Hi We have done a Thyroid test of my Wife and we got to know that it is grater then 100 . Please help us know that is it really serious we will soon see the doctor but any information will be helpful. Below is the readings..
Serum T3 0.43 ng/ml
Serum T4 1.03 ug/dl
Serum TSH >100 uIU/ml
Any help will be really appreciated.
A TSH > 100 means she almost certainly has primary hypothyroidism, a failing thyroid gland. The high TSH means she probably has quite substantial hypothyroidism, as the pituitary pumps out more TSH trying to get more hormone from the thyroid. She should see a doctor soon and perhaps consider taking time off work if necessary. She will be treated with levothyroxine, the starting dose should usually be between 50 and 100 mcg for someone with a high TSH. However, if she has been hypo for a long time she may not be able to start on a high dose, the doctor should check her out and make a judgement.
We need to see the reference intervals for these blood test results (numbers in brackets). It looks like these T3 and T4 results are for total T3 and total T4, these are not much use it is free T3 and free T4 that are informative. The doctor can take another blood sample for these tests but shouldn't delay treating her.
Thanks for reply. When she was on pill 50mg thyroxin in moth of FEB 2019 the reports came as below.
Serum T3 243 ng/dl
Serum T4 12.07 ug/dl
Serum TSH <0.01 uIU/ml
As TSH is very low she stopped taking thyroxin and now after two and half month it is more then >100 uIU/ml.
As her levels are swinging up and down, she almost certainly has autoimmune thyroid disease also called Hashimoto's
She will need to restart her Levothyroxine
Doctor should test both TPO and TG thyroid antibodies. If either or both of these are high this confirms the cause is autoimmune thyroid disease
Very important to test vitamin D, folate, ferritin and B12 too. These are frequently too low and need supplementing to improve and regular retesting to check levels
See GP next week to get restarted on Levothyroxine and referral to endocrinologist
If in the UK email Dionne at Thyroid Uk for list of recommended thyroid specialists
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_...
NHS guidelines on Levothyroxine including that most patients need somewhere between 100mcg and 200mcg Levothyroxine. Also what foods to avoid (note recommended to avoid calcium rich foods at least four hours away from Levo)
nhs.uk/medicines/levothyrox...
The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH under one) and FT4 in top third of range and FT3 at least half way in range
All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels
NICE guidelines
cks.nice.org.uk/hypothyroid...
The initial recommended dose is:
For most people: 50–100 micrograms once daily, preferably taken at least 30 minutes before breakfast, caffeine-containing liquids (such as coffee or tea), or other drugs.
This should be adjusted in increments of 25–50 micrograms every 3–4 weeks according to response. The usual maintenance dose is 100–200 micrograms once daily.
We really need the reference intervals for these results, especially as they are from different assays. Also it’s not clear if they are total or free T3, T4 figures. I would not worry about the TSH for now and resume the levothyroxine. She may have autoimmune hypothyroidism, this can cause erratic thyroid allergies secretion, so the doctor should check her antibodies. In the short term resume 50 mcg levothyroxine as this will be a safety net.
Note I am a patient, not a doctor.
They are total T3 and T4
Makes sense. I would resume the 50 mcg and ask for TSH, fT3, fT4 and antibodies be tested. This is what you need to make a diagnosis and guide treatment.
Casn I suggest you wife goes gluten free and takes plenty of rest until things are more stable and she does need to resume levo. It might be really helpful if she was able to take her pulse to guide her dose as well.I imagine it is very low at the moment. There is no need to panic people can be ill for a very long time with thyroid disease with out going into a coma or anything nasty like that and it does take a while to get well. She also needs her ferritin, folate, b12 and vitamin D taken so make sure this is asked for when you see the doctor. Keep coming back to us until she is better.
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