Everything I thought I understood about thyroid... - Thyroid UK

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Everything I thought I understood about thyroid ranges . Please help

Gcart profile image
25 Replies

My blood test through Blue horizen and NHS ones have had the same ranges ie. pmol/L. I have understood about the ratio ideally being 4 to 1 or less.

My last blood test done through blue horizon is different. With great surprise my T 3 was 4.67. Range (1.88-3.18 H )HOWEVER. The T4. Was 13.78 range( 9.01-19.051) Yes the same value pmolL

Now how can the ratio be applied to this range. Is it a plot ?

As I understand have they (the lab) down graded the T3 test proving no one would need it ??

Maybe I have got it wrong.

Will add, I straight away lowered my T 3. 10 mcg to 5 Mcg (lowish dose anyway, TT 3 yrs ago)

2/3 weeks on started to notice symptoms returning and then scrutinised the test results. Totally confused now . Surely the ratio we use cannot be applied to the ranges from last test .

Please help to throw some light on this .

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Gcart
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25 Replies

I know that NDT reduces T4. So my bloods on NDT often have a high T3 and below range T4. I think you are on T3 and it has similar effect others will hopefully comment on this.

Gcart profile image
Gcart in reply to

Hi Mandyjane. Think I understand a bit better now. I take T4 and T3 now ,

Couldn’t get on with NDT sadly .

greygoose profile image
greygoose

My advice is to forget ratios. The very rarely apply to hypos. They are for healthy people. And this is where hypo treatment goes wrong, doctors comparing hypos to healthy people and expecting them to react in the same way. When you are hypo, you need what you need and to hell with ratios and ranges and all the rest. If you felt well on 10 mcg T3, then stick to it.

diogenes profile image
diogenesRemembering

In therapy, ratios are only of any use on T4 only, accompanied by the actual values as an indication of adequateor inadequate dose. With any T3 added, they mean nothing.

Gcart profile image
Gcart in reply todiogenes

Thanks for explaining

Gcart profile image
Gcart in reply todiogenes

Thanks for info

Gcart profile image
Gcart in reply todiogenes

Sorry to trouble you but could it be possible that the labs are lowering the range so proving no one needs T3?

diogenes profile image
diogenesRemembering in reply toGcart

No I don't think so. Refusal of T3 is based on ignorance and high price of the hormone.

Kalicocat profile image
Kalicocat in reply toGcart

Gcart and diogenes , my lab is doing the same thing. They are allowed to change their own ranges based on their local population. And they recently reduced the free T3 range using Free T3 averages based on multiple tests over a period of time. If they included my results (and other sick thyroid patients) as part of their range readjustment then it's skued in the wrong direction as I have a huge conversion problem.

helvella profile image
helvellaAdministrator in reply toKalicocat

If you have not already seen it, please have a look at this post:

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MaisieGray profile image
MaisieGray

"My blood test through Blue horizen and NHS ones have had the same ranges ie. pmol/L."

pmol/L is a unit of measurement, not a range. But you can compare where one result is in it's range, with where another result is in that range, if you are medicated with Levothyroxine to give you a good level of T4, and you have a FT4 result that sits say, at 98 % of its range; but a corresponding FT3 result sitting at say 25 % of its range, you don't need a ratio or a unit of measurement, to tell you there's possibly a problem in conversion. However, when you are taking T3 in whatever form, this doesn't apply because your FT4 level is most likely going to be lower/low in range even when FT3 is optimal.

Gcart profile image
Gcart in reply toMaisieGray

Thanks MG I was concerned with over range result 4.67 (1.88-3.18)

First time over range .

But thanks, I understand about ratio now once T3 is added

SeasideSusie profile image
SeasideSusieRemembering

Gcart

Those are very unusual ranges for Blue Horizon. Was this test done at a private hospital?

Is it Total T3 or Free T3?

Are you still taking 75 mcg levo and 10mcg T3

I have understood about the ratio ideally being 4 to 1 or less.

