Thyroid test over replaced?: Hi All, Can anybody... - Thyroid UK

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Thyroid test over replaced?

Fedup12 profile image
20 Replies

Hi All,

Can anybody help with me understand my TFTest Results. (I had TT in Jan 2019)

I was doing OKish for around 3 mths going to work, then suddenly one day I couldn't get out of bed. I had difficulty breathing, palpatations, flu like feeling and painful joints. My eyesight went worse ( I have graves eye disease)

I didn't want to call the doctor as the last few times I have spoken to them about feeling unwell, I was left feeling like a hypochondriac.

But after 2 weeks in bed and still not feeling any better I decided to call them. They told me to come in for a thyroid function test. She said I was over replaced and dropped my medication from 75mg of levothyroxine to 50. I went back after 6 weeks for another test and she advised I was still over replaced and dropped the dose to 25mg . Ive been taking this for 2 weeks and I'm still struggling. Any help with the test results would be great and does anyone know what over replaced means. Thanks

Serum free T4 level 24.6 pmol/L (9 - 24

Serum TSH level < 0.01 mu/L (0.2 -5 . 0 )

Free T3 level 5 .6 pmol/ L (3. 6 - 6.4)

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20 Replies
shaws profile image
shawsAdministrator

Did you have the earliest possible blood draw? Fasting (you can drink wate)r. Also did you allow a 24 hour gap between last dose of levo and test and take it aferwards? I believe your doctor is only going by your low TSH result so the assumption will be that you're taking too much replacement hormones. Keep in mind that Thyroid Stimulating Hormone (TSH) is from the pituitary gland not the thyroid gland.

Fedup12 profile image
Fedup12 in reply toshaws

I had blood draw at 10.0 am , I left a 24 hr gap between my last levo dose and test, and took it after my blood test.

Thanks for the advice re TSH.

Marz profile image
Marz in reply toFedup12

You are not over medicated as your FT3 is in range ... seemingly your Doc is not aware - sigh ! Without a thyroid your dose should not have been reduced - in my non - medical opinion ..

Fedup12 profile image
Fedup12 in reply toMarz

Thank you Mars, sadly at the moment I don't know how to interpret the results. And if I say anything to the Drs they just shrug me off or say I might be depressed and need to exercise.

Marz profile image
Marz in reply toFedup12

There is a section on thyroiduk.org - Undersranding Results.

If you still had a thyroid if would be producing T4 & T3. The T4 you are taking also converts into T3 and yours is looking good. However if your Doc keeps reducing the T4 - in time the T3 will reduce. T3 is the ACTIVE hormone needed in every cell of your body. Your Doc is wrong to adjust the dose according to the TSH.

shaws profile image
shawsAdministrator in reply toFedup12

Doctor has only taken notice of the TSH which is from the pituitary gland - not thyroid gland and TSH rises if we're not on a sufficient dose of hormones or we're undiagnosed.

The following excerpt is on the link below and no wonder this specialist cannot take on any new patients (he is in the USA).

"Dear Thyroid Patients: If you have thyroid gland failure--primary hypothyroidism--your doctor is giving you a dose of levothyroxine that normalizes your thyroid stimulating hormone (TSH) level. Abundant research shows that this practice usually

does not restore euthyroidism--sufficient T3 effect in all tissues of the body. It fails particularly badly in persons who have had their thyroid gland removed. TSH is not a thyroid hormone and is not an appropriate guide to thyroid replacement therapy.

The hypothalamic-pituitary secretion of TSH did not evolve to tell physicians what dose of inactive levothyroxine a person should swallow every day. A low or suppressed TSH on replacement therapy is not the same thing as a low TSH in primary

hyperthyroidism. IF you continue to suffer from the symptoms of hypothyroidism, you have the right to demand that your physician give you more effective T4/T3 (inactive/active) thyroid replacement therapy. Your physician can either add sufficient

