I have a follow up to my post of a few days ago regarding my friend who had a blood test and had a phone call to go to the surgery as her T4 reading was 32.5. She went to the surgery today and got a print out of her test. It showed Free T4 32.5 range 9.00 to 26.00 pmol with TSH of 0.05. range of 0.27 to 4.20 mu/l and she was told the thyroid tezt is abnormal. She was taking 125 mcg of levothyroxine she has now been told to reduce her dose immediately down to 75 mcg daily. They didn't test her Vitamin D or Iron but did her ferritin which was 158 and her B12 and foluc acid was high but no action required but she doesntvtake supplements. and they didn't do her vitamin d. is the doctor right in telling her to reduce. They didn't test her T3 as most doctor surgeries won't. She is really worried as she has been losing her hair and very tired all the time.
Written by
Bookworm1961
To view profiles and participate in discussions please or .
No she hasn't had her antibodies tested as yet her doctors don't do that I told her today thatshe needs to get referral to my endo she spoke to her doctors and they told her you don't need a referral and just reduce her dose. I try and pick up lots of information from here could it be she is not converting her T4 to T3 properly. She has been underactive for about 25 years. If she reduces her dose will she get worse.
She could get the antibodies tested privately. The NHS only do one of the antibodies, anyway, and there are two that should be done.
A conversion problem would not give an FT4 result that high. That is a typical Hashi's result, and it will go down again by itself as the excess hormone is used up or excreted. Right now, she could be feeling bad because her FT4 is so high - and, presumably her FT3 is high, too, but she'll only know that if she has it tested. What we normally suggest in such cases is to stop the levo completely for a few days, and restart when she feels hypo again.
The problem is, of course, that doctors know nothing about all this. They don't know about antibodies, or how Hashi's affects the patient, and just lower the dose regardless. You would think that an intelligent human being would suspect something else was going on when levels suddenly change like that without changing the dose. But no, it goes completely over their heads. And, the result is the patient suffers.
So, I would suggest complete private thyroid testing, so that she knows exactly what is going on. Details of private tests here:
I have just spoken to my friend and I will send her your link and info regarding the blood tests. she is extremely grateful for both yours and SlowDragon quick responses. It has recently come to light that I have extremely low stomach acid ct scan came back normal on my pancreas but now be treated for SIBO with antibiotics this all started with a tip I pickedup a do it yrself DIY home bicarb test for low stomach acid.
I forgot to mention that her doctor was very, very wrong to reduce her levo by 50 mcg. Reductions, like increases, should be no more than 25 mcg every six weeks.
I would be lost without this forum now with all its helpful members and tireless support from the administrators. I have learned so much about my condition that no doctors have told me. Thank you all. Next step for me now is antibiotics for SIBO then heal my body as I have now have malabsorption for being left so long and then go gluten free. THANK YOU ALL. I have given all your advice to my friend and encouraged her to join our forum😊.
For full Thyroid evaluation she needs 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)
Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins
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 .
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.
Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
Personally I would get FULL Thyroid and vitamin testing before reducing if she didn't feel over treated
I was only telling her about your post earlier and the blood tests you always recommend I tell her what we on the forum know Doctors dont always know that much about thyroid problems.
I have struggled with low Ferritin doc said blood was ok at 50 but I felt unwell so after using Better You Iron spray my ferritin has gone up to 76😊 I know if u have underactive thyroid it needs to be over 70. Due to malabsorption and weightloss struggling with vitamins have also been using Better you Vit D and Vit k 3000 iu but my level is only 65 I thought it would be higher.
Antibodies were low at 20. Just diagnosed borderline severe pancreatic insufficiency . Suspecting SIBO but no hydrogen breath tests given just 3 different antibiotics to try then review again. CT scan showed no abnormality to pancreas . He said can't have allergy to gluten as don't have celiac. after antibiotics see what happens then try gluten free
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a
diet low in gluten as far as the progression and the potential disease complications are concerned
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
Going gluten free is a strategy that everyone with Hashimoto’s should try. In some cases, we see a complete remission of the condition; in other cases (88% of the time), the person feels significantly better in terms of bloating, diarrhea, energy, weight, constipation, stomach pain, reflux, hair regrowth, and anxiety.
Many clinicians report that eating a gluten-free diet may help improve thyroid function in nonceliac gluten intolerance. “Getting gluten out is primary for patients with Hashimoto’s, even without celiac disease,”
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Ferritin, TSH, gluten and B12 blood test results advice please
sister's blood test results
Getting Blood results from Gp ? 
Blood test results 
T3/T4 blodd test Monday.
