Advice Please :). Had blood results today, my tsh has gone down from 10 to 7.5 since last results but T4 remains high at 11.5 (slightly above range). Doc has reduced levo to 25mcg daily from 50 as it appears thyroid is producing t4. This has confused him so has forwarded me to an Endo and said they may have to do something to my Thyroid, what would this mean? My B12 is also low at 158, he has prescribed 5 x B12 injections over 5 weeks, does this sound right? He did prescribe B12 tablet after my previous blood test but the reading of 158 was unchanged. I also have Hashimotos.
I'm Male age 55. Thanks in advance for any advice.
Phil.
Written by
pipshaw
To view profiles and participate in discussions please or .
What’s the laboratory reference range for that T4 result?
At first glance, it’s looking like your doctor might be a complete numpty when it comes to treating thyroid disorders but that rather depends on the answer to my question about the range.
Re the B12 - that sounds more promising (because that’s a very low result and it will be making you feel awful) but he really ought to be doing more tests first to see if you test positive for pernicious anaemia. Plus “over 5 weeks” isn’t in fact the correct protocol for treating Vit B12 deficiency....
T4 range is 4.6>10.5. I also thought it strange about the B12 routine, Maybe this is why he has referred me to an Endo not sure, what would be the usual protocol regards B12 injection. I've recently moved to Spain by the way so not sure if they do things differently here. Thanks for reply
Well, let's face it, it doesn't take much to confuse a GP. If only they would test the FT3, that would probably solve a lot of these so-called mysteries. I would imagine, for your TSH to still be that high, you're not converting that levo to T3, and your FT3 is low. Reducing the levo is also going to reduce the FT3 as well, and make you feel worse. But GPs know nothing about conversion.
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.
All thyroid tests should ideally be done as early as possible in morning and fasting. When on Levothyroxine, take last dose 24 hours prior to test, and take next dose straight after test. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)
As you have Hashimoto's are you on strictly gluten free diet? Many find it helps, sometimes significantly
Your high FT4 (or is it total T4?) could be due to transient Hashimoto's flare. This is when you get temporary high levels as thyroid dumps load of hormones
It just says ‘T4 in serum’ on the results not sure if it’s ft4 or total t4 it’s measured in mcg/dl if that helps. As I say I’m living in Spain so I expected vit D to be ok but I’ve just had appointment come through to see Endo next week which will hopefully shed some light on what’s going on
suggest posting on the pasoc forum - if the results were private then GP may want to run their own results but it is very unlikely that you aren't deficient with a result that low. If you have previous results showing levels in past have been significantly higher then that would be good evidence of an absorption problem.
You might find this old thread interesting. Not suggesting that anything in it is what’s happening to you, but your doctor should be investigating further rather than guessing what to do.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Low tsh and low t4 levels
Normal TSH but low T4
High TSH, Low Normal T4, High TG Ab but Low TPO?
Help TSH 0.2 T4 26 
T4 Only, Low TSH