T3 (10 to 20mcgs) to your T4 dose, or lower your T4 dose while adding the T3. The most convenient form of T4/T3 therapy, with a 4:1 ratio, is natural desiccated thyroid (NDT-- Armour, NP Thyroid, Nature-Throid). If you have persistent symptoms, ask your physician change you to NDT and adjust the dose to keep the TSH at the bottom of its range-- when you have the blood drawn in the morning prior to your daily dose. This may be sufficient treatment, but IF you continue to have persisting hypothyroid symptoms, and no hyperthyroid symptoms, ask your physician to increase the dose to see if your symptoms will improve, even if the TSH becomes low or suppressed. You can prove to your physician that you're not hyperthyroid by the facts that you have no symptoms of hyperthyroidism and your free T4 and free T3 levels are normal in the morning, prior to

your daily dose. They may even be below the middle of their ranges. Your free T3 will be high for several hours after your morning T4/T3 dose, but this is normal with this therapy and produces no problems. You should insist that testing be done

prior to your daily dose, as recommended by professional guidelines. If you have central hypothyroidism, the TSH will necessarily be low or completely suppressed on T4/T3 therapy. In all cases, your physician must treat you according to your signs and symptoms first, and the free T4 and free T3 levels second.

hormonerestoration.com/

Fedup12 profile image
Fedup12 in reply toshaws

Thanks shaws that as given me more understanding, I was saying to Mars I don't know how to interpret the thyroid results. So from what hes saying I should ask the Drs about adding T3 or NDT.

I can just imagine what the response will be. But I'm going to build up some courage and ask them.

in reply toshaws

It's a good article, but seems to assume that 10-20 mcg of T3 is enough for everyone. However, many people need a lot more than that. 20 mcg of T3 is what you get from 2.25 grains of NDT, but many people need a lot more NDT than that to rid themselves of all symptoms.

shaws profile image
shawsAdministrator in reply to

25mcg of T3 is sufficient for me. It is understood that we're all different and have to take into account our symptoms - the aim being to relieve all of them and we need an optimum dose to do so.

in reply toshaws

Exactly my point! I personally find the T3 in NDT to affect me very differently than synthetic T3. Which makes sense since the hormones in NDT are bound to proteins so most likely absorbed differently than synthetic hormones.

shaws profile image
shawsAdministrator in reply to

p.s. Dr Lowe took 150mcg T3 once daily (in the middle of the night). He was 'thyroid hormone resistant'.

in reply toshaws

It's such a shame he's no longer around, isn't it?!:-(

shaws profile image
shawsAdministrator in reply to

Yes, he was a big loss to the community as was Dr Gordon Skinner and Dr Barry Peatfield who were 'trained' before blood tests and levo was introduced and people got back their lives. This is one of them:-.

dailyrecord.co.uk/news/real...

shaws profile image
shawsAdministrator in reply toshaws

He also stated that levothyroxine became the No.1 of thyroid hormone replacements due to payments made to doctors/endos to prescribe (mainly in the USA I believe) levo alone instead of NDT (natural dessicated thyroid hormones) prescribed since 1892 without blood tests but symptoms alone taken note of and from then on patients didn't due to hypothyroidism.

greygoose profile image
greygoose

Do you have Hashi's? Sounds like a Hashi's 'hyper' swing, to me, and nothing to do with your dose.

Fedup12 profile image
Fedup12 in reply togreygoose

Thanks greygoose.

The endocrinologist said I've got graves disease, he never mentioned anything about Hashi's. Do you know if the test for Hashi's is different to the test for Graves.

in reply togreygoose

Just curious: can you have a Hashi hyper swing after a TT, on a low dose of T4 only? I always thought a Hashi hyper swing was caused by large amounts of thyroid hormone being dumped into the bloodstream from the thyroid following an autoimmune attack.

SlowDragon profile image
SlowDragonAdministrator

You need vitamin D, folate, ferritin and B12 tested

These need to be optimal for good thyroid function

If vitamins are low, tends to lower tsh and poor conversion of FT4 to FT3

Fedup12 profile image
Fedup12 in reply toSlowDragon

Thanks SlowDragon, the Dr said the test for my vitamins were ok, that was a while ago. I'm due another TFTest in 4 weeks, I will ask to be tested for vitamins again as well.

shaws profile image
shawsAdministrator in reply toFedup12

A statement of OK isn't o.k. if we feel awful and are symptomatic. O.K is for when we feel well, with no clinical symptoms and feel our health is now normal.

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