Help with blood tsh results

[AleB]

Please could somebody give any advice on bloods done ... (19th Oct 2018) TSH 0.26 T3 4.5 T4 21.4 I have been hypothyroid for 9 years, back in April 2018 my thyroid levels were too high, alternate days 125mcg/150mcg levothyroxine, dropped to 125mcg with a a massive crash ... whole body packed up! Taken until November to get endocrinologist appointment. I am due bloods again Friday 30th Nov with a reviw from endo on the 8th! I still feel extremely tired, legs are very tired, can't think straight, sometimes difficut to walk. Air hunger, up and down moods, brain fog! Currently taking 100mcg every 2 days then 125mcg then 100mcg then 125mcg! Apologies if this is confused ... I'm at my wits end!!

[greygoose]

I'm so sorry but we absolutely have to have the ranges for those results to make sense of them. Ranges vary from lab to lab.

[AleB in reply to greygoose]

Reference ranges are from GP (endo uses different range, but yet to get this info), T4 lab range is 10.30 - 24.50pmol/L, T3 is 3.50 - 6.50pmol/L and TSH 0.30 - 5.50mlU/L. I would appreciate your interpretation on this. Thanks.

[greygoose in reply to AleB]

TSH 0.26 (0.30-5.50)

FT4 21.4 (10.3-24.5)

FT3 4.5 (3.5-6.5)

OK, so you have a conversion problem, there. And, your FT3 is too low. And, tinkering around with the levo dose is not going to help much. What you need is a reduction in levo, and some T3 added. I suggest you discuss that with your endo when you see him. It's low T3 that causes symptoms.

[AleB in reply to greygoose]

Thank you Greygoose ... I really appreciate your advice. Had to go to GP for urgent appt this afternoon, my dizziness/balance was way off, headaches etc, all too common stiff joints and muscle fatigue. Doc requested further bloods of B12, Folate, Ferritin,Iron profile (iron TIBC, SAT), vit D. Endo has requested TSH, blood FT4, FT3 and Thyroid peroxidase Ab level plus 5HIAA 24hr urine and Catecholamine output! Been taking B12 1000jug every day since last crash in July. Doc told me to double my Vit D to 2000jug! Since all this started I have had in excess of 60 bloods, I have seen neurology, cardiology, rheumatology, CT scans, MRI scans, phisio ... none at my request, the doc couldn't pin point, said maybe it was chronic fatigue ... but I said it was thyroid all along ... the end of the chain, finally the endo! At least I have some more questions for endo from your advice. Thank you.

[AleB in reply to AleB]

Hello SlowDraggon, thank you for your advice and I read some time ago from all you lively people here not to take thyroid meds on the day you get tested ... I have a blood draw tomorrow for all vitamin tests plus another draw at the hospital (details posted in Greygoose reply), thank you and will post again when I get results back! ☺

[AleB in reply to AleB]

Sorry my message mean't to say lovely people, not lively! 😕

[greygoose in reply to AleB]

You're welcome.

Not sure SlowDragon will see your response to her, because you replied to yourself, not to here - it happens. So, I've notified her.

Take care.

[AleB in reply to greygoose]

Thank you Greygoose for notifying Slowgraggon! I had my blood result this afternoon from this mornings draw (I've never had results back the same day), turns out my iron levels are very low (wasn't given the readings), prescription is for Ferrous Furmarate 210mg x3 per day for 2 months ... here we go again! It seems there is a pattern surrounding iron especially, been like this the past 3 years! One to raise with the endo next week maybe?

[greygoose in reply to AleB]

Well, the thing is, if you stop taking the iron supplements, levels are just going to fall again, unless you fix the problem that is causing the it to fall. It could be gut problems, low acid in the stomach, under-treated thyroid, all sorts of things, and that's what the doctor is supposed to find out. No point keep prescribing iron, then stopping, without fixing the underlying problem.

[SlowDragon Administrator]

As well as ranges on these TSH FT3 and FT4 results, it would be extremely helpful to add vitamins and antibodies results

When dose has been messed about by GP then vitamin levels often crash right down

Do you have results from when on 125/150mcg that you can add too

For full Thyroid evaluation you need TSH, FT4, FT3 plus TPO and TG thyroid antibodies and also very important to test vitamin D, folate, ferritin and B12

Ask GP to test vitamins and antibodies ASAP if not been done

All thyroid blood tests should ideally be done as early as possible in morning and fasting. Do not take Levothyroxine dose in the 24 hours prior to test, delay and take immediately after blood draw. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or vitamins

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

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 special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's. Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

List of hypothyroid symptoms

thyroiduk.org.uk/tuk/about_...