FT4 &FT3 result

[Tabitha6]

I have my latest FT4 & FT3 results and would be grateful for any thoughts.

FT4 19.98 (12-22)

FT3 4.1. (3.1-6.8)

The lab comment reads “suggest send fresh sample for FT3 analysis”. My oncologist has ignored this comment so obviously thinks the results are ok.

Thanks for reading.

[Blueskyyy]

Plz post your TSH so we can see how your body reacting to your hormones level.

Actually if your TSH is within average then you can ignore for now the fTs values, if tsh is high then you can work on optimizing the hormones levels

[Tabitha6]

Thank you for reply.

My TSH result is very suppressed :

0.098 mIu/L (0.27-4.20) thyroid cancer patient.

[greygoose in reply to Tabitha6]

So, what are you taking, now? Did you get yourself some T3? You really don't convert very well.

Once you are on thyroid hormone replacement, the TSH ceases to be of any help - unless it's high. It's the FT3 result that is most important, and yours isn't even mid-range. How do you feel with those results?

[Tabitha6 in reply to greygoose]

I’m taking 100/75 thyroxine alternate days. I get very tired but I do feel better with the slight reduction in medication due to palpitations previously, however since learning about T3 and T3 testing from this forum, I do wonder if some T3 would help.

[greygoose in reply to Tabitha6]

To know if you need T3, you would have to get your FT4 and FT3 tested at the same time, to see your T3 level and how well you convert.

Palpitations can be a symptom of under-medication.

[Tabitha6 in reply to greygoose]

Oh I didn’t know under-medication could cause palpitations, thank you. I will push for both tests to be done again.

[greygoose in reply to Tabitha6]

You're welcome.

[jimh111]

The important question is how you feel? Do you have signs and symptoms that concern you or are you worried about the numbers?

It is usual to suppress the TSH after thyroid cancer but nowadays this is usually done for a shorter period. It would be very wrong for me to try and second guess your oncologist but you could check whether you still need your TSH so low. It depends very much on the type and severity of the cancer and obviously I haven't a clue about that. It would be worthwhile asking the oncologist how important it is that your TSH is still kept very low.

The lab comment is weird. Are they suggesting the blood wan't fresh enough or are they trying to second guess the what the fT3 should be. The fT3 looks reasonable to me for your high fT4 and low TSH, so I'm with the oncologist on this one. However, if you have noticable symptoms then it's more important to get you well than to make the numbers look good.

[Tabitha6]

Thanks for your reply. I feel better with the reduction medication which was causing palpitations, though still very tired. I’m not young though so maybe thats to be expected! I had a total thyroidectomy 15 years ago and since that time my TSH has been almost totally suppressed. Interestingly, I had to see an ENT specialist who is also a thyroid surgeon and during our chat he mentioned, as you say, that these days it is felt unnecessary to keep patients TSH so suppressed for so long, especially in my circumstances, ie papillary cancer and 15 years clear. I would have liked to have had a thyroid appointment with him but he was reluctant “to tread on my oncologists toes”. Previously I saw the surgeon who operated on me regularly but he has now retired and the oncologist has taken his place. The oncologist readily admits that his thing is really the cancer and has suggested in the past that an endocrinologist might be helpful. I did have an appointment with an endo once who was happy with the blood results at the time.

I spoke to the pathology department and queried the comment re T3 result and they said “the lab had made the comment based on the result”. I will query with the oncologist just to make sure he’s picked it up. Thanks again for your help.