Hi, thanks for all your help last wk, confused ... - Thyroid UK

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Hi, thanks for all your help last wk, confused now, FT4 11 on nhs test, pinprick results read FT4 16? Any ideas please?

Jo5454 profile image
16 Replies

Hi,

Many thanks for all your help, advice and suggestions last week. I'm a bit confused as my pinprick tests have returned...

nhs test (late afternoon)

FT4 11 and tsh 3.7

Pinprick test (fortnight later, 7.15am)

FT16 and tsh 3.4

Antibodies all fine along with T3.

Is it usual for such a difference in FT4 please or do you think I need to try another pinprick or nhs to check please? The only difference was B12 was 3 days overdue for the nhs test and obviously 2wks into the month for the pinprick? Could the lack of it cause thyroid to do this do you think?

Thanks for your time!

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16 Replies
diogenes profile image
diogenesRemembering

Was there any difference in the time between your last dose of T4 and the time of testing? This can have a discernible effect on measured FT4. But also on therapy your FT4 can vary, though, as expected, your TSH doesn't respond quickly (same result). There's also perhaps a 1 pmol/L variation in a test's reliability which could add to the difference in the two tests. In your case the TSH is saying that you are underdosed if on T4 therapy. TSH down to 1 or less should be the aim. No matter if your FT4 goes above range - it's the FT3 (which isn't measured) which tells the whole story as to your correct dosing.

Jo5454 profile image
Jo5454 in reply to diogenes

Thank you diogenes, I'm not taking anything for thyroid, I've Been trialing iodine, selenium, magnesium, alongside other vitamins I take (plus monthly b12) to correct an iodine deficiency for 6 months. Many people helped me last week on here with the iodine...but I'm confused as to the FT4 result.

The f3 is 5.25 (3.1-6.8)

I've added the the ranges of both results further down...thanks for your help.

diogenes profile image
diogenesRemembering in reply to Jo5454

If you are not hypothyroid actually, your TSH is not optimal and it looks as if your thyroid is struggling. If so, your FT4 will vary from time to time as to how the struggle is going. Iodine is not helping the situation in that taking it in too large a quantity can partially suppress thyroid activity and alter results., So it may be the time between taking iodine and testing that changes the FT4.

Jo5454 profile image
Jo5454 in reply to diogenes

thats interesting thanks. I take the iodine at lunchtime, so yes that could explain. Also if the t4 struggles then maybe the thyroid is struggling more when b12 is due too. Thanks for your answer.

SeasideSusie profile image
SeasideSusieRemembering

What are the reference ranges for both the tests, often the NHS ranges are different from the private ones.

Jo5454 profile image
Jo5454 in reply to SeasideSusie

Hi Seaside Susie, thanks for your help. I've just written these in and lost them, so here goes 😀

Nhs 3.45pm 2 wks ago

Tsh 3.72 (0.35-3.50)

Ft4 11 (8-21)

Pinprick test 7.15am Thursday

Tsh 3.47 0.27-4.2)

Ft4 16.4 (12-22)

F3 5.25 (3.1-6.8)

Thyroglobulin ant 11.8 (0-115)

Thyroid peroxdase ant 9.71 (0-34)

Thanks...

SeasideSusie profile image
SeasideSusieRemembering in reply to Jo5454

OK, so the TSH is comparable, ranges don't vary that much with TSH.

The FT4 result is not comparable because the ranges are so different so we have to work out the percentage through range to compare.

Ft4 11 (8-21) = 23.08% through range

Ft4 16.4 (12-22) = 44% through range

[If you want to do this yourself, here is a link to the calculator: chorobytarczycy.eu/kalkulator - use the "hormony tarzycy" tab for thyroid, the other tab for any other test]

Antibodies aren't raised so for this test they don't suggest autoimmune thyroid disease (Hashimoto's) but one negative test doesn't rule it out as antibodies can fluctuate.

As Diogenes has mentioned, your TSH level suggests your thyroid is struggling.

Jo5454 profile image
Jo5454 in reply to SeasideSusie

Thank you Seaside Susie, I've obviously been totally misunderstanding ranges.

I presumed if something was measured in for instance pmol/L , like the 16 and 11, then that measurement is equivalent, one I higher, one lower and that different establishments just use different ranges to determine deficient?

Thanks for that calculator, will make a note of that👍

SeasideSusie profile image
SeasideSusieRemembering in reply to Jo5454

Ranges are apparently based on a healthy, local population, which is why ranges vary from lab to lab. For instances, where I live the range fot FT4 is 7-17, others we see here are 9-19, 11-23, 12-22, etc. So to compare our results, if ranges are different, we just need to work out the percentage through the range.

Jo5454 profile image
Jo5454 in reply to SeasideSusie

I see, thanks for explaining 😀

SlowDragon profile image
SlowDragonAdministrator

B12 levels are likely to affect Thyroid

What are folate, vitamin D and ferritin levels like?

Jo5454 profile image
Jo5454 in reply to SlowDragon

Thank you again SlowDragon...I didn't know if F4 is that moveable in a fortnight, I thought it took longer to change.

I've added them in above. I didn't retest these on the pinprick, seeing as they'd just been done under nhs, apart from vit, will have to test that.

B12 was 1699 (130-1100) though lower than last time when it was 5000!

Folate 13.1 (2.7-15)

Ferritin 28 (23-300)

Thanks for your time.

SlowDragon profile image
SlowDragonAdministrator in reply to Jo5454

Ferritin is very low. Needs to be at least over 70

Has GP done full iron panel test for Anaemia

No vitamin D test results either

Ask GP or use NHS postal kit £29

vitamindtest.org.uk

GP will only prescribe to bring vitamin D up to 50nmol. Aiming to improve by self supplementing to at least 80nmol and around 100nmol may be better .

20% of Hashimoto's patients never have raised antibodies so an ultrasound scan of thyroid might be beneficial

healthunlocked.com/thyroidu...

Jo5454 profile image
Jo5454 in reply to SlowDragon

Thanks SlowDragon, will do a vit d test again, thanks for the link.

Jo5454 profile image
Jo5454 in reply to SlowDragon

And no, I've always been told I don't need iron tests, even tho my ferritin has been down to 12 before.

Again, I did a pinprick for that a while ago, even though ferritin was in the 40s the two parts of the test were indicating I needed to take iron, without having notes here, think it was Tibc and transferrin?

Think i'llndo that again too, I've started upping iron, but guess that won't matter...thank you.

SlowDragon profile image
SlowDragonAdministrator in reply to Jo5454

Eating liver or liver pate once a week, plus other iron rich foods like black pudding, prawns, spinach, pumpkin seeds and dark chocolate, plus daily vitamin C can help improve iron absorption

Links about iron and ferritin

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

drhedberg.com/ferritin-hypo...

restartmed.com/hypothyroidi...

Post about iron supplements

healthunlocked.com/thyroidu...

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