Results FINALLY !!!

[Michaelg193]

So after much digging at the worst doctors on this planet I finally have blood results printed

All i have as follows :

T4:16.4

TSH:20.2

What does this mean?

[SeasideSusie Remembering]

Michaelg193

Do you have the reference ranges please? We know that your TSH is high and will be over range, but we haven't a clue how to interpret your T4 without it's range. Nor do we know if it's Free T4 (FT4) because T4 can be Total T4. Ranges for FT4 that we see on here are 7-17, 9-19, 11-23, 12-22 and others. So you see, you can be over range or you could be half way through range or anywhere in between. If you have a print out of your results then the reference range should be on their - usually at the side of the result, maybe in brackets.

For a full picture just testing TSH and FT4 isn't enough, we also need FT3 and do you know if you've ever had thyroid antibodies tested?

[Michaelg193 in reply to SeasideSusie]

That is all i have been given on my sheet on paper just t4 16.4 and tsh 20.2 have no reference nothing no t3

At my wits end

[SeasideSusie Remembering in reply to Michaelg193]

Was this a print out or did somebody just write this down on a piece of paper?

Can you edit your opening post and add a picture of this?

How to edit a post:

support.healthunlocked.com/...

FT3 is unlikely to be done at primary level unless TSh is suppressed, and then not always. This is why hundreds of us here do private tests.

But as I said, your TSH is obviously well over range but we can't interpret your FT4 without the range.

[Michaelg193 in reply to SeasideSusie]

It was just a hospital letter I got from when I was there with chest pains all it states is t4 and tsh in afraid .. will need to get them tested again get proper ranges etc

[SlowDragon Administrator]

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

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)

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

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all primary hypothyroidism in Uk is due to Hashimoto's.

Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

List of hypothyroid symptoms

thyroiduk.org.uk/tuk/about_...

If hypothyroid a long time without treatment, adrenal glands can be affected and it can make starting on Levothyroxine extremely difficult

What dose of Levothyroxine were you started on? standard starter dose is 50mcgs

Many people react badly to some brands of Levothyroxine, especially Teva brand. So we often have to try different brands before finding one that suits you

You should be referred to endocrinologist if you can't tolerate Levothyroxine. There are other options e.g. Liquid Levothyroxine

But endocrinologist should test adrenal levels too before starting on Levothyroxine

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 in top third of range and FT3 at least half way in range

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

[Michaelg193 in reply to SlowDragon]

I will get these checked privately thanks you and my starting dose was 125mcg and raised to 175mcg with these latest results

Hospital stated my thyroid levels where high but unclear if they ment I have hyperthyroidism or not

Doctors surgery told me I have hypothyroidism so am seriously worried I am being wrongly prescribed levothyroxine

I didn't know what Ievels where required so I will get this updated as soon as possible thanks

[Michaelg193 in reply to Michaelg193]

To clarify to this my surgery have been wrongly diagnosing people for months now and had several investigations and complains filed against them so will need to get full results asap for everyone

[greygoose in reply to Michaelg193]

When they say 'thyroid levels' they usually - and incorrectly - mean TSH levels, although TSH is not a thyroid hormone, they believe it tells them everything about the thyroid! Totally delusional! But, with a TSH of over 20 you are very hypo. If you had hyperthyroidism, your TSH would be around zero. And, your FT4 would be a lot higher than 16. So, don't worry on that score. You haven't been wrongly prescribed levo.

[Michaelg193 in reply to greygoose]

Thanks great to know! Time to get these levels sorted now

[SlowDragon Administrator in reply to Michaelg193]

Your results show you are HYPOthyroid

High TSH = hypothyroid

Standard starter dose is 50mcgs Levothyroxine

Not surprised you felt terrible starting on 125mcg. You might eventually need 125mcg....or even higher dose, but we have to start slowly......other its too much of a shock to the system

Starting on 50mcg. Getting bloods retested 6-8 weeks after each dose increase

Getting vitamins tested and supplementing to bring to optimal can help too

[Michaelg193 in reply to SlowDragon]

I agree a private set of blood work done sounds like the appropriate way to go for my situation thank you

[SlowDragon Administrator in reply to Michaelg193]

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

Guidelines on dose by weight

healthunlocked.com/thyroidu...

NICE guidelines

cks.nice.org.uk/hypothyroid...

The initial recommended dose is:

For most people: 50–100 micrograms once daily, preferably taken at least 30 minutes before breakfast, caffeine-containing liquids (such as coffee or tea), or other drugs.

This should be adjusted in increments of 25–50 micrograms every 3–4 weeks according to response. The usual maintenance dose is 100–200 micrograms once daily.

[Michaelg193 in reply to SlowDragon]

See I had no idea when to take or which foods to avoid thank you !

[SlowDragon Administrator in reply to Michaelg193]

Most GP's haven't read guidelines either !

Levothyroxine should always be taken on empty stomach and then nothing apart from water for at least an hour after

Many people take Levothyroxine soon after waking, but it may be more convenient and more effective taken at bedtime

All other medication at least two hours away from Levo. Some like HRT, PPI's, magnesium, iron or vitamin D, at least four hours away

verywellhealth.com/best-tim...

Many people find Levothyroxine brands are not interchangeable.

Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased or at repeat prescription.

Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients. Teva is the only brand that makes 75mcg tablet.

[Michaelg193 in reply to SlowDragon]

I am on the mercury pharma levothyroxine sodium I am going to start myself on a low dose as the doctors 125-175mcg is way to much I can feel it hit me like a tonne of bricks but thank you for the information

[Treepie in reply to Michaelg193]

Medichecks usually have deals on Thursdays. You can have a diy finger prick test ( if you can get the blood out!) or have it done at a private clinic or a hospital dependent on where you live.

[Michaelg193 in reply to Treepie]

Definetly an option for me thanks will keep everyone updates as I go along can't thank everyone enough

[MaisieGray in reply to Michaelg193]

With results of T4:16.4 and TSH:20.2, whatever the ranges, and given you are taking 125 or 175 mcg Levo, there's no need to suspect you can be hyperthyroid! If you look at the various FT4 ref ranges SeasideSusie mentioned, 16.4 fits within all of them which wouldn't be the case if you had a hyperthyroid-elevated level plus taking Levo on top! But as has been suggested, the only way to know exactly what's going on, is to have a comprehensive set of tests carried out privately.

[Michaelg193 in reply to MaisieGray]

These levels where with 6/7 months with zero medication but yes I totally agree a private set of tests complete would be much more beneficial for me