NDT for 6mths - help with test results interpretation

[KWallis76]

Hi all

I have now been taking NDT for 6mths and before on Levo my results were

TSH - 0.52 miu/L (0.2 - 4.0)

FT4 -20.2pmol/L (10 - 20)

A recent test results show that my TSH is now less than 0.05 and my FT4 is 16.5

Should I be worried??

Any help is appreciated 😊

[Aurealis]

Hi KWallis76, you haven’t told us what dose of Levo you were on, or what dose of NDT you’re currently taking. Also you have no test of fT3 which you really need to properly make sense of what’s going on.

That said, your NDT contains T3 and T4. The T3 is likely to be responsible for the lowered tsh. The tsh is not much use (in my opinion, at all) but especially when you take T3 (as in your NDT). Perhaps fT4 is lower because you’re taking less now than you were? Or converting more to T3, now you’re on NDT. As I said, you really need the fT3 test to make sense of it. There is no need to worry about your results, but more importantly, how do you feel?

[KWallis76 in reply to Aurealis]

I feel better if I’m honest, less fatigue and brain fog, but my weight has remained the same unfortunately ☹️. I was on 100 Levo and I’m taking 3 grains of Thyroid S. I’ll request a T3 test...

[Aurealis in reply to KWallis76]

Good news! Sometimes it just makes it possible to lose weight, but in my experience it seldom falls off ... unfortunately x

[silverfox7]

When on any form of T3 so that includes NDT then results are read differently so I'm presuming your HP doesn't know this or he would have insisted T3 was tested.

So a guide to understanding tests-TSH should be suppressed and FT4 can be lower in its range but FT3 should be high in the range but never over. The only important reading is the FT3 which you haven't got.

That said did you ever have FT3 tested whilst on Levo? If you weren't feeling well then it's highly probable that your FT3 would be low suggesting that you weren't converting properly the T4 to the active T3 that all our cells need to function properly. If that was the case it would also suggest that you vitaminsxand Minerals were/are also low and we need Vit D, B12, folate and ferritin to be optimal, not just in range. So once on NDT we can't test conversion rates as FT4 reading can fall so it's not a know figure though you should still test those 4 things and get them optimal. Plus on NDT you are relying on good conversion for the T4 in the medication.

So a little bit of my experience as I was previously on Levo and went over to Thyroid S as well though it's not right to take much into the fact as we can all react differently as other things could be different but I spent a long time getting those 4 optimal. Took me about 5 months as two were pretty low is it's not a quick fix but well worth the effort. I then went over to NDT and followed the STTM book. Fell at the first hurdle as that said to go up with a lager amount but once at 2 grains proceed in quarters. I'd also done it when I k ew I was seeing an Endo so if I had problems he could advise. He took one look at my results, FT3 was 6 and top of range was 5.7. So he dropped me to 1.75 which I thought was too much but turned out he was spot on! Previously I was taking 125/100. Whist I was on 3 grains I felt better than Levo but not as good as I was expecting. (I'd been started on NTD when first diagnosed over 30 years ago and took it for about 3 years before a strike left me without).

So I hope you can see how important-essential-to get a full set of results.

I would ask your GP to test the 4 things I mention. SeasideSusie has loads of info on recommended levels and how to get to that level. Then explain to your GP how important it is to get the right testing done and take it from there. Getting more things optimal may need you have to change/loercyour NDT which could happen gradually but you need to keep an eye on things but as I found it's well worth doing.