Hi
Following an annual thyroid check my GP is reducing my Thyroxine prescription from 100mcg to 75mcg. I'm dreading the outcome as I am constantly tired, overweight and find losing weight impossible.
My results are as follows:- TSH - 0.08, T4 - 23.6, Ferritin - 354, Bilirubin - 7, Serum Alanine - 38, Alkaline - 107, Protein - 72
I would really appreciate some help with interpreting the reading as none of it makes any sense to me.
Sorry, but you need to put the ranges with those results, as they vary from lab to lab. 
Thank you grey goose. I took the results over the phone but I shall pick up a print out from my GP surgery.
You need to call Lab or Doc and ask for the normal range. In the US, range is usually about 0.5 to 4.5. IF we were to use the US range , a TSH of 0.08 is low...according to most, it is too low. It means that your thyroid is not producing much thyroid because you are taking so much by mouth. Reducing your dosage would be the thing to do.
Again we cannot accurately compare normal ranges in U.K. with those in US....but the usual range here is about 13 - 25. So if your labs range is similar, you would be at the high end... which means again, that you have a bit too much thyroid.
US normal range for female ferritin is up to about 220. IF we were to compare, then by US standards you would be elevated. Hyperferritin can be caused by too much thyroid ... again. !
I think my ferritin is way too high. Thank you for your reply.
It's no good using a range from a different lab - it has to be the range from the lab that did the test as there NO standard range
I found a U.K. list of normal labs and the protein was listed as 60 - 80....
UK Alanine normal range was 10 - 40. Yours then ...looks ....normal.
Depends on the lab - mine is 1-33. You have to use the ranges from the lab that did the test.
As greygoose has said we can't really advise without the ranges. Ranges differ from lab to lab so we need the ranges that the machine has that did the testing. In the U.K they are in brackets after the results but have no idea what the US do.
I would refuse to change anything without an FT3 reading as well.
From what you describe you don't seem to be feeling good so I just want to throw something else into the mix. A high FT4 if that is what your labs are saying could be a conversion issue so you need to have an FT4 reading at the same time as an FT3 reading so you can compare where in each range these two fall. If your FT4 is high and your FT3 is low then you may not be converting enough of your T4, hence the higher reading than the active T3 if a very low reading so need to address that. Getting optimal vitamins etc helps so more testing and patience as it's not a quick fix but all this cannot be taken as gospel without the correct ranges your lab uses and both FT3 and FT4 tested at the same time. Your doctor lowering your T4 will also lower your T3 so you will feel much worse.
Thank you for your reply. My GP has said the lab the surgery use won’t test T3. She referred me to an Endo who refused to test T3 and tried to put my symptoms down to depression!! I’m going to purchase a test and do it myself. Have looked at going private but the fees are huge. I don’t think I will be able to get out of bed if I feel worse. I’m operating on autopilot at present.
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if Thyroid antibodies are raised
Essential to test FT3 and FT4.
Just dosing according to TSH is completely inadequate
Recommended on here that 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)
Low vitamins often then TSH goes low
Thank you for your reply and the tip. 👍I usually hold off taking my thyroxine until after the test. This was the first time I didn’t. I just didn’t think of it before going 🙄. I’m going to buy a test so I can get my T3 levels.
Essential to test vitamins too
Your ferritin looks very high ...what was the range on this?
Vitamin D, folate and B12 need testing
Until I pick up a print out of my results I don’t the range. I have to wait until Monday now as GP surgery closed for staff training this afternoon.🥺I’m concerned about it though as it was lower in my last test and my Gp had me back for liver function tests for a while. This time I’m told it’s satisfactory. I asked for vitamin levels to be checked but told by the nurse they don’t do it. I feel really poorly so I’m not going to waste anymore time at the surgery I’m going to order a test to do myself. Meanwhile I’ve started taking vitamin supplements.
Only add one supplement at a time and wait at least ten days to assess any improvement (or not)
Ideally, especially with B vitamins you should test first
Vitamin C is good to start on
selenium can improve conversion of FT4 to FT3
Meanwhile getting private testing of vitamin D, folate, B12 and ferritin
Shouldn't ever supplement iron without testing first
Vitamin D is ok to start. Test within 2 months to see where levels are
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results
Your t4 is at the high range so hence needing to reduce levothyroxine. The symptoms of hyperthyroidism are similar to hypo, feeling tired, palpitations and pins and needles in hands and feet x
Thanks for your reply. I’m wiped out at the moment but have been experiencing palpitations also. I was a little confused as I thought palpitations were linked to hyperthyroidism only.
Are sure that those tests are for Alanine (an amino acid) and Alkaline not Alanine Aminotransferase (ALT) and alkaline phosphatase (ALP) - liver function tests? Were GGT and LDH not tested? How about Albumin and Globulin?
Thanks for your reply. I’m not sure. I took the readings from my GP surgery’s receptionist over the phone. I have to pick up the print out from the surgery. I’m so tired I haven’t felt like I should be driving.
You might consider registering for online access to your medical record. Though not all surgeries have blood tests online yet. It's being rolled out everywhere soon
Useful in future test results too
You need to fill in form at GP and take along Photo ID
It takes a few days to process
They won't do FT3 here in the UK, I've asked. Unless you see an endo, but from what I've read here, even getting an endo to prescribeT3 (assuming you can get to see one who knows much about the thyroid - most seem to be diabetes specialists) is like pulling teeth. Government guidelines and the beyond extortionate cost of T3 is no doubt the reason.
I'm having the same kind of problem at the moment, Levo decreased because TSH was 0.01and T4 almost at top of range. At least it was only decreased a fraction, from 100mcg to 100/75 alternate days
I saw an Endo twice who refused to test me for T3 and said he could tell from my T4 and TSH levels that I didn’t have a conversion problem. He put all my symptoms down to depression. I’m depressed because I’m tired of feeling like crap. How are you feeling since the decrease in your thyroxine? I’m going to buy a test to check my T3 levels.
Essential to test vitamins and antibodies too
Low vitamins can badly affect conversion
Low vitamins are especially common with autoimmune thyroid disease (Hashimoto's) diagnosed by high thyroid antibodies
It's shocking that we can't have the basic tests done. Use you test aswalier as you can as TSH is at its highest in the early hours so less chance of anyone suggesting you should lower your dose. Best as well to be fasted since the night before as that also helps the TSH reading to be higher. We don't let on though to the doctors, a patient to patient tip! Take you medication after the test. My doctor once asked why my result was fasted so I said some tests I have to be (glucose) so I do them all the same!
Yeah I thought so too but it can be both, don't know what age you are but menopause can cause same symptoms as hypothyroidism 😣 worth getting your fsh checked x
Help interpreting Test Results Please. 
Help with interpreting test results
Help interpreting results please
Help with interpreting Cortisol blood test results please.
Help with interpreting test results
