Blood test results on thyroxine

[Caze]

These blood test results are old by several years but I do not recall asking about them on this site at the time and was wondering if anyone had any ideas about them. I have Hashimotos and am type 2 diabetic.

Taking 100mcg thyroxine TSH 0.35 FT4 16.4 FT3 4.1

On same dose 8 weeks later TSH 0.91 FT4 15.2 FT3 4.3

Ref range at the time TSH .35-5 FT4 9-22.7 FT3 3.5-6.5

With an increase in thyroxine my FT4 would increase, eventually going over range but the FT3 would remain low. This sounds like pooling but at the time I did not know this and I never did a Reverse T3 test. It would also seem that I do not convert well. I understand that this can be due to low iron/low cortisol which would need to be addressed. However, it still leaves the question of why the suppressed TSH on a relatively low dose of thyroxine??

I consulted an endo (this is some years ago) who suggested I stopped the thyroxine for 2 weeks to see if my TSH would rise which it did – to over 5. I was then told that I did not have a pituitry problem and was offered T3 to add to my thyroxine. However, I never did get an explanation at to why I should have a suppressed TSH with a mid range FT4 and a lowish FT3.

Some have suggested that I might just have a sluggish TSH, others have suggested thyroid resistance. I know I have an adrenal problem with low cortisol on my 2nd spit (saliva test).

I went T3 only for a while and now at my NHS endo’s insistence I have added in a small amount of T4 and monitoring. I have just done a 9am ACTH blood and cortisol test – awaiting results. I am still far from well and seem to be on a merry-go- round of trying different things and being disappointed - though I suspect there are many on this site on the same merry-go-round.

I would be very interested to know if anyone else on the forum has had similar results to mine and if

they got any answers.

Many thanks

[SlowDragon Administrator]

We are often poor converters with Hashimoto's

Vitamin D, folate, B12 and ferritin need testing regularly and many of us need to supplement some or all these to maintain levels

Have you had these tested recently? What supplements do you take?

Are you on strictly gluten free diet? If not you may find it helps, sometimes significantly

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

Ideally ask GP for coeliac blood test first

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

Low stomach acid is common result with Hashimoto's, causes malabsorption and/or leaky gut.

All these steps help improve conversion

Lastly look at getting DIO2 gene test to see if you have this gene variation. It's common problem. If you do....you need T3. It's good evidence, should the NHS decide to stop your T3 (sadly far too frequent occurrence recently)

thyroiduk.org.uk/tuk/testin...

Professor Toft recent article saying, T3 may be necessary for many

rcpe.ac.uk/sites/default/fi...

DIO2 gene test article

thyroiduk.org.uk/tuk/testin...

[Caze in reply to SlowDragon]

Many thanks for your reply. I am doing most of the things you have mentioned having tried to educate myself over the years. I purchase the T3 myself as I had so much hassle with the NHS so I did not bother with the D102 test as I am sure I am a poor converter. I need to make sure I am doing everything you mentioned to aid conversion as I am now taking some T4. I have just recently discovered I have low stomach acid and need to address this. I was wondering about taking supplements sublingually where possible. I can take my T3 this way which helps when trying to space out supplements away from thyroid meds. I was curious about the low TSH but maybe this isn't an issue - just wondered if anyone else had got similar results.

Thanks again for taking the time to answer my query and for the information.

[greygoose]

Your TSH wasn't suppressed. It was low, but not suppressed. And, there is no way of knowing why, these things just happen sometimes - there is no direct link between levels of TSH, FT4/3 levels and levo dosage. Everyone is different and therefor levels will vary.

If your FT4 is over-range, it is going to convert to more rT3 than T3, that is a given. But, it has nothing to do with 'pooling', which is a concept that means different things to different people, and doesn't really exist. You just had a conversion problem, and the answer was to do what your endo suggested, decrease the levo and add in some T3.

A 'sluggish' TSH, would just mean a pituitary problem, which your endo ruled out. It's just that some people have lower TSH than others. That's the way it is. The question is: why are you worried about your TSH?

[Caze in reply to greygoose]

Many thanks for your reply. I am not worried about my TSH just curious - you may well be right and for me a low TSH is just the way I roll.

Thanks again.

[greygoose in reply to Caze]

You're welcome.