My results are very confusing please if anyone would kindly shed some light

[lemondrop123]

Hello,

I had a blood test done ( private ) and I am confused , my energy is ok but this year as a whole has been my worst for energy but I suffer from depression. I have had Hashimoto for about 10 years. I take 1and a half gram of nature throid a day ( t3 13.5 and t4 57mcg). My results are:

Thyroid Function TSH 0.52

T4 Total (Low) 59.9

Free T4 ( Low) 11.20

Free T3 6.13

Anti-Thyroidperoxidase abs ( High) 435.0

Anti-Thyroglobulin Abs (High) >4000

My D vitamin is normal and my B12 is a bit too high ( over supplemented)

hs-CRP 0.07

I am a bit concerned after these results and I have been looking at the internet and thinking maybe I need a CT scan of my pituitary gland or am I been a drama queen ?

I have not felt well for years really but just got used to been a thyroid patient so just get on with it and buy my thyroid meds from abroad because levo has little effect for me and GPs are really not interested but would like me to reduce my medication. Only problem is if I did reduce I would be confined to my bed.

Please if anyone has had results similar or any idea what this is saying to me I would be very grateful ,

Many thanks

Maria

[lemondrop123]

Thank you . I will edit it in the morning but they are uk levels I do not know if that helps any.

I agree I feel like i should increase but the gp tells me to decrease so it makes me feel like i would be risking my health . My pulse is always low as too my temperature so I'm hardly hyper , food for though thank you again

[lemondrop123]

Hi Londinium,

Thank you for your reply . I agree with you on caution because I am aware that the heart can also suffer if the thyroid meds peak too much and this can cause Atrial Fibulation and death in some instances .

My b12 is too high and my D3 is in normal range . I recently read that the TSH can fluctuate during the course of the day so that's a bit misleading as to what is happening ! Talk about me getting confused🙄

I've determined my TSH is low (hyperthyroidism) and my t4(hypothyroidism) is below range and my t3 is near the medium range. Hence I think the pituitary is involved (Thanks be for spell checker ) because the hormone message is wrong . I do hope I'm making sense 🤔 I am going to increase my t4 only at thus stage and see what happens run another test in 6 weeks or can you run it sooner ? Thanks again for taking the time to reply

[lemondrop123]

Thanks I was not aware of the different lab screening . Talk about adding more confusion why the labs can't go with one standard screening is beyond me , but I suppose it helps to keep us in the dark. My GP was advising on the advice of the endocrinologist when she suggested i lowered my dose but she was concerned about how i was feeling . I have sort of given up on GP helping me with this condition i think they are just too overburdened with work to dig deeper and they have to follow guidelines that are usually drug company directed sadly. Thanks again

[lemondrop123]

Biochemistry

hs-CRP 0.07 <5.0 mg/L

Ferritin 72.2 13 - 150 ug/L

Thyroid Function

TSH 0.52 0.27 - 4.20 mIU/L

T4 Total L 59.9 66 - 181 nmol/L

Free T4 L 11.20 12.0 - 22.0 pmol/L

Free T3 6.13 3.1 - 6.8 pmol/L

Immunology

Anti-Thyroidperoxidase abs H 435.0 <34 kIU/L

Anti-Thyroglobulin Abs H >4000 <115 kU/L

Vitamins

Vitamin D (25 OH) 102 Deficient <25 nmol/L

Insufficient 25 - 50

Consider reducing dose >175

Vitamin B12 H 639 Deficient <145 pmol/L

Insufficient 145 - 250

Consider reducing dose >569

Serum Folate 23.10 8.83 - 60.8 nmol/L

Many thanks Londinium

[Hidden]

I take 2.5 grains of NDT and it's fine for me without a thyroid. Before I was taking 3 grains

per day and my FT3 reading was 1/3rd over the top range. It requires quite a bit of trial and error before we can obtains optimal levels and feel well.

When I was on the higher dose my heart rate was quite high and I was losing to much weight an my indication of over medication.

You have a high reading for antibodies but I don't know about those, sorry.

