Mum's blood results - help please analysing

[mb008]

Hi

My 75 year old mum had her thyroid removed about 20 years ago. She is on Levo- 125g and 150g alternate days. She is just getting over a bug, but is not feeling good, a bit shaky, dry mouth and eyes. Can someone advise pls on the following:

FT3 4 (3.1-6.8)

FT4 42.1 (10.8 - 25.5)

TSH 0.32 ( 0.27 - 4.2)

Ferritin 491 ( 30 - 400)

B12 1035 (180 - 999)

She wasn't tested for Vit D3.

She took her Levo in the morning of the test.

Also, is she too old to change to NDT? I am taking her to see my endo next week, but it would be good to get the knowledgeable people on this wonderful site's views before we go.

Thanks as always,

[diogenes Remembering]

First lets see if the bug hasn't caused a nonthyroidal illness syndrome, where FT3 is reduced. Recover from that and remeasure. But if this is not caused by that an FT4/FT3 ratio of over 10! I've never seen this before. Also a FT3 fairly low in range. It's a clear sign of extremely poor T4-T3 conversion if nonthyroidal illness is ruled out. Therefore in that case either T3 supplementation or NDT might be considered to give more T3. BUT she is elderly and this has to be tried with extreme caution - its easy to makes matters worse. My thoughts are to cautiously give some NDT at a low level start and slowly balance up increasing NDT and reducing T4. And by slowly, I mean over months.

[mb008 in reply to diogenes]

Thank you Diogenes.

Yes, her FT4 is very high- should she reduce her Levo until she sees endo next week? If she hasn't a thyroid, what could be the cause of non conversion?

[jimh111]

I would keep her levothyroxine dose until the next blood test. She should not take levothyroxine within four hours of the blood test because it can cause a misleading fT4 result - but nothing like fT4 = 42.1. As diogenes mentioned it could be due to non-thyroidal illness. If the next blood test gives similar results I would ask for her selenium level to be checked because selenium deficiency can reduce T4 to T3 conversion, although this usually results in a high TSH as the pituitary fails to convert T4 to T3 also.

[greygoose]

Is she taking a B complex with her B12, containing biotin? If so, did she stop it five days before the test? If not, that could have skewed the FT4 result.

[mb008]

No, she's not taking b complex. I don't think she's taken b12 for a long while either.

[Hidden]

Your Mum should not have taken her Levo before the test firstly. I am 72 years old with no thyroid and feel great I never visit the doctor or endos just self medicate with NDT.

Being 75 years is certainly not too old for NDT.