Can you please, help me with the last blood tests?

[Floriana]

Here i'm posting my blood tests from yesterday:

Currently i'm on Levothyroxine one day 100mg, the next 75mg and etc...

But with these results i think i'm now hyperthyroid...

Tyreoglobulin- 3.66 ng/mg

FT3 - 4.98 ref; 3.1- 7.5

FT4 - 23.13 ref; 9.65- 19.8

TSH - 0.003 ref; 0. 49- 4.67

My partial /left/ thyroidectomy was March 2016 since i'm on suppressive therapy.

Thank you everyone!

[Marz]

I think your last figure is the TSH. From my non-medical opinion you are only over- medicated when the FT3 is over range.

How are your levels of B12 - Folate - Ferritin - VitD ? They need to be optimal for good conversion of T4 to T3 ...

[Floriana in reply to Marz]

Sorry yes, TSH...

About B12- Folate- Ferritin- VitD, except B12 the last time i checked them all were low, but now i take supplements so have to do new labs i suppose.

What about FT4 it's above the range?

Thank you!

[Marz in reply to Floriana]

What time was your test ? & was it fasting ? Also if you are supplementing B12 further testing will only show skewed results. it would be helpful if you are able to post your Vitamin and Mineral results and say which supplements and how much you are taking. It is possible someone can spot something to help you improve things ...

[SeasideSusie Remembering]

Floriana

When you have hypothyroidism, you can't then become hyperthyroid, it's not possible. But you can be overmedicated.

With your results

TSH - 0.003 ref; 0. 49- 4.67

FT4 - 23.13 ref; 9.65- 19.8

FT3 - 4.98 ref; 3.1- 7.5

Your TSH is suppressed (as you know ) and your FT4 is over range. But it's your FT3 that is telling the story here. You are taking too much Levo as shown by your high FT4 but your FT3 is only 42% through the range which means that your T4 to T3 conversion is poor. What you need is less Levo and the addition of T3.

Before adding T3 you need optimal levels of vitamins and minerals.

[Floriana in reply to SeasideSusie]

Thank you SeasideSusie!

The next time i will talk in more detail with my Endocrinologist because I have no idea how much T3 to take and i'm a little bit scared of that...

[jimh111]

You could be hyperthyroid with these levels, strictly speaking the term is thyrotoxic but we often refer to patients being hypothyroid with similar hormone levels so don't worry about the terminology. I'm curious about you saying you are on 'suppressive therapy', did you have thyroid cancer? It would be unusual to institute suppressive therapy and leave half the thyroid in. Although your fT3 looks OK your fT4 is high and many tissues convert T4 to T3 locally. fT4 does matter. Also, a suppressed TSH is associated with bone problems. TSH plays a role in bone development independent of T3 and T4.

The above relates to the numbers. How are you doing? Do you have signs or symptoms and what are they? It’s important to pay attention to the clinical presentation as well as the blood test results.

[greygoose in reply to jimh111]

Also, a suppressed TSH is associated with bone problems. TSH plays a role in bone development independent of T3 and T4.

This is new, where did this come from? Links, please?

[jimh111 in reply to greygoose]

frontiersin.org/articles/10... is an example. There are a number of studies, see ncbi.nlm.nih.gov/pubmed/?te... . I have a poor understanding of how bone formation works, hence my slightly vague statement. I'm not sure the experts understand to what extent TSH affects bone development but having a decent TSH does seem beneficial. Of course some of us have to have a low TSH, it's a trade off between being able to function and having perfect conditions for our bones.

[StillEverHopeful in reply to jimh111]

I’d be interested to know if the bone problems associated with suppressed TSH is directly due to TSH or if it is to do with levels of the thyroid hormones become raised...

[jimh111 in reply to StillEverHopeful]

That is a difficult question. Certainly the (lack of) TSH plays a role. I wouldn't be surprised if thyroid hormone levels also had a role but a study I recently read said TSH might be the culprit. Sorry I can't remember which study!

[greygoose in reply to jimh111]

Thank you. It's going to take me a while to work my way through that lot! But, I'm sure the latest thinking is that suppressed TSH due to exogenous thyroid hormone doesn't have the same effects as endogenous. I'll have to have a look through diogenes' posts.

[jimh111 in reply to greygoose]

Not sure about exogenous v endogenous, my point is TSH itself (or lack of) has an effect. Hormones tend to have multiple roles and if there are receptors they are likely to have a role, which may be minor.

There are many studies but I think this one academic.oup.com/jcem/artic... led by Grahame Leese is the best. It explains the relative risk of various TSH levels in patients on levothyroxine.

[shaws]

Read the following and in particular from:

"Dear Thyroid Patients" and go on to read about the TSH.

Did you have your blood test at the earliest, fasting (you can drink water) and did you allow a gap of 24 hours between your last dose of levo and the test and take afterwards?

[penny]

My damn memory...I’m sure that I read something about suppressed tsh and bone density loss which concluded that studies had not taken into account that speeding up the metabolism would mean that any normal bone loss would be accelerated with return to normal metabolism. Also, those against whom the bone loss was measured, some may have been hypothyroid and therefore their bone loss would not be a true control. I’m not too clear on this as, as I say, my memory is a bit hazy; I understand these things for about 2 minutes and then they fade - like looking at print through smokey glass.