Latest blood test results

[Aloha79]

Dear all, thank you in advance for this. Any insights appreciated.

I have been on levo (5omg) for 5 weeks and will be tested after 6 weeks. However, I have been tested regularly for other things and they have thrown in basic thyroid tests each time, plus I contacted old GP from the first half of this year (we moved house and GP over the summer) so get older results (which showed elevated TSH but that GP didn’t inform me!). We were TTC after an early miscarriage (fell pregnant end of May).

Next week I will have full thyroid tests again.

January 2019 (GP at the time did not flag these results):

TSH 4.48 (mU/L 0.3-4.2 range)

T4 16.9 (pmol/L 12-22 range)

May 2019:

TSH was 1.9

T4 was 15.22

Start of September 2019:

TSH 4.09

T4 15.6

Mid September 2019: started 50mg Levo

End of September 2019:

TSH 1.54

T4 18

T3 4.9

Vit D 117 nmol/L

TPO antibodies <15

End of October 2019:

TSH: 1.17

T4: 17.8

Cortisol 185 nmol/L (range 166-507)

Cholesterol HDL 1.17 nmol/L (range 1.2-99)

Cholesterol LDL 2.7 nmol/L (range 0-3)

Cholesterol non HDL 3.2 nmol/L (range 0-3.8)

Cholesterol (total) 4.4 nmol (range 0-5)

Testosterone 0.4 nmol/L (0.3-1.7)

Celiac (TTG) 1.2 U/mL (range 0-6.99)

C-reactive protein less than 1 mg/L (range 0-5)

B vits (folate) high end of range, as are all iron counts. Sodium, potassium, creatine, urea, all high end of the range.

[Aloha79]

PS fasted, no levo before the tests first thing in the morning etc.! Am 40, BMI 19, lots of symptoms around exhaustion/brain fog, immunity issues.

[greygoose]

Well, you don't convert very, do you. Your FT4 is good, but the FT3 is low. And, it's low T3 that causes symptoms.

[Nanaedake]

January 2019 (GP at the time did not flag these results):

TSH 4.48 (mU/L 0.3-4.2 range)

T4 16.9 (pmol/L 12-22 range)

It is not unusual for a GP not to flag results such as yours (copied from above). Your TSH is only very slightly over range and your FT4 is well within range. It would have been better to also test FT3 but you would have had to get tests done privately for that.

Your current test results do not show elevated thyroid antibodies but there is no TgAb test to help rule that out. You do not say whether you have a goiter or have had an ultrasound.

There can be a range of reasons for elevated TSH, not necessarily thyroid disease so it's usual to retest a few times when borderline and many doctors will not initiate thyroid hormone until TSH reaches 10.

[Aloha79]

Thank you both, am not in the UK and my new GP is great, doing any tests I request.

greygoose Thank you, as always. What should I request regarding T3 in the next test, and what can I do about it? If levels still as above should I request 25mg more levo? What does not good at converting mean?

[greygoose in reply to Aloha79]

What you want is your FT4 and FT3 tested at the same time, to see how well you convert.

T4 is basically a storage hormone. It needs to be converted into the active hormone, T3. If you don't convert very well, your FT3 will always be too low. Adding more levo is not a good idea, because that could make your conversion worse, if the FT4 goes too high. What you need is some T3 added to your levo.

There's often not a lot you can do about poor conversion. It could be due to low nutrients, but you say yours are all top end of the range, so it's not that. You could try taking some selenium, see if that helps. Otherwise, the only solution is taking T3.

[Aloha79 in reply to greygoose]

Thank you, is this a common prescription as well as Levo? What problems in particular are caused by low conversion/T3?

[greygoose in reply to Aloha79]

It's low T3 that causes symptoms - not T4 and not TSH. The symptoms are all down to the T3. It's low T3 that makes you hypo.

I don't know where you live, but it some countries it's very difficult to get T3. Doctors don't like it because they don't understand it, they think it's dangerous. But, I don't know what it's like where you are.

[Aloha79]

Oh and PS no goiter or ultrasound. Should I request? Nanaedake

[Nanaedake]

You could request TgAb thyroglobulin antibodies test.

Have you any coexisting conditions or infection and are you taking any other medication? These factors can influence thyroid function and could cause elevated TSH. Best to rule these factors out. If you have signs or symptoms of a goiter you could request an ultrasound scan.

[Aloha79 in reply to Nanaedake]

No, no other treatment or conditions. Hypothyroidism/Hashimoto's seems to make some sense, I have felt "not right" all year tbh.

[Nanaedake in reply to Aloha79]

There is no evidence of Hashimotos in your present results. It would be worth testing TPO antibodies again in a few months or a future blood test and doing TgAb antibodies at the same time. It's possible for thyroid gland to fail without Hashimotos thyroiditis being present.

