Weird Results

[hellothereyou]

low tsh and low free thyroxine?

[MaisieGray]

You need to give more detail than that for folks to comment usefully. What are your actual results and their respective ranges? Do you have results for your FT3 in addition to the TSH and FT4, because T4 is largely an inactive pro-hormone and it is T3 that is the active hormone. Are you diagnosed hypothyroid, and/or have Hashimoto's, and if so, what meds are you taking, and what dose? Do you have test results for these key vitamin and minerals: folate, ferritin, Vit D, Vit B12?

[hellothereyou in reply to MaisieGray]

Hi, thanks for replying. No hasi .. this test was done as part of a hormone profile - I'm in my mid 40s' and struggling with sleepiness/joint pain/horrid periods/uncontrollable sweating (changing tops 2/3 a day and at night). All I have is tsh at 0.09 Miu/l and free thyroxine at 10.7 and d vitamin at 69 nmol/l.. I have genetic issues with oxaltes/sulphates/chlorogenic/phosphates and my diet takes this into account. Meds - NDC 13.5 MCG t3 and 57.0 MCG t4. Considering compounding pharmacy for hormones for pre-menapausal. Thx 🌚

[MaisieGray in reply to hellothereyou]

So you are taking T3 13.5 mcg, and T4 57 mcg - is it correct to assume that by NDC you are referring to the FDA's National Drug Code, or is it something else ( as this is a UK-based forum we aren't always familiar with the detail of other countries). Those doses are unusual, are you taking compounded thyroid meds? I ask because not every compounded med and/or compounder are created equal, and accuracy, and appropriateness of excipients, can both be an issue. Sorry about the questions but there's no one size fits all answer to "wired results" and it's necessary to get the back ground. As you are taking T3, it is common for the TSH to be low or surpressed, so your result is unsurprising in that sense, and to be expected. Likewise with exogenous T3, the FT4 can be lower or even very low in range, as in your case. However without the reference interval, it's not possible to say if it is below or at the bottom of the range to make a guess at whether you are simply under-medicated or if there is something else going on. And without knowing your FT3 result, the problem is compounded - when on T3 in whatever form, some people are fine with an optimal FT3 level even if their FT4 is low, whilst others need both hormone levels to be optimal in order to be well. Without knowing your FT3 a definitive answer is pure guesswork, but it would probably be a good guess to say that on those doses, you remain under-medicated.

[hellothereyou in reply to MaisieGray]

Thanks - typo error! NDT not compounded. It sounds like I'll get the ft3 done for the specialist to be able to analyse correctly! . I was surprised with the result myself! Really confusing given the issue with the sweating!

[MaisieGray in reply to hellothereyou]

Some people believe that sweating/over-heating is always and only a symptom of being hyperactive or over-medicated; but it isn't so - I've never been over-medicated but for the past 10 or so years suffer terribly. It's very common for me to be unable to even get dressed in the morning and likewise very common for me to strip off in the toilets when I'm out, in order to try and cool/dry off. Right, so you are taking NDT, and the same comments hold good - you appear undermedicated but absolutely need your FT3 level to confirm that. 1.5 grains, if that's what you are taking, isn't an overly large dose.

Regarding your Vit D, the Vit D Council recommends a level of 125nmol/L (50ng/ml) and the Vit D Society recommends a level of 100-150nmol/L (40-60ng/ml, so yours at 69 nmol/l is too low.

[MaisieGray in reply to MaisieGray]

BTW You shouldnt assume that your specialist will be able to analyse the results correctly - even when they prescribe T3 in whatever form, many can't seem to grasp that it will lower both the TSH and the FT4 .......

[hellothereyou in reply to MaisieGray]

Thx will find out what the test has to say!

[SlowDragon Administrator in reply to hellothereyou]

You need to test TSH, FT4 and FT3 together

On NDT make sure last dose is 8-12 hours prior to test

Important to test vitamin D, folate, ferritin and B12 too

[hellothereyou in reply to SlowDragon]

Thx