This is my blood test result after Levo was red... - Thyroid UK

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This is my blood test result after Levo was reduced a few weeks ago. Does it look ok?

Ellie-Louise profile image
26 Replies

The doctor had reduced my Levo from 100mcg to 75mcg because he had been bothered by the TSH result previously, I thought it was ok but he insisted I reduce my dose and have another blood test in October.

So this is the latest result, I had to insist that he tested the T3 because apparently the NHS no longer test for it, so after thinking for a while he decided to ask for it anyway and tell them that he suspected that I was going hyperthyroid, (he wasn't but thought only way to get test done).

TSH = .022 (0.35-4.94)

FT4 = 13.2 (9.0-19.0)

FT3 = 4.8 (2.6-5.7)

What do you think?

I think it looks ok and I do feel pretty normal if that’s the right word. Lol

Thank you. x

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Ellie-Louise profile image
Ellie-Louise
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26 Replies
Aurealis profile image
Aurealis

It depends how well ‘pretty normal’ is? :)

Ellie-Louise profile image
Ellie-Louise in reply toAurealis

Ok, then I feel fine most of the time.

I do have other things going on like arthritis and my hiatus but I doubt they’ve got anything to do with things.

Aurealis profile image
Aurealis in reply toEllie-Louise

I would only make changes if you feel you need to, you can never be certain that blood tests are accurate enough to base dose changes on. They’re just a guide if you’re unwell and don’t know what to do.

NWA6 profile image
NWA6

The results don’t look great if you ask me. The only good thing going is that you appear to be a good convertor.

NWA6 profile image
NWA6 in reply toNWA6

Sorry had to run out but wanted to say that your T4 is only 42% through range and T3 71%. So this is potentially why you feel ‘okaish’ your T3 isn’t too bad. But does that put strain on your endocrine system to have such low T4 and covert so well? I doubt you needed your Leno reduced. What are the results that made your GP warrant a lower dose?

Ellie-Louise profile image
Ellie-Louise in reply toNWA6

To save me typing them out again, I just posted a reply to Seaside Susie with my previous results. Those are the results when I was on 100mcg and was tested in March. :)

SeasideSusie profile image
SeasideSusieRemembering

Elle-Louise

Your GP should not be dosing by TSH, it's not a thyroid hormone, it's a signal from the pituitary to tell the thyroid to produce hormone if it detects there's not enough. The thyroid hormones are FT4 and FT3 and this is what tells us what we need to know and should be used to adjust dose, with the FT3 being the more important result but unfortunately doctors are brainwashed into thinking that TSH is all that matters.

What were your results before the reduction?

What is your new dose?

How long have you been on the reduced dose? It can take 6-8 weeks for hormone levels to properly stabilise.

If you feel well on your new dose and it has been a couple of months since reduction and you are happy with how you feel then that's fine. If you have symptoms creeping back, or if it hasn't been a couple of months for your levels to stabilise, and your start having symptoms again, then reducing your dose might not have been the right thing to do.

Your FT4 is only 42% through range yet your FT3 is an amazing 71% through range, terrific conversion of T4 to T3, that's more like a result you'd expect when someone is taking a combination of Levo and T3.

How are your nutrient levels - Vit D, B12, folate, ferritin - often low with us Hypos and that can bring it's own symptoms, so it's a good idea to test them.

Ellie-Louise profile image
Ellie-Louise in reply toSeasideSusie

Yes, I did tell him that. I even got him looking at ThyroidUK on his computer.

He’s usually very good. I should have to look up my previous results as I can’t remember when it was. System online needs precise dates which is a bit of a nuisance in my opinion.

Ellie-Louise profile image
Ellie-Louise in reply toSeasideSusie

I have finally remembered to check the calendar and look up my previous results.

These are all they tested for btw. (I was on 100mcg levo daily when these were taken).

05/03/19

TSH - 0.03 mu/L. [0.35-4.94]

FT4 - 18.8 pmol/L. [9-19]

26/03/19

TSH - 0.03 mu/L. (same ranges)

FT4 - 18.1 pmol/L. " "

I can't remember why they repeated the blood tests.

So I may have it completely wrong from what has been said about FT$ levels needing to be high in the range, but to me it looks as if I need to go back up to 100mcg of levo again.

Would you agree, or do I have it wrong please?

Also a question about FT3, I know they haven't tested for it but if the FT4 has a higher result, would it follow that the FT3 result would have also been raised? and would it matter if it had and might be higher than the top of range?

This is all so complicated and my head proper panics and freezes up trying to get thyroid info into my brain.

Thank you so much x

SeasideSusie profile image
SeasideSusieRemembering in reply toEllie-Louise

The aim of a treated hypo patient generally is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their ranges if that is where you feel well. You can, of course, feel fine with different results, it's very individual and we all learn where we need our levels to feel best.

