Confuseing blood test

[Adam1805]

Hi

I am 32 years old with hashimoto

I check my tyroid 6 time in this year with similer result

Tsh 3.3-4

Ft4 11-13.5 (range 7-16)

Ft3 6-6.4 range 3-7.2

Anti tpo ab0ve 1000 6 time in a row

Anti tg 1000 and decrease slowly maybe beacuse i am gluten free now anti tg 550

My endo accept and give me levo 50mg 6 days in a week and after 6 weeks is my symptoms increasing and i feel tirednees and brain fog ( i stop smoling maybe its irrelevant)

But my blood check after 8 eeeks with levo is

Tsh 3.2

Ft4 14.5 range 7-16

Ft3 6.4 range 3-7.2

I have appointment to my endo in 2 weeks and i dont know if to ask increasing my levo beacause my tsh is still high but ft4 and ft3 is top of range

What are you suggest?

[shaws Administrator]

Are your blood tests taken at the very earliest, fasting (you can drink water)?

You must allow a gap of 24 hours between your last dose of levo and the test and take afterwards. If you don't follow this regime your results will be skewed? The TSH is highest early a.m. and drops throughout the day. It is not from the thyroid gland but from the pituitary gland which tries to pump out more thyroid hormones if gland is failing.

50mcg is a starting dose and should be increased by 25mcg every six weeks until TSH is 1 or lower.

Your doctor should also check B12, Vit D, Iron, ferritin and folate. Deficiencies can also cause problems. If you have not had thyroid antibodies checked - ask for these as well. If antibodies are present you have another form of hypothyroidism - called Hashimoto's or Autoimmune Thyroid Disease.

Always get a print-out of your results for the GP. We are entitled by law in the UK for your own records and you can post if you have a query.

[Adam1805 in reply to shaws]

Thank u for your reply

I not taking levo 24 hours before

I do check in the morning

I just confuse with result .

My ft4 anf ft3 is top range but tsh 3.2

If i take more levo i not be hyper?

[shaws Administrator in reply to Adam1805]

No - if we are hypO we do not get hyPER. If we have an Autoimmune Thyroid Disease (that is what you have) a rush of antobidies onto your thyroid gland can make you feel 'hyper' when they attack your gland and attacks can continue until you are hypOthyroid. You are doing the right thing by going gluten-free as that helps reduce the attacks.

You have an Autoimmune Thyroid Disease - commonly called Hashimoto's or hashi's due to having thyroid antibodies present in your blood.

It is recommended that the TSH is 1 or lower but many doctors are happy if it is somewhere in the range. As yours are in the upper part and you may not want to increase your dose - that's o.k. if you feel fine but If you have clinical symptoms you might want a small increase.

It is how 'we' - the patient - feels on a particular dose which is the best judge of whether we need an increase or not.

[Adam1805 in reply to shaws]

Thank u

My symptoms are increasing (maybe beacuse i stop amoking)

I just afraid to increase levo from 50 to 75 and that ft3 increase above range

[shaws Administrator in reply to Adam1805]

I am not medically qualified so cannot advise on your dose and can only try to help.

This is an extract from the following link:-

I have my labs done at Quest Diagnostics. The Free T3 reference range listed is 2.3-4.2 pg/mL. Now different labs use different units of measurement and they also use different ranges, therefore the reference range listed on your lab results may be different. Go by the numbers listed on your lab results sheet to the right of your Free T3 score. How do you calculate the top quarter of the reference range? Let’s see if we can keep this simple.

If the normal reference range listed for Free T3 is 2.3 – 4.2

4.2 − 2.3 = 1.9

1.9 x 0.75 = 1.425

2.3 + 1.425 = 3.725 (round off to 3.7)

So for the reference range 2.3 -4.2, the top quarter of the reference range is between 3.7 and 4.2. Now you can do the same calculations with whatever numbers are listed as the normal reference range for Free T3 on your lab results.

hypothyroidmom.com/the-thyr...