I had my thyroid removed a month ago due to Graves and have been put on 75mcg thyroxine. I had a blood test a week ago and the results are this:
Tsh 0.122 range: 0.27-4.20
FreeT4 16.76 range 12-22
What do these results suggest to you? The tsh looks like it is still very low suggesting overactive am I right? Does that mean I’m over medicated?
It's not a low TSH that makes you hyper, it's a high FT3, and they haven't even tested that. But, your FT4 is under mid-range, so you're actually under-medicated.
As you had Grave's, your TSH will take quite a while to rise - and might never rise at all. But, that doesn't mean you're hyper/over-medicated. So, dosing you by the TSH is completely inadequate. It's the FT3 that is the most important number.
Hey 👋 Hows it going? This is probably going to take some getting used to being at the other end of Thyriod disease 😔 Is that your endo getting those blood tests for you? Such a shame that they don’t understand that you really need your FT3 testing. And a lot of people who’ve had their thyroid removed really need to add T3 to their daily dose too. How much will really all depend on well you convert. Have they given you any plan going forward? I’d be asking for an increase to 100mcg, hold for 6wks but also ask for FT3 to be measured aswell so you can get a full picture.
I agree, the rough rule of thumb when dosing Levothyroxine is that you want the freeT4 to be high in range, it can even go slightly over range if you need that to feel better. The reason this is useful to check for is that Levo contains only T4, so looking at freeT4 shows how it's raising levels.
The freeT3 is more important overall, because this is the active hormone that most closely reflects symptoms. T4 has to be converted into T3 before it can be used. Its possible you'll eventually need a bit of T3 medication to go with your T4 and get this level up. But you won't really know this until your T4 has been increased all the way.
Doctors will often talk as if you're supposed to feel better straight away, but its common to feel rubbish at first after the operation, and even for several months after. If you're pretty lucky and all goes smoothly it will still take 6 months or more to get settled on thyroid hormone replacement. Many of us have a bit of a struggle.
This forum is brilliant to learn more about blood tests and dosing, and hear about other people's experiences. If you search for Graves a lot will come up.
How do you feel?
For full Thyroid evaluation you need TSH, FT4 and FT3 tested. Also important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially with Graves or Hashimoto's
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).
Is this how you did this test?
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
Hi all sorry for not coming back to you. Thank you so much for your helpful suggestions. After the results I posted above I had some more bloods done with my gp last week (5 weeks post op) again they only tested it tsh and t4 and all I got was a text to say come for another test in 2 months! No discussion about the results or my symptoms
The results this time are
TSH 0.14 range 0.34-5.60
T4 10 range 7.70-15.10
In reality I’m putting on weight despite radically cutting what I’m eating, cutting bread etc. I’m shattered come mid afternoon. My hair feels disgusting and my skin is really dry and I keep getting pins and needles in my fingers.
Should I get my own bloods done and go back armed with these or just stick at it for 2 months on the 75mcg?
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