please advise result t4 listed

[ja12]

finally got my result can anyone help tsh level is 2.77 and serum free t4 is 18 can anyone help still constiped with low heart rate ?

[SeasideSusie Remembering]

ja12

Can we have more information please.

Diagnosed hypothyroid?

On Levo?

If so, how much?

Please add reference ranges for your results so they can be interpreted properly.

[ja12 in reply to SeasideSusie]

hi o Levo125 all my results says is tsh serum level 2.7 mu/l serum free t4 level 18pmom/l

[SeasideSusie Remembering in reply to ja12]

Are you in the UK?

Is this a print out from your GP's surgery? They usually have the ranges.

Your TSH is high for a treated hypo patient. Most feel best when TSH is 1 or below with FT4/FT3 in the upper part of their reference ranges.

We can't interpret your FT4 result because ranges differ from lab to lab and on here we see ranges of 7-17, 9-19, 12-22, 12-23, and others. So you could be over range, top of range or mid-range, we just don't know.

[SlowDragon Administrator]

If you are on Levothyroxine just testing TSH and FT4 is completely 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, especially if Thyroid antibodies are raised

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose 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 all 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_...

[ja12 in reply to SlowDragon]

thanks my vitamin d is at 47 at y

the minute b12 is normal

[SlowDragon Administrator in reply to ja12]

We need ranges on these results. The figures in brackets after each result

B12 - range is usually very wide. Result needs to be over 500

Folate and ferritin need testing

If you are in the UK, vitamin D is probably measured in nmol and 47nmol is too low

Are you supplementing any vitamin D?

Have you had thyroid antibodies tested?

[ja12 in reply to SlowDragon]

no I have not had them antibodies tested I have been supplementing on vitiam d for 2 years does not seem to be going up

[SlowDragon Administrator in reply to ja12]

Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine

(Many of us need TSH nearer 0.2 than 2.0 to feel well)

See box

Thyroxine replacement in primary hypothyroidism

pathology.leedsth.nhs.uk/pa...

Low vitamins are common if under treated for thyroid

How much vitamin D are you taking each day? If level is not going up you need higher dose

With thyroid problems we frequently need higher dose than average

Or if taking tablets, they can be poorly absorbed in gut, especially with Hashimoto's

Vitamin D mouth spray can be much more effective.

betteryou.com/vitamin-d-ora...

Especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by high TPO and/or high TG thyroid antibodies

Getting online access to your medical record and blood tests is always worth doing

Need to see if thyroid antibodies have ever been tested

Also results and ranges for folate, ferritin and B12

UK GP practices are supposed to offer online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances.

Most common by far is gluten.

Dairy is second most common.

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

Ideally ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first




Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

[ja12 in reply to SlowDragon]

thank you how do i get my doctor to increase my Levo as I have been back a few times advising I do not feel right he says it is normal range ?

also I'm taking 3000 it mouth spray bit d

[ja12 in reply to SlowDragon]

level 2.77 mu/l (0.1 -5.0)

serum free t4 level 18pmo/l (12- 23)

[SeasideSusie Remembering in reply to ja12]

thanks my vitamin d is at 47 at y

Is the unit of measurement nmol/L or ng/ml?

the minute b12 is normal

Can you tell us the result, with unit of measurement and reference range please.

Is this Active B12 or Serum B12?

[ja12]

hi thanks for your advice yes I am supplementing on vitiam d the blood results are very vague so here goes tsh see I tsh level 2.77 mu/l (0.1 -5.0)

serum free t4 level 18pmo/l (12- 23)

I will have a look at Medicare and blue horizon thanks