Confused can anyone advise?!?

[JodieMH]

My results are not straight forward

6 June 18, 50mg Thyroxin

TSH 0.42 ( range 0.35-5.00)

Free T4 16.7 (range 9.0 - 21.0)

Total T3 1.4 (range 0.9 - 2.5)

24 November 18, 50mg Thyroxin

TSH 0.63( range 0.35-5.00)

Free T4 14.4 (range 9.0 - 21.0)

My latest results

31 May 19, 100mg Thyroxin

TSH 0.47( range 0.35-5.00)

Free T4 14.6 (range 9.0 - 21.0)

Total T3 1.9 (range 0.9 - 2.5)

No much change even thought my medication has been increased. Does anyone has any advice or insight??

Thanks

Jodie

[SeasideSusie Remembering]

JodieMH

How are your nutrient levels now? 2 years ago your Vit D and folate were very low, and now I know more about the Active B12 test your result of 44.1 (25.10-165) that result suggested you should be tested for B12 deficiency.

With your thyroid results, do you always do your test as we advise here:

* Book the first appointment of the morning, or with private tests at home no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.

* Fast overnight - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Eating may lower TSH, caffeine containing drinks affect TSH.

* If taking thyroid hormone replacement, leave off Levo for 24 hours before blood draw, if taking NDT or T3 then leave that off for 8-12 hours. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.

* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it will give false results (Medichecks definitely use Biotin, they have confirmed this and the amount of time to leave the supplement off).

These are patient to patient tips which we don't discuss with doctors or phlebotomists.

Total T3 is not a useful test and doesn't tell us anything, it was mentioned before that it's Free T3 that tells us what we need to know.

[JodieMH in reply to SeasideSusie]

Hi Seaside Susie,

I now get B12 injections, I take folate, Vit D, selenium, K2 and magnesium on a daily basis.

My appointment was in the morning and I had fasted. I took my medication levo after my appointment and hadn’t taken it in 24hours. I do not take any other medication.

Thanks

Jodie

I don’t drink caffeine, I only drink water. I hadn’t ate anything.

[JAmanda]

Your numbers look fine - your t3 went from 1.4 to 1.9 which is about 30% higher - the issue is only how you feel. So how do you feel?

[danym]

do you feel better with the increase? are you taking any supplements 2 hours after your meds?

[SilverAvocado]

JodieMH, my experience has been that free hormone levels don't always reflect dose increases. At one point I had 6 increases in a row, over about a year, and my freeT3 remained about the same. Now, it's very possible there is something strange about me and that isn't a typical result

In my case, I continued to increase, and in the longer term the trend is an increase in blood test results. I'd suggest the same in your case. You're looking at only one anomalous result, representing only one increase. Overall our bodies are unpredictable, but also blood tests aren't completely reliable. I think if you continue to increase, you'll find that eventually your blood numbers do change. By the way while my own blood numbers weren't changing, my symptoms were still improving, so I didn't care too much about the figures!

When taking Levothyroxine most people will need freeT4 high in range. Levo contains only T4, so the body needs a good supply to convert into T3. Best practice is to increase by 25mcg, then hold on that dose for 6 weeks and have a new blood test, then adjust by 25mcg and retest in another 6 weeks. Carry on until the freeT4 is at the top and/or your symptoms resolve.

On the NHS we will often have to wait longer, but you should get a rough approximation of this! Doctors will often want to dose on TSH, but if you're able to always argue to be dosed on freeT4. Once freeT4 is good you will also want to see freeT3. Unfortunately you've only got totalT3 here, which doesn't tell us as much.