[Aloha79 in reply to Nanaedake]

Ok thank you. Are there any reasons why my TSH would fluctuate so much throughout the year?

[Nanaedake in reply to Aloha79]

I really don't know but it's not an enormous fluctuation. It's mostly in range. A virus or infection can affect thyroid function. You might discover you do have TgAb antibodies which could be a factor. Other female hormone fluctuation like pregnancy might affect thyroid function if your thyroid isn't working very well but I don't know anything about it, you'd have to find out.

[sadst8]

So your TSH and T4 are almost always in norm (but one that I could see). Do you persist in your worry? Maybe for naught? Do you really need Levo?

[Leharv]

You don't say when you were diagnosed, what previous dosage was, if symptoms are responding to treatment. Your symptoms could be of low vitamin b12.

[suztango]

Your cortisol levels are low! Did they not show up as ‘borderline low’ to the doctor? Mine at 302 did. Was the blood test done at 9am or before, though? If not, that could account for the low cortisol

[Aloha79 in reply to suztango]

Test done at 9am. I wondered about the cortisol. Is my level not normal? WHat should it be? What does my level mean? Thank you.

[suztango in reply to Aloha79]

I believe it should be above 400 or so. Can’t remember the exact range for ‘normal’. Yours is so low it’s verging on Addison’s.

Did the doctor really not mention this? My GP did (on my ‘borderline low’ result of 302). And this result, together with my hypothyroidism, prompted a referral to an endocrinologist. This was in the spring. My appointment with the nhs endo is in December, so I decided to go private.

The first thing the endo did was investigate the low cortisol result. I believe that each cell needs T3 and cortisol to make the energy. You don’t have a lot of either.

[Aloha79 in reply to suztango]

Goodness, thank you. It appears within the lab range, though? I’ll be going private to see an Endo, certainly.

[suztango in reply to Aloha79]

Can you do a 4 pt saliva test for your cortisol? It would tell you your cortisol levels throughout the day. Will help inform the endo. I did a Medichecks one, but they don’t test DHEA. People here recommended the regenerus one that also includes DHEA. I’m not entirely sure how DHEA completes the picture. Maybe someone else can explain? (I’ve now ordered a regenerus one for myself.)

[Aloha79]

Thank you Leharv and sadst8 We have had three early miscarriages (from May this year) and it was the fertility clinic who diagnosed high TSH in September, and started treatment then, B12 levels great. Symptoms: skin cancer in April) (no treatment was required other than removal), cognitive dysfunction, fatigue, infertility, inter-menstrual bleeds, stress, among others. I have two children so my health is paramount, as well as TTC.

[marvalrus in reply to Aloha79]

Definitely get your adrenals tested, mainly Cortisol and DHEAS. Are you taking vitamins?

[Aloha79 in reply to marvalrus]

Pre-conception vitamins, yes. Procieve normal strength.

[marvalrus in reply to Aloha79]

Have you thought about not trying to conceive until you get the thyroid numbers under control and address adrenal issues? Personally, I'd ditch those vitamins. Could be the whole problem! How long have you been taking them? Some vitamins can mess up thyroid function. Just eat well. Could be the iodine in the supplement. How much is in it? Anyways, it is not as common for someone to be hypothyroid w/o antibodies, thus, you are mostly witnessing Hashimoto's people on this forum, the main cause of being hypothyroid, although just for being factual, some can be hypothyroid w/o antibodies but low statistics. Some are dealing w/Graves Disease (hyperthyroid). I'd personally ditch those vitamins and retest thyroid and adrenals in a month and then another month later and see if there's an improvement pattern. Plus, the previous miscarriages could have messed up your hormones. Like turning a switch on/off. You need to work on getting stable. Wish you the best!

[Aloha79 in reply to marvalrus]

Thank you! Yes, TTC on hold since thyroid diagnosis in September. Taking the vitamins for the past month or so, only.

[marvalrus in reply to Aloha79]

Hold off on the vitamins because they do contain iodine (most prenatals do). And iodine supplements while taking thyroid medication is uncertain the effects. I'm wondering if your doc is testing FT4 and FT3, that would be "Free T4" and "Free T3". Most of us want to know what is "freely" available in the blood. I know here in the USA many endos and GPs don't even test that unless you ask.

[Lambyla1]

I have central hypothyroidism, my thyroid tests always come out within range (I take 50 mg Levo) I had a real struggle to get diagnosed. I suffered 5 really early miscarriages 10 years ago. I have recently had my hormones tested privately by medichecks and interestingly they are all a bit out of whack, but my prolactin levels are 3 times over the top of the range. I don't recall ever having these tested during my pregnancy issues. but I know that this can be related to miscarriage and fertility issues - have you had this tested, it may be worthwhile if not - just a thought

[Aloha79 in reply to Lambyla1]

Thank you. Yes, thyroid issues seem to common in infertility issues.