TSH = .022 (0.35-4.94)

FT4 = 13.2 (9.0-19.0)

FT3 = 4.8 (2.6-5.7)

As mentioned, your FT4 is 42%through range and FT3 is 71% through range. Many people would need a higher FT4 but if you increased your Levo to raise your FT4 then your FT3 may rise as well. However, if you are feeling well with those results then you could stay on that dose. How we feel is paramount, we are not a set of numbers.

"Also a question about FT3, I know they haven't tested for it but if the FT4 has a higher result, would it follow that the FT3 result would have also been raised? and would it matter if it had and might be higher than the top of range?"

One would normally expect to see a higher FT3 if FT4 increases.

FT3 is the result that tells us if we are overmedicated. It's generally said that FT3 should stay in range. Overmedication can cause symptoms, just as undermedication can.

Sarahlouise1980 profile image
Sarahlouise1980

Hi Ellie-Louise, what amount of Levothyroxine were you on before and what are you on now? I only ask as my doctor is wanting me to reduce my Levothyroxine now xx

Ellie-Louise profile image
Ellie-Louise in reply toSarahlouise1980

I was on 100mcg and was reduced down to 75mcg.

(which was what I was on before it was raised due my feeling tired more than usual)

SlowDragon profile image
SlowDragonAdministrator in reply toEllie-Louise

NHS guidelines recommend that most patients need somewhere between 100mcg and 200mcg levothyroxine

nhs.uk/medicines/levothyrox...

Most important results are FT4 and FT3 ....not TSH

SlowDragon profile image
SlowDragonAdministrator

Strongly suggest you get vitamin D, folate, ferritin and B12 tested soon

These frequently drop when Levothyroxine dose is reduced

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

Perhaps Ask GP to test vitamin levels, as he insisted you reduce Levothyroxine

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 .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Is this how you do your tests?

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

You might get thyroid levels retested privately in another six weeks....if FT4 is still dropping you are under medicated, regardless of TSH

Ellie-Louise profile image
Ellie-Louise in reply toSlowDragon

I forgot to click your reply button so my reply to you is just below.

Ellie-Louise profile image
Ellie-Louise

Yes it is how I’ve always done my tests.

I take my levo in the early hours so leave it out the day of the test and have my test as early as they have an appointment which is usually around 08:00-08:30.

jgelliss profile image
jgelliss

Problems arise when Dr's dose with TSH results only. Is it a wonder that patients are not feeling *Optimally*. To feel well one needs FT3 FT4 values .

I honestly don't understand how any doctor can reduce your levo with lowish FT4 levels but with FT3 levels looking pretty good. Since you seem to be converting well, you should be on enough T4 to ensure there is enough raw material to convert to T3 according to your body's needs. As others have pointed out, the TSH is NOT a good indicator of thyroid health.

If your GP is otherwise sensible, maybe you could get him to understand that?

It's important that you watch for out for symptoms of lowered metabolism in coming weeks and make sure you are allowed to go back to 100 mcg daily if your symptoms warrant it.

Ellie-Louise profile image
Ellie-Louise in reply to

My metabolism has never changed, whatever dose I’ve been on over the last 10 years or so. I’ve always been a laid back, things will happen when they happen sort of person.

It’s probably why my husband took over the cooking when I broke my wrist a few months ago. He still does it, he likes his meals on time. 😂

SlowDragon profile image
SlowDragonAdministrator

Ask for follow up thyroid test in few weeks

Plus vitamins need testing now

Ellie-Louise profile image
Ellie-Louise in reply toSlowDragon

I’m due my next test in February. I try to keep teeth, eye and thyroid tests around my birthday so that I don’t forget and know where I am.

SlowDragon profile image
SlowDragonAdministrator in reply toEllie-Louise

Suggest you treat yourself to early Christmas present of FULL thyroid and vitamin testing

Ellie-Louise profile image
Ellie-Louise in reply toSlowDragon

I ordered the Vit D about 30 mins ago.

SlowDragon profile image
SlowDragonAdministrator in reply toEllie-Louise

Come back with new post once you get results

SlowDragon profile image
SlowDragonAdministrator

These results from on 100mcg levothyroxine show poor conversion of Ft4 to Ft3

And that you were possibly under medicated

You need FULL thyroid and vitamin testing. Cholesterol levels checking too. High cholesterol is linked to being under medicated thyroid wise

Extremely common to have low B12 as we get older, especially if under medicated

Ellie-Louise profile image
Ellie-Louise

When I spoke to the doc last week (had another problem, nothing to do with thyroid) I mentioned I thought my blood test was due soon, he looked it up and told me it was not due until May.

So I’ll wait until then and do it properly having recently read about the 24 hr leave off levo until test. I had been leaving it much longer than that.

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