[lemondrop123]

Hi reallyfedup123,

These are the ranges, many thanks for your reply I will research central hypothyroid

Biochemistry

hs-CRP 0.07 <5.0 mg/L

Ferritin 72.2 13 - 150 ug/L

Thyroid Function

TSH 0.52 0.27 - 4.20 mIU/L

T4 Total L 59.9 66 - 181 nmol/L

Free T4 L 11.20 12.0 - 22.0 pmol/L

Free T3 6.13 3.1 - 6.8 pmol/L

Immunology

Anti-Thyroidperoxidase abs H 435.0 <34 kIU/L

Anti-Thyroglobulin Abs H >4000 <115 kU/L

Vitamins

Vitamin D (25 OH) 102 Deficient <25 nmol/L

Insufficient 25 - 50

Consider reducing dose >175

Vitamin B12 H 639 Deficient <145 pmol/L

Insufficient 145 - 250

Consider reducing dose >569

Serum Folate 23.10 8.83 - 60.8 nmol/L

[lemondrop123]

Thank you for your reply Bunnyjean I assume the antibodies indicates I still have some thyroid left but my antibodies seem to have taken a long time destroying my thyroid I have had this diagnosis 10 years and was ill for many years before i was taken seriously by the doctor. My antibodies need new batteries by the looks of it thanks again for your experience

[lemondrop123]

thank you , yes I take a daily dose of D3 . I consume gluten, lots of it really as it is in most things. It must take some dedication to stop eating gluten completely and there is so much misinformation around but I will give that a try after seeing these results.

I will wait hopefully I will get more response now I have posted my ranges

[lemondrop123]

Thank you , I was not aware of that either 40 years !

[lemondrop123]

yes it does not make sense to me either , that is why I am wondering if it pituitary because the TSH is saying I am towards hyper but the free T4 is saying I am towards hypo , so I am wondering if my pituitary is sending out the wrong message. I am not an endocrine person or have medical training but I do not believe it is a straight forward Hashimoto issue as in I can fix it with increased meds. I did think about taking more T4 ( levo) I hate levo it makes my eyes dry and painful but on second thought I cannot see that helping, just me shooting in the dark so to speak. I have made a GP appointment fist availability July 5th but in the meantime I may just keep researching into what these weird results mean. The other strange thing is I have been the same weight more or less most my adult life and out of the blue I have gained 7 pounds with no change in eating . I had an early menopause onset with Hashimoto so the weight gain is not menopausal I am past all that.

I found this on this site and it sort of explains it...Most body tissues are less responsive to T4 than is the pituitary gland. A dose as low as 75 mcg leaves the metabolism of most body tissues abnormally slow. In contrast, the pituitary gland may readily respond to the 75 mcg. If so, the pituitary decreases its release of TSH into the blood. TSH, of course, is the pituitary hormone that stimulates the thyroid gland to release thyroid hormones into the blood. So, when 75 mcg of T4 causes the pituitary to decrease its release of TSH, the thyroid gland in turn decreases its release of thyroid hormones. The decreased secretion of thyroid hormones (both T4 and T3) may then further slow the metabolism of most body tissues. The paltry 75 mcg dose of T4 won’t drive the metabolism of the tissues enough to compensate for the metabolic showdown caused indirectly by the 75 mcg dose....so maybe I do need to increase t4 but slowly ..although it does not explain the raised t3

[lemondrop123]

Thanks I am going to get a book on gluten free eating, has this film been released on DVD ? do you know

[Judithdalston]

I must admit I can't understand the problem with your thyroid results, you take a T4 /T3 combo : 57 mcg T4 and 13.5 mcg T3. So these ' meds' behave very differently from levothyroxin alone , where we talk about ideal results with TSH of 1 or under, and FT4 and FT3 in upper part of range. The FT3 is mainly a result of conversion of our own remaining T4 or T4 'meds'. But with NDT etc we are largely bypassing this cycle by adding T3 directly, and presumably expecting some of the T4 'meds' to convert to active T3 too. So we don't need to engage the pituitary gland and TSH production ( though some believe a suppressed TSH feels better), to tell the thyroid to produce T4 as you are adding that artificially. The only important test figure for thyroid production is the FT3, and yours is good to high; FT4 can be low.

Did you ever take levothyroxin by itself for any length of time and reasonable dose; were you a proven poor converter ( ratio of FT3: FT4 greater than 1:4)? You didn't get on with levothyroxin, and it didn't work, any idea why? Perhaps you need T3 only.

[lemondrop123 in reply to Judithdalston]

Thank you I was worried to be honest because I find the whole chemistry part confusing. I had limited help with levothyroxine and spent most my time in bed or moaning to someone , also my eyes were awfully dry and my eye lids swelled . My limited knowledge is dangerous I've convinced myself I need a scan of my pituatory gland , first class drama queen 🤣.

[Elainemawby]

Hi lemondrop123,

With low FT4 and high FT3 you could have high RT3 (reverse T3) and be pooling the T3, normally due to iron or cortisol issues, which means the T3 is not getting to the cells and is hanging around in the blood. Have you had cortisol testing done? And for iron you would need a 4 point iron panel (serum iron, ferritin, transferrin and saturation as ferritin alone doesn't give you the full picture.

Elaine

[lemondrop123 in reply to Elainemawby]

Thank you Elaine, I have ordered a cortisol test. I will look out for the 4 point iron panel.