I have just managed to pick up these blood results the first ones done at my doctors my other ones going back to may I have to obtain them from the hospital I'm still waiting on these.. Quick run down.. Was diagnosed with graves.. Thiyroid removed this may.. Been on 125mg levo in May then reduced to 100mg then 75mg and now I've to reduce to 50mg..can anyone give me advice on these results
Many thanks in advance
Karen..
I would be feeling very poorly with these results! Ft3 is at the bottom of the range. Most need it well up towards the top to feel well. Ft4 is low too, so a drop in levo would not be a good idea in my opinion. The GP is looking only at tsh. Once we are on levo and with having no thyroid, tsh is not really important. The tsh, pituitary, thyroid feedback loop is broken and cannot be fixed. Ft4 and FT3 are the important results. Sorry can't comment on vitamins.
Thanks for your reply lalatoot
I do feel unwell this last 3/4 weeks I've been so fatiqued and lethargic it's heartbreaking.. I was hyper for 4 years but my gp always put it down to the menupause.. I knew otherwise so 3/4 years of hell then my thiyroid had to be removed (graves toxic).. Thought I would be feeling somewhat better by now.. 😔
birkie
Oh my goodness, whoever is looking after you really doesn't have a clue. They're dosing purely by TSH which is wrong but they're brainwashed into thinking the TSH test is all that matters. I see the comment next to your TSH of 0.05 that says to reduce Levo to 50mcg.
Let's look at your thyroid results:
TSH: 0.05 (0.30-4.50)
FT4: 13.3 (11-22)
FT3: 3.1 (3.10-6.80)
So TSH is suppressed. Your FT4 is 21% through range. Your FT3 is is 0% through range.
FT4 and FT3 are the thyroid hormones, T4 converts to T3 and T3 is the active hormone that every cell in our bodies need. You have zero!
TSH is a pituitary hormone - Thyroid Stimulating Hormone - it tells the thyroid to produce thyroid hormone when it detects there's not enough. Well, you certainly don't have enough thyroid hormone but your pituitary isn't sending the signal. This was mentioned in your previous post and Humanbean explained why it might be staying low.
It's the thyroid hormones - FT4 and FT3 - that are important.
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the magazine for doctors):
"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).*"
*He recently confirmed, during a public meeting, that this applies to Free T3 as well as Total T3.
You can obtain a copy of the article by emailing Dionne at
tukadmin@thyroiduk.org
print it and highlight question 6 to show your doctor.
You do not need a reduction in your dose of Levo, you need to get more thyroid hormone so more Levo.
Now let's look at your nutrient levels:
Ferritin: 17 (23-400) - that range - going up to 400 - is usually for males, for females the top end is usuallly 150 or 300.
Anyway, regardless of the range, you are below range. What are they doing about that? Low ferritin can suggest iron deficiency anaemia so you need a full blood count and an iron panel.
It's said that for thyroid hormone to work properly (that's our own as well as replacement hormone) ferritin needs to be at least 70, preferably half way through range, although I've also seen it said that for females a level of 100-130 is good (but doctors probably wont necessarily agree, they only want to see it somewhere within range).
B12: 254 (197-771ng/L)
This is low.
According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
Many people with B12 in the 300s have been found to need B12 injections.
Do you have any signs of B12 deficiency? Check here:
b12deficiency.info/signs-an...
If you do have any then list them to discuss with your doctor and ask for further testing for B12 deficiency/pernicious anaemia.
You also need folate testing as B12 and folate work together.
Vit D: 70nmol/L (28ng/ml) tested in May 2019
This is on the low side. 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). You need this retesting to work out the dose of D3 you need to take. If GP wont do it then you can do this with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
Thank you so much for your reply seasidesusie
How can they put normal beside results that are clearly not.. On the serum ferritin it says see DR/NP.. But Ive been told I don't need an app as all results are fine except TSH which just need adjusted and this was told to me from the receptionist not my doctor zoo 🙄🙄
On the serum ferritin it says see DR/NP
I don't know what NP means but it's clear that it says to see the doctor. As for the receptionist telling you everythig was fine except TSH, well she's not medically trained nor qualified to comment on your results. If she can read (!) she should have seen that it says "See Dr). So if I were you I'd ring and make an appointment, if necessary pointing out that your ferritin is below range and the instruction on the print out very clearly states that you should see the doctor.
How can they put normal beside results that are clearly not..
They've put normal beside your B12 result because it falls within the range but it is very low. Some doctors will pick up on this, some wont. They are "range" driven, they don't care how the patient feels, it's basically "If it's in range then the patient is well" as far as they are concerned.
Same for your FT4 and FT3, but any idiot can see that your FT3 is right at the bottom of the range. If it was just 0.1 lower, at 3.0, then it would say abnormal but even then some doctors will say "Well, it's only just below range". They clearly have no clue.
DR/NP is likely Doctor or Nurse Practitioner
Ah right, thanks MaisieGray.
Ho thanks that's cleared that up.. 👍
Hi again seasidesusie
Can I just ask if cereable leakage can have any affect I'm under a ENT surgeon at the moment as my right ear drum as sunk in to my canal and I'm having leakage from my left nose and eye I see the surgeon on the 4th of Nov 2019..ive gone deaf to in the right ear.. 🤔🤔🤔
I'm sorry Birkie, I really have no idea, it's not something I have personal experience of.
Hi
To tell you the truth seasidesusie I told my GP I had concerns with my pituitary gland years ago when I started with hyperthiyroidism but nothing was done I also put this to my surgeon who done my TT same thing nothing was done...it's disgraceful how they can umberella each pacients as OK if within range even if it's at the bottom..I'm clearly not well they should go off how you feel not the flipping ranges 😡😡😡😡😡
GPs don’t understand Graves because it’s not dealt with in primary care. But because you now have no thyroid you’re thrust back into primary care as a hypo patient. Then the fun starts because although you now have no thyroid you still have Graves. And if your antibodies are active they can exert a direct suppressive effect on the TSH. Graves sufferers must never ever be dosed on TSH. Cardinal rule. You are still a Graves sufferer 🤷🏻♀️. Seems like your GP is trying to finish you off. You need to find someone who knows what they are doing, fast.
Hey there Birkie,
Well it's pretty much what we expected yesterday, isn't it.
Is there a chance of seeing a different doctor in the surgery ?
You desperately need an increase in Levothyroxine and as already covered by Seaside Susie your vitamins and minerals aren't well placed and will be compounding your conversion of Levothyroxine to T3, which is the hormone the body runs on.
I went through a similar situation with my doctor. My TSH was at 0.01 and I paid for T3 and T4 blood tests, which came in at T3 25% and T4 80% through the ranges.
She maintained I was overmedicated despite these results, and said I was very lucky to have any T3 at all and since my ferritin was at 22 and " in range " - I was ok, and good to go ????
Needless to say, I've gone on the self medicate, as the stress and anxiety caused in this continual circle of misinformation and NHS dogma is truly upsetting.
Your Graves antibodies are causing your TSH to be supressed. The TSH must not be used when monitoring and treating Graves Disease patients, but sadly this seems a little known and poorly understood fact. The fact that your thyroid has been removed means the feedback loop is broken, the TSH reading is of no value, as there is no thyroid to stimulate, and T3 and T4 blood tests should be obligatory.
You need a dose increase. Your free T3 - the active hormone is right at the bottom of the range and your free T4 is also very low in range. Most people need their thyroid hormones int eh top third of the range to feel well. Often TSH never increases or behaves "properly" after being hyper. I'd try to find a new GP with a clue - that one will make you very ill.
Blood results
Strange blood test results...
Could someone explain my blood results please?
past results 
