more confused: hi there, i recently posted my t... - Thyroid UK

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thyroidnodules profile image
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hi there, i recently posted my t4 and tsh results from my doc. as i am on ndt thiroyd and my surgery doesnt test t3, i did a test with medichecks. i thought i might need an increase but this was my result and doc at medichecks opinion. any thoughts as to where i go from here. thank you

"Thank you for providing your medical history. I can see that you take natural desiccated thyroid for your underactive thyroid and regularly monitor your thyroid function with medichecks.

Your thyroid stimulating hormone is stable but remains below the normal recommended target of 0.3 to 3.0 mIU/mL. This can suggest that your thyroid is overactive and that your dose may need adjusting. I recommend discussing this with your doctor who will be able to advise you about your thyroid medication.

Chronic low thyroid stimulating hormone levels have been associated with increased risk of osteoporosis therefore if you have not done so already, I recommend discussing your overall risk with your doctor. If you are at risk, you may benefit from a bone scan. Your doctor will also be able to assess other lifestyle risk factors and your need for medicines to help, including calcium and vitamin D supplements.

The low free thyroxine and normal T3 is common with combination therapy"

TSH 0.16 (0.27 - 4.2)

T3 4.24 (3.1 - 6.8)

T4 11.3 (12 - 22)

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thyroidnodules
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Lalatoot profile image
Lalatoot

Tsh is of little importance and the information re osteoporosis is misleading. You have more danger of it from being undermedicated! Once we are diagnosed and on medication the thyroid/pituitary feedback loop measured by tsh is broken. We need to look at ft3 and ft 4 levels. Your ft3 level is still low. Many would need it well into the 5s to feel well.

SlowDragon profile image
SlowDragonAdministrator

The "blurb" from Medichecks doctor is just standard NHS guidelines.....not applicable to anyone on NDT.

TSH is almost always suppressed on any dose of NDT or T3

Most important results are FT3 and FT4

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water . This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

If/when on NDT or T3, make sure to take last dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you did your test?

Assuming you took last dose NDT approx 8-12 hours prior to blood test, your results suggest you are perhaps under medicated

FT4 is often low on NDT

But FT3 is only 30% through range

Useful calculator for working out % through range

chorobytarczycy.eu/kalkulator

What vitamin supplements do you currently take and when were vitamins last tested?

Canadian Thyroid association article on Low TSH and why it's often irrelevant

thyroidpatients.ca/rational...

thyroidnodules profile image
thyroidnodules in reply toSlowDragon

thank you for your reply. i took the test on an empty stomach and missed out my nightly dose of ndt so it was well over 12 hours. i do have supplements but always forget to take them in time to avoid the four hour space for meds. i do take vit d3 spray and vit b12 spray. my understanding was i needed an increase as my last few t3 results have been in the lower range and i knew about the tsh being suppressed. however, the comments from medichecks last year and this year thew me a bit so i didnt know whether to increase or decrease. it is quite scary self medicating not always knowing if you are doing the right thing but levo did not help me at all and thiroyd has helped. thank you for your input and links

SlowDragon profile image
SlowDragonAdministrator in reply tothyroidnodules

Most members have found Medichecks doctors comments only reflect NHS guidelines (i.e. Completely wrong especially for anyone on T3 or NDT)

Personally I never bother to get the doctor's comments - they always have hissy fit at suppressed TSH

Vitamin D spray is absorbed in mouth so doesn't need to be four hours away from taking NDT

Only iron of magnesium supplements that you swallow would need to be four hours away

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