH was 0.23 (0.27 - 4.20 miu/L) and T4 was 25.5 (12.00 - 22.00 pmol/L). I am currently on 100 mg of Levothyroxine after having my Thyroid removed last year.

My results seem to be getting better from what I can understand, the results I have to hand are :

Jan 18 TSH 44.9 (0.27 - 4.20) T4 14.5 (12.00 - 22.00) - Taking 50 mg Levothyroxine

March 18 TSH 0.95 (0.27 - 4.20) T4 20.3 (12.00 - 22.00) - Increased to 100mg Levothyroxine

So the TSH getting lower is a good thing but the T4 is getting higher is that good also? Sorry for my ignorance but I am really struggling to understand (and must be very thick!) I have read different things that have been suggested on here to give information but I am still unsure.

thanks in advance for any help/info given.

[SeasideSusie Remembering]

Squiddie82

The aim for someone on Levo is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges if that is where you feel well. Your FT4 is a little on the high side, you really need FT3 testing to see if you can convert T4 to T3 well enough. Some people who have had their thyroid removed do better on a combination of Levo and T3. If you continue with an over range FT4, there's a chance that you will end up making reverse T3 rather than FT3. So testing FT3, at the same time as FT4, is important for you now. If GP can't or wont do it, there are recommended labs where you can get private tests, either by fingerprick or venous blood draw if you prefer.

[squiddie82 in reply to SeasideSusie]

Thanks for your reply.so with my results should I be feeling better? as I feel worse the last week or so I feel so drained! Think I will have to go down the private route as they won’t even entertain the idea of doing a full blood count at the same time as testing my TSH and T4. Didn’t even know about reverse T3 so will try my hardest to try and understand this also. I naively thought that once my thyroid had been removed and was put on tablets I would feel so much better, I could not have been more wrong!

Thank you for your help it is much appreciated! 🙂

[SeasideSusie Remembering in reply to squiddie82]

Squiddie82

You may not feel better with an over range FT4. I didn't. I had a previous GP who was trying to be helpful, I was still symptomatic and she kept on increasing my Levo until my FT4 was well over range. It didn't help at all, I never felt any better. What I eventually discovered was that my nutrient levels were poor, severely deficient Vit D, low ferritin and folate, plus my T4 to T3 conversion wasn't particularly good.

With your results, I would want to see FT3 tested with FT4. It may be that if your conversion is good then slightly reducing your Levo will help.

Do you have any results for vitamins and minerals:

Vit D

B12

Folate

Ferritin

[greygoose]

An increase of 50 mcg in one go is too much. It shouldn't be more than 25 mcg.

Have you had your antibodies tested?

[squiddie82 in reply to greygoose]

Thanks for your reply, they seem to like increasing or decreasing me in doses of 50 mg! When I first had my op I was put on 100 mg then was dropped to 50 mg and then straight back up to 100 mg!

Antibodies were normal from what I can remember were tested way before any mention of thyroid being removed and haven’t been tested again since.

[greygoose in reply to squiddie82]

Ah ok! You've had your thyroid removed, so you wouldn't have Hashi's antibodies, then. But, you are going to have to try and cool their enthusiasm for huge jumps in dose, because that's not good for you!

[SlowDragon Administrator]

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

[e-mail]

Professor Toft recent article saying, T3 may be necessary for many, especially after thyroidectomy

rcpe.ac.uk/sites/default/fi...

You need full testing including vitamins

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

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. Medichecks do offers on Thursdays

All thyroid tests should ideally be done as early as possible in morning and fasting. If on Levothyroxine, don't take in the 24 hours prior to test, delay and take straight after

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)