What ratio are you talking about? If you are talking about the ratio of T4:T3 to see how you convert then when you take a combination of Levo and T3 (or if you take NDT) then it's irrelevant. You are taking exogenous T3 so you can't know your natural conversion when you're adding T3 replacement. You can only work out how well you convert from FT4 and FT3 results when you are on Levo only.

Gcart profile image
Gcart in reply toSeasideSusie

Thank you. Yes. Blue horizen. And yes 75. T4. And 10 T3

Thought I was doing well until I reread the range ?

I think I will get in touch with BH and see there is a mistake

SilverAvocado profile image
SilverAvocado

I agree with Seasidesusie, the range for T3 in particular looks quite strange. For freeT3 my last Bluehorizon range was (3.1-6.8). Double check to make sure this is freeT3 you are looking at, or maybe there's a mistype or even misprint from BH in the range.

Gcart profile image
Gcart in reply toSilverAvocado

Thanks I will check with BH . That blood test would put me a lot over range quoted there.

Gcart profile image
Gcart

Thank you SS GG. MG. Diogenes Mandyjane

I have some understanding of this now , as you say because I am taking T 3 ratios can’t be used.

SS, It was a blue horizen test. and I had been taking 75 mcg T4 and 10mcg T3 for some time now . I lowered T3 to 5mcgs straight away and now feeling less well .

GG thank you I was concerned with result 4.67 pmolL (1.88-3.18)

But yes I did feel ok . Should I e concerned with over range result ?

Thanks Diogenes. That is clear

helvella profile image
helvellaAdministrator in reply toGcart

SS, GG, MG, diogenes and Mandyjane won't see your reply here - unless they just happen to notice.

Have a look at this Help topic:

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SeasideSusie greygoose MaisieGray diogenes Hidden

Gcart profile image
Gcart in reply tohelvella

Thanks for that info

SeasideSusie profile image
SeasideSusieRemembering in reply toGcart

Gcart

SS, It was a blue horizen test.

Was this a fingerprick test?

If so, was the sample sent back to The Doctor's Laboratory or County Pathology?

Or a venous blood draw?

If a venous blood draw, was it a home blood draw or a hospital blood draw?

If a home blood draw, did the nurse post the sample or did you? Was it to The Docto's Laboratory or County Pathology?

If a hospital blood draw, did the hospital keep the sample and do the test themselves?

I'm trying to understand why your reference ranges aren't the same as the usual Blue Horizon ones.

My first ever BH test I did I had the blood drawn at a Spire hospital, they kept the blood and tested it themselves. But even so, the TSH and FT4 ranges were exactly the same as BH fingeprick test ranges (FT3 wasn't included).

Can you please clarify if your T3 is TOTAL T3 or FREE T3, the ranges will be very different.

greygoose profile image
greygoose in reply toGcart

No, I don't think you should be that concerned. Remember, a blood test is just that: testing what's in the blood. And, just because it's in the blood, doesn't mean it's getting into the cells. If it were all getting into the cells, you would probably have hyper-type symptoms. Some people need their FT3 blood level to be over-range in order to get enough into the cells to make them well. So, if it were me, I would put the dose back up to 10 mcg again. :)

Gcart profile image
Gcart in reply togreygoose

Thanks will do so.

Gcart profile image
Gcart

Hi. It was a blood draw a t my home, I posted the blood straight away .

The only name I can see on test result is London medical Laboratory.

Yes , it clearly says free T3

Result on that occasion. TSH. 0.03. (0.35-4.94)

Free T4. 13.8pmol/L. (9.01-19.051)

Free T3. 4.67 pmol/L. (1.88-3.18)

SeasideSusie profile image
SeasideSusieRemembering in reply toGcart

It looks like London Medical Laboratory could be a new lab that Blue Horizon are using, when doing BH home tests mine always used to go to County Pathology but lately they've been going to The Doctor's Laboratory.

The FT4 range is basically 9-19 which we do see on here from time to time. The FT3 range though, I've never seen one like that and it is a very narrow range, usually there is at least 3 between the lowest and highest ends of the range, e.g 3.1-6.8

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helvellaAdministrator

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