Blood Test Help again pretty please

[smileplease]

I wish I was more knowledgeable and could help others more and not just always ask for help but I will be honest I am clueless everything I read seems to float back out of my ears I just cant make sense of it all. So i need to turn to you more knowledgeable people yet again for help please.

I am currently 26 weeks pregnant and so far this time all is going well, had to see consultant due to Hashi's and he admited he knows nothing about it and has referred me to Endo (hoping app doesn't come tbh as only saw one twice when 1st diagnosed and he was awful and made me feel hopeless and it was family & friends research for me that got me to taking t3 only and living a good life at last) but anyways he did some bloods and the letter i got from them i cant even understand as usual.

i take 100mcg T3 daily split into 2 doses and have done for a long time and feel good on it no symptoms really for a long while apart from pregnancy tiredness really

TSH 0.008 mu/L range 0.2-5.0

(now last bloods came back TSH L 0.01mIU/L normal range 0.27-4.2)

Free Thyroxine 0.6 pmol/L range 10 - 24

Total T3 7.3 nmol?l range 1.3-3.1

I know TSH will be supressed as i am on T3 only but does this mean my T3 is too high now as at last private full bloods i was showing spot on these were results

T4 Total L 5.4 nmol/L normal range 66-181

Free T4 L 0.71 pmol/L normal range 12.0-22.0

Free T3 4.6 pmol/L normal range 3.1-6.8

I just have no idea what to do for best my dr wont assist me and the endo if i ever see one is likely to want me to go back to T4 which made me so ill i couldn't work and i also worry to wait for an app as have no idea how long it could take

[jimh111]

This is a very difficult area with conflicting evidence. Research suggests that T3 doesn't cross the placenta and so theoretically pregnancy would need T4. However, the late Dr John Lowe treated many patients with high dose T3 and they had successful pregnancies. So, the point I'm making is there are no hard facts in this area.

As you are 26 weeks pregnant you baby will have developed its own thyroid by now. My best guess (and it is a guess) would be to stay on the lowest dose of L-T3 you feel well on. The fT3 result of 4.6 pmol/L from you old blood test looks wrong, fT3 would be much higher for someone on 75 or 100 mcg L-T3. I suspect you left too long between taking the tablet and having the blood taken. T3 doesn't always suppress TSH, it depends on the dose. Some patients do need high dose L-T3.

I think you doctors should monitor your response, your pulse, signs of hand tremor, whether you sweat etc. to determine your thyroid status.

Eight months ago you posted that you were 11 weeks pregnant, did that pregnancy go wrong? This is a very difficult area because nobody understands what is happening, why you need so much hormone.

[smileplease in reply to jimh111]

Hi

Thanks for the reply, it really is so complex and when you cant find a dr to treat you and you are like me just dumb with medical things, if my OH wasn't at least decent at taking info in i would be screwed, in life i can take in many things in my job and related things but anything medical just seems to evaporate i just cant seem to grasp information or retain it.

Yes it did unfortunately i lost that pregnancy at 12 weeks but this one seems to be going well I am on growth scans as i am measuring rather large (1st child 9 years ago was born 2 weeks late at 10lb 10.5 oz so we are expecting a large child)

I do feel fine on this dose i must say my pulse is same as always, i have no hand tremor, sweating etc, i am functioning really well to be honest i am just tired a lot and a big foggy but thats more likely pregnancy now than my Hashi.

Thanks for the advice

[SlowDragon Administrator]

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. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

If/when also on T3, make sure to take last dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you did your tests?

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