Test results: Hi all, could someone help me with... - Thyroid UK

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Test results

Sveistre profile image
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Hi all, could someone help me with test results please? Thanks in advance

I’m currently on 150mcg Levo, this is repeat test after increase the dose (all vitamins are ok)

Serum cortisol level 161 nmol/L [166.0 - 507.0]

Serum TSH level 0.11 mu/L [0.27 - 4.2]

Serum free T4 level 25.9 pmol/L [12.0 - 22.0]

Serum free T3 level 4.5 pmol/L [3.1 - 6.8]

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Sveistre
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SeasideSusie profile image
SeasideSusieRemembering

Sveistre

Serum free T4 level 25.9 pmol/L [12.0 - 22.0]

Serum free T3 level 4.5 pmol/L [3.1 - 6.8]

What time did you take your last dose of Levo before the test?

If you left the recommended 24 hours between Levo and blood draw, then you are overmedicated with Levo, but your FT3 is very low and shows poor conversion of T4 to T3. You really need a lower dose of Levo and the addition of some T3.

Serum cortisol level 161 nmol/L [166.0 - 507.0]

I don't know anything about serum cortisol tests, but that is below range. You need to speak to your doctor about it.

Sveistre profile image
Sveistre in reply to SeasideSusie

I left 24h after my last tablet of Levo.

SeasideSusie profile image
SeasideSusieRemembering in reply to Sveistre

OK, so it would seem that you are taking too much Levo and reducing that to bring your FT4 into range and adding some T3 would be the way to go. Your results are similar to mine before I discovered I didn't convert well.

Sveistre profile image
Sveistre in reply to SeasideSusie

But the last results showed I was undermedicated that’s why the dose was increased - high TSH, normal T4, but low T3..

Cortisol is related to thyroid, so the deficiency of that means problems with adrenals or pituitary gland. Anyways going to see doc Tue, but I though I would ask people here what were the thoughts

SeasideSusie profile image
SeasideSusieRemembering in reply to Sveistre

Do you mean this thread where you said

results cameback TSH 3.2, T4 24.3

healthunlocked.com/thyroidu...

There is no FT3 result there. And Greygoose replied

Having a high TSH like that, with a high FT4, usually means that you are not converting well and your FT3 is low. To find out how well you are converting, you need to get your FT4 and FT3 tested at the same time - privately, if necessary

Also Jim said

Your TSH is a bit high for your fT4 levels which suggests T4 to T3 conversion is impaired a bit.

and

It would be sensible for your doctor to prescribe some liothyronine as 1) your fT3 is probably a bit low

So with a FT4 level of 24.3, despite there being no range given, you weren't undermedicated. As everyone has pointed out, conversion was likely to be poor and T3 was suggested.

With a cortisol level below range, I have little doubt that adrenals are involved.

Sveistre profile image
Sveistre in reply to SeasideSusie

No I had one more blood test after that which came back as follows:

TSH 3.16 [0.35-4.5]

T4 18.2 [11-26]

T3 3.0 [3.9-6.8]

SeasideSusie profile image
SeasideSusieRemembering in reply to Sveistre

If you're having your blood tests done under the same conditions every time ie

* Early morning blood draw

* Leave off Levo for 24 hours

* Fast overnight (delay breakfast) and water only before blood draw

then the fluctuation in your FT4 level is quite dramatic if the reference range has been the same every time. Have you had thyroid antibodies tested?

But those results clearly show that with a below range FT3 then you need T3 adding to your Levo, you would certainly have FT3 in range if you were converting well enough.

Sveistre profile image
Sveistre in reply to SeasideSusie

Yes the same conditions as it should be, and yes I do have Hashimoto’s, well the private endo said he would prescribe T3, but not sure what GP will say, cause as I understand they can refuse to prescribe it?

SeasideSusie profile image
SeasideSusieRemembering in reply to Sveistre

I imagine your Hashi's comes into play then where the fluctuation in FT4 was concerned. Do you address the Hashi's with a gluten free diet and supplementing with selenium to try and reduce the antibodies?

If a private endo prescribes T3, there's nothing to say that you GP will take over, it might be different if an NHS endo prescribed it and your CCG would allow it, but if you go private then I imagine you would be on your own. As long as we're in the EU (and time is fast running out), you can send a prescription to Germany for T3 as long as it's written correctly. What happens after Brexit then I don't know but I doubt they'll continue.

Sveistre profile image
Sveistre in reply to SeasideSusie

Yes, I’m on Keto diet which is gluten, soy, sugar, grains free, also eliminated caffeine totally, taking selenium, vitamin D, B12, magnesium, probiotics, adaptogenic herbs. I’m so frustrated now as I thought increasing the dose will be the answer and result will come back normal, but it seems that instead of one problem Hashimoto’s I’ll have smth more related to cortisol😥

SeasideSusie profile image
SeasideSusieRemembering in reply to Sveistre

Can I just say, considering your low cortisol level and the fact that you are taking adaptogenic herbs. Almost 3 years ago, I consulted a practioner with a load of test results, including a 24 hour saliva adrenal test which showed 3 of the 3 samples showed top of range results and the fourth one showed an over range result. One of the things the practioner suggested was a supplement that contained 3 adaptogenic herbs, to "balance" everything.

Some time later I actually ditched the practioner but foolishly forgot to retest my adrenals, and I took the adaptogenic herbs for 2 years. By the time I retested, all my levels had fallen way below range. Looking into this, although adaptogens are mean to be balancing, they are often referred to as lowering cortisol, and I'm not the only member this has happened to.

I'm wondering if your adaptogenic herbs has caused your low cortisol. Did you have an adrenal test before starting them?

Sveistre profile image
Sveistre in reply to SeasideSusie

No I haven’t..I’ve had so many blood tests but doctors never tested adrenals, only now the private endo decided to look at it, after I asked him about adding T3. I’m wondering what my GP would say about prescribing T3, need to see the endo first to discuss the result, what are his thoughts.

Thanks for info about the herbs, I’m taking them cause they suppose to balance everything but it seems it can make things worse

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