I am confused by my recent blood test results, my Dr seemed to be too...
TSH - 0.0624 uIU/ML RANGE 0.35-4.94
FREE T 3 - 1.74 pg/ml RANGE 1.71-3.71
FREE T 4 - 1.18 ng/dl RANGE 0.70 - 1.48
ANTI-TG - 9.72 IU/ML RANGE <4.11
I am currently taking 100mcg T4
He mentioned that there might a secondary cause for hypothyroidism, pituitary adonema. He has lowered T4 dosage to 75mcg to see if this improves TSH will go back in 6 weeks.
Has anyone else experienced this? Thank you in advance!
Welcome to our forum Victoria2603 and members are very helpful.
When you have a blood test for thyroid hormones, do you have the very earliest test, fasting (you can drink water) and allow a gap between your last dose of levo and the test and take afterwards?
No I did not fast, I went mid-morning. I have never fasted before blood tests, is it necessary?
I see that greygoose has responded as to the reason why and it is only in regard to thyroid hormones. Not other problems we may hve.
This is a patient-to-patient hint in order for us to get the best possible results. The TSH is highest early a.m. and drops throughout the day, meaning we may not get the increase we actually need. Maybe even have our dose reduced.
We ask the surgery for the earliest a.m. test to prevent an unnecessary reduction. You don't need to mention the reason as they wont believe us - (they are not hypo themselves).
Many members have been told that this procedure isn't necessary - that's because professionals seem to be unaware that a blood test taken at a.m. or noon or 5 pm. will have different numbers. Earliest a.m. following advice above gives us the highest TSH and may prevent an unnecessary reduction in our doses.
Quite a number of members have told by the nurse etc that they need an early a.m. test and are told NO you don't have to so. we don't state why as the doctor will have already completed the form..
The pity is that doctors seem to only look at the TSH as yours also seems to have done. If it is too low they get nervous and I think they believe that we are verging on hyper thyroidism due to a low or very low TSH. This is not correct because we are hypO and not hypER and once it is within the range the assumption is we're on sufficient.
Your doctor is adjusting your dose due to the TSH result alone and considering that levothyroxine T4 is an inactive hormone and has to convert to the active T3 - this is required in our millions of T3 receptor cells and the heart and brain need the most. He wants to get your TSH higher without considering your very low FT3.
That's why it is good to read others' posts and we learn from their experiences and there's not much better than advice from the 'horses' mouths.
The aim is a TSH of 1 or lower and FT4 and FT3 in the upper part of the ranges.
thyroiduk.org.uk/tuk/testin...
Always get a print-out from your surgery, with the ranges, for your own records and post if you have a query. You would need thyroid antibodies checked. If they are present you'd have an Autoimmune Thyroid Disease - also called Hashimoto's or hashi's but treatment is the same and going gluten-free can help reduce antibodies which attack the thyroid gland and they wax and wane until you're hypo. On the link below there are other topics which may be helpful.
thyroiduk.org.uk/tuk/about_...
We have to read, learn and ask questions for us to have a healthy, symptom-free life.
Thank you! Anti bodies listed under the other results.
We always advise people to have an early morning test - before 9 am - and fast over-night. TSH is highest early morning, and drops throughout the day. It also drops after eating and drinking caffeine.
Even so, I don't think having had breakfast, etc. would have made all that much difference to your TSH. But, you doctor should not be dosing by the TSH. If he reduces your levo, your FT3 will drop, too, and it's already bottom of the range! What you need is an increase in dose, regardless of the TSH.
Even if there is a pituitary problem causing the low TSH, reducing your dose will not fix it. And, if there is a pituitary problem, he should be totally ignoring the TSH. But, if he does think that is the problem, what is he doing to do about it?
Do you have your results from when you were diagnosed? Or even your results before these? In cases like this it can be helpful to look back over past results.
Have you had your antibodies tested?
@greygoose, her Free T3 isn't over range in the above results. It's right at the bottom of the range. Unless I'm misunderstanding something or something got changed?
Oh, gosh! you're right! I'm so sorry, Victoria2603 . Thank you for picking up on that, FancyPants54 . I will delete my response and start again. 
I hardly liked to mention it because you are always spot on. But I read it several times and couldn't see it.
Well, feeble excuse, but I was seeing the 3 of 'T3' and the number after the decimal point, and the 1 in between just got lost! Just goes to show, one should always question if one feel its not quite right.
Antibodies under the other results. Tks
Ah yes. Tg antibodies. Didn't you have the TPO tested? I meant to ask. Unusual to test Tg and not TPO.
TPO normal
OK Doesn't tell us much, then.
Are you in the UK?
Just dosing according to tsh is inadequate
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 and can lower TSH
Ask GP to test vitamins
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)
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