T3

[Saorlaith]

Hi I’m new to this form I have under active thyroid for 30+years I have only ever been prescribed thyroxine and after reading other people’s stories would like to know more about t3-t4 is it on prescription

[SeasideSusie Remembering]

Saorlaith

Before we know if we need T3 we need to know our thyroid and vitamin levels.

For thyroid we need to test

TSH

FT4

FT3

Thyroid antibodies

This will tell us if we are converting T4, the storage hormone, into T3, the active hormone which every cell in our bodies need.

If those results suggest we may not be converting well enough, it's essential to know if we have optimal nutrient levels so testing the following is needed

Vit D

B12

Folate

Ferritin

If we do have a conversion problem the only way to get T3 on prescription is to be referred to an endocrinologist and if s/he agrees then a prescription may be issued. It is extremely difficult at the moment to be prescribed T3, it is a very expensive medication and many health authorities are reluctant to prescribe to new patients.

So if you can post results, with reference ranges, for all those tests we can comment further.

[Saorlaith in reply to SeasideSusie]

Can you help me please with my results Serum free t4 legal 20.9pmol/(12-22) T-shirt leval2.19miou/l(0.27-4.2)

[SeasideSusie Remembering in reply to Saorlaith]

TSH: 2.19 (0.27-4.2)

FT4: 20.9 (12-22)

Well, those are "euthyroid" because they're within the normal range. However, when on Levo only, the aim of a treated hypo patient generally is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their ranges if that is where you feel well. So your TSH tells us that if you are symptomatic then you could do with an increase in your Levo, but your FT4 tells us that you are quite near the top of the range and an increase would push you over range.

It's possible that you aren't converting T4 to T3 very well. To convert well we need optimal nutrient levels, so testing these is important:

Vit D

B12

Folate

Ferritin

And we also need FT3 testing at the same time as TSH and FT4 as that shows us how well we convert when TSH is down to about 1.

[Saorlaith in reply to SeasideSusie]

Thanks so much for all your help I did get b12 and ferritin test but I don't know how to understand the Reading what should they be

[SeasideSusie Remembering in reply to Saorlaith]

It depends on the reference range, and with B12 if it's Serum or Active test. Post results with the ranges and unit of measurement for B12.

[Saorlaith in reply to SeasideSusie]

Thanks again for all your help

[Saorlaith in reply to SeasideSusie]

Hi my b12 and serum vitamin 543ng/l(197-771)

Serum folate 2.7ug/l(3.9)

[SeasideSusie Remembering in reply to Saorlaith]

Saorlaith

b12 543ng/l(197-771) - ng/L is the same as pg/ml

According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

So you are slightly under the 550 which I would say is the minimum, but if you are in the older age group it would be better nearer 1000.

Also, bear in mind that you can have a decent Serum B12 level but a low Active B12 level. Serum B12 shows the total amount of B12 altogether, Active B12 shows what is free and available to be taken up by the cells.

Serum folate 2.7ug/l(3.9)

You are folate deficient, your result is below range, this is something your GP should be addressing.

You still need Ferritin and Vit D testing, plus to know if you are converting T4 to T3 well enough you need TSH, FT4 and FT3 tested at the same time. If you haven't already had a positive antibody test result, it would be useful to test thyroid antibodies as a positive result would mean that your hypothyroidism is due to autoimmune thyroid disease (Hashimoto's).

[Saorlaith in reply to SeasideSusie]

Thanks for this I'm going to see if I can get my bloods done private I'm 61 and have been on different levels of thyroxin over the years I'm always so tired and have flu like symptoms

[SeasideSusie Remembering in reply to Saorlaith]

ThyroidUK have recommended labs which many of us use, and they offer fingerprick tests for quite a lot of the tests, also venous blood draw at extra cost.

thyroiduk.org/tuk/testing/p...

If you want the full thyroid/vitamin test either of the following are suitable:

Medichecks Thyroid Check ULTRAVIT medichecks.com/thyroid-func... .

or

Blue Horizon Thyroid Check PLUS ELEVEN bluehorizonmedicals.co.uk/t...

Both tests include the full thyroid and vitamin panel. They are basically the same test but with the following small differences:

For the fingerprick test, Blue Horizon requires 1 x microtainer of blood (0.8ml), Medichecks requires 2 x microtainers (total 1.6ml)

Blue Horizon includes Total T4 (can be useful but not essential). Medichecks doesn't include this test.

B12 - Blue Horizon does Serum B12. Medichecks does Active B12.

Serum B12 shows the total B12 in the blood. Active B12 shows what's available to be taken up by the cells. You can have a reasonable level of Serum B12 but a poor level of Active B12. (Personally, I would go for the Active B12 test.)

[SlowDragon Administrator]

First thing is, do you have any actual blood test results? if not will need to get hold of copies.

You are legally entitled to printed copies of your blood test results and ranges.

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.

Come back with new post once you get results and ranges

Unlikely that GP will have tested all of these.

But first step is to see exactly what has been tested and equally important what hasn't been tested yet

Then can ask GP to do any missing tests or test privately

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)

[Saorlaith in reply to SlowDragon]

Thanks for all this information I didn’t know I could get my blood test results from the doctors