Strange blood results . Clues please

[poppppy]

Hi anyone can help me out here please . Would be much appreciated .

I am on liothyronine only . I am auto immune thyroiditis or ords. ( high antibodies and USS shows scarring and shrinkage .presented with high tsh low t4 )

After finding I didnt convert thyroxine tablets to t3( through blood tests) . I eventually ended up on liothyronine only . I take no thyroxine now .

So for years ( on t3 only )my blood results are characterised by a very low tsh ( about 0.1 to 1) , a t4 of about 1 and a t3 in range or a little high . I am under a consultant for all these years .

So imagine my surprise when my blood results came back this time with a tsh just above range ! It was 5.95( range in my lab 0.3 to 5.0)

The t4 was 1.3 . The usual .

The t3 was 4.7 . In normal range.

I thought I had heard somewhere u can get a high tsh if you have an infection or inflammation hence differential diagnosis when first presenting with high tsh .instead of straight off diagnosing hypothyroid disease .

And at the time I had a UTI not yet treated . And developed a few days after the bloods shingles . So could this be the reason. Or is it a sign my thyroid could have less antibodies attacking . As I have been experimenting with auto immune protocols .

I think I know the answer to the last one . If I had less antibodies attacking anx hence a healthier thyroid . My t4 would be higher not my tsh ??

Anyway thankyou for reading. if you got this far you are a Saint. Thank you .

[greygoose]

The t3 was 4.7 . In normal range.

The fact that it is in the normal range means nothing. We need to the actual range to make sense of that result. To me, it looks too low. It would be too low if the range is anything like the one we usually see. And, if it's low, that would explain the high TSH.

I thought I had heard somewhere u can get a high tsh if you have an infection or inflammation

That is true. But not if you're on T3 only. The TSH goes up when you have an infection because the conversion of T4 to T3 reduces (it converts to more rT3) so the TSH rises. When you are taking T3 only, you won't get that effect with an infection. So, neither your UTI nor your shingles would have affected the TSH.

Or is it a sign my thyroid could have less antibodies attacking.

Absolutely not. Lowering antibodies do not raise the TSH. But, it isn't the TPO/Tg antibodies that do the attacking, anyway. These antibodies just come along after the attack and clean up the traces of TPO and Tg that have leaking into the blood during the attack. So, even if you got rid of your antibodies completely, you would still have Hashi's.

So, for me, the TSH has risen because your FT3 is too low. Try an increase in T3 and see what happens.

[poppppy in reply to greygoose]

Hi my tsh came back in normal range on repeat bloods . Thankyou for support

Poppy

[greygoose in reply to poppppy]

Where in the normal range?

[poppppy in reply to greygoose]

Hi Greygoose , sorry tsh was 3.36 ( range 0.3 -5)

They didnt do my t3 or t4 .

Typical !

I just have always had a subnormal tsh since on t3 only ( about 0.1 ) and a t3 of about 1 .

Thankyou for your concern and kindness in sharing your knowledge

Poppy

[greygoose in reply to poppppy]

OK, but the range is too wide, and 3.36 is too high. Anything over 3 is still hypo. And, your FT3 is too low. You are still hypo, so you need an increase in dose.

[poppppy]

Thank you Grey goose . That clears up a lot thankyou so much .

Because u asked ;the range my lab goes by is 3.1 to 6.8 for t3 .

But I understand what you are saying . That the high tsh suggests my t3 intake needs to increase .

I know that lately I have missed the odd dose because I forgot . I take 20 t3 a.m and 15 of t3 at night . And then on the day of my bloods I took my a.m dose after the blood draw and it was overdue by 4 hours . But then my t3 was in my labs range.

It is so confusing . Thankyou for clearing up a lot for me . You are very clever and very kind

Thank you .

[Marz in reply to poppppy]

Have tagged greygoose so she can see your response. You inadvertently forgot to click Reply so gg would not have received an alert. Easily done 😊

[poppppy in reply to Marz]

Thankyou Marz . No idea what I did wrong but hope it works this time thankyou

[greygoose in reply to poppppy]

So, your FT3 is below mid-range. That's why your TSH is too high. If you forget the odd dose of levo here and there, it won't have much effect, it will even itself out. But, T3 is different. You need to take a constant, steady dose of T3 to get good results. Therefore, it seems to me, you need to try and increase in dose, and be more vigilant with taking your hormone.

Oh, and being four hours late takin your T3 won't have any effect on your TSH. It doesn't change that fast. And won't have all that much impact on your FT3, either.

[poppppy in reply to greygoose]

Thank you Grey Goose for your wise words . Feel so relieved it is nothing bad . I have had repeat bloods done today . I will let you know results thankyou again

Poppy

[greygoose in reply to poppppy]

You're welcome.

[poppppy in reply to greygoose]

Hi greygoose ,can I just ask what would be a good t3 for me to have . The labs range is 3.1 to 6.8.

And should I just aim for an optimum t3 and not really go on the tsh at all . As it will go lower once my t3 is higher anyway say .

Or if I get my t3 to what ever you tell me is best and the tsh still isn't whatever u feel would be optimal . Then do I carry on increasing the dose till the tsh is optimal even though the t3 may then run above range .

Thank you for your help

Thankyou

Poppy

[Hypopotamus]

Don't rule out a mistake in your results. How about asking for another test given the abnormality of this one?

[poppppy in reply to Hypopotamus]

Thankyou for reply . Doc has given me another blood form . I will let you know so thankyou Hypo

[poppppy in reply to Hypopotamus]

Hi Hypo , my repeat bloods came back . Tsh normal range so thankyou

Poppy