Hi everyone below are my 7week blood tests I'm on 25mg of levo.. No thiyroid due to removal this may..
Serum free T3.... 2.3 pmo/L.... Ranges.. 3.10-6.80
Serum free T4.. 10.9.pmo/L...ranges..11.00-22.00pmo/L
TSH...3.53..
TSH...target on therapy for primary hypothyroidism = 0.3-4.5mu/L
Serum folate-2.8 ug/L.. Range..> 2.50 ug/L
Serum vitamin B12.. 310ng/L..range..197.00-771.00ng/L
Serum ferritin.. 26ug/L..range..23.00-400.00ug/L
Can anyone interpret these for me
Many thanks.. ❤️❤️
birkie
TSH...3.53..
Serum free T4.. 10.9.pmo/L...ranges..11.00-22.00pmo/L
Serum free T3.... 2.3 pmo/L.... Ranges.. 3.10-6.80
The aim of a hypo patient generally, when on Levo, is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their reference ranges, if that is where you feel well.
Your FT4 and T3 are both below range. These are the actual thyroid hormones. TSH is a pituitary hormone and tells the thyroid to make hormone when it detects there's not enough. You don't have a thyroid so are solely reliant on synthetic hormone. You clearly are not taking enough, which is what your FT4 and FT3 results are telling you.
The usual starter dose of Levo is 50mcg unless you are a child, elderly or have a heart condition. Considering you have no thyroid I'm at a lost to understand why you have been started on 25mcg.
You need an immediate increase of 25mcg, retest in 6-8 weeks, followed by reguar 6-8 weeky retesting/increasing dose until your levels are where they need to be for you to feel well.
To support your request for an increase in dose, use the following information:
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the magazine for doctors):
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l. In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l. This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).*"
*He recently confirmed, during a public meeting, that this applies to Free T3 as well as Total T3.
You can obtain a copy of the article by emailing Dionne at
tukadmin@thyroiduk.org
print it and highlight question 6 to show your doctor.
You can also refer to NHS Leeds Teaching Hospitals who say
pathology.leedsth.nhs.uk/pa...
Scroll down to the box
Thyroxine Replacement Therapy in Primary Hypothyroidism
TSH Level .................. This Indicates
0.2 - 2.0 miu/L .......... Sufficient Replacement
> 2.0 miu/L ............ Likely under Replacement
Was your thyroidectomy due to cancer? If so, in some circumstances the aim is to keep TSH suppressed to stop cancer reoccurring.
Also, your ferritin is barely in range. Ferritin is recommended to be half way through range. The female range usually goes up to 150, 200 or maybe 300, the 400 limit is usually for males so I've no idea why that range has been used for you.
Low ferritin can suggest iron deficiency anaemia so yourGP should do a full blood count and iron panel.
Hi seasidesusie
Thanks for your reply actually I was started on 125mg and my surgeon and GP have dropped me from 125mg to100mg 50mg and now 25mg been on this dose for 7weeks these are my blood results from the 25mg dose...I feel awfull 😩😩
Birkie
Why was your dose dropped?
I'm not surprised you feel awful, If I had your FT4/FT3 results I'd be bed-bound.
What has your doctor said about these results? You absolutely must have an immediate increase - go and see your GP and kick and scream if necessary until you get an increase.
Serum folate-2.8 ug/L.. Range..> 2.50 ug/L
Serum vitamin B12.. 310ng/L..range..197.00-771.00ng/L
Sorry, I seem to have missed these out in my last reply.
B12 is low. According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
Do you have any signs of B12 deficiency - check here:
b12deficiency.info/signs-an...
Many people with a level in the 300s have been found to need B12 injections. If you have any signs then list them to show your GP and ask for further tsetig for B12 deficiency and Pernicious Anaemia.
If you definitely don't have any signs you could supplement with sublingual methylcobalamin.
Folate has barely scraped into range and needs improving.
If you don't have any signs of B12 deficiency then you could start a good B Complex containing methylfolate (consider Thorne basic B or Igennus Super B. I used Thorne Basic B and raised my bottom of range level to top of range in 2.5 months with 1 x capsule daily.)
If you do have any signs then don't start the B Complex until further testing of B12 has been carried out as the methylfolate will mask signs of B12 deficiency and skew results, B12 injections have to be started before folic acid/methylfolate supplements.
Thanks
I've been to my doctors today but can't get an app till my gp looks at my CT scan results receptionist told me to ring back.. And no never had cancer my thiyroid was toxic and I couldn't take the anti thiyroid meds.. ☹️
Hi
My dose was dropped because they were going off my TSH.. It was suppressed.. I said I don't think that matters its the T3 we should be looking at.. Obviously they know nothing I have my ammo again with these results so it's back to the war again.. This is what would happen and I told them so.. Wonder if I can have their wages for the last 7 weeks.. 🤣
Birkie I am really sorry that you are suffering due to having your thyroid gland removed altogether.
The fact too that you are being treated according to your TSH alone is ridiculous and shows how ignorant the pofessionals are, particularly when someone has their thyroid gland removed.
You have to have sufficient hormone replacements to remove miserable clinical symptoms and they should make sure that your FT4 and FT3 are near the upper part of the ranges. I do wish they were taught (or thought) like the following Expert in thyroid hormones and its no wonder he cannot take on any more patients (he is in the USA).
Excerpt from above expert:-
"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.
If you're in the UK, goodness knows who makes the 'regulations' that keep people unwell or very unwell due to the utter ignorance. Neither are they aware of any clinical symptoms and that the AIM is to relief ALL clinical symptoms not just fit the TSH into the range, when it should be TSH of 1 or lower with both frees in the upper part of the ranges. They've also withdrawn options which used to be prescribed if patient wasn't improving on levo.'
Yes. When I saw the statement "TSH...target on therapy for primary hypothyroidism = 0.3-4.5mu/L" what came to mind is "Whoever wrote that is very ignorant regarding effective treatment for hypothyroidism."
Hi vocalEK
And I'm sure these people must have done some sort of education uni ect to gain the qualifications needed.. One wonders where they are getting this information from??? Sounds like medical history from the 1800s doesn't seem like thiyroid illness and help with it has come to far does it... 😠😠😠😠
The problem started when they normed the lab tests based only on folks doctors sent to the lab for testing because they suspected those patients of having thyroid problems. In other words, they normed the test on sick people, and then applied a rule-of-thumb that "95% of the people we test are healthy," which is quite untrue, at least for thyroid problems. So the ranges have been insanely too broad for years. I am appalled that the UK is using 10 as the cut-off for a healthy level of TSH. In the U.S., most labs use around 4.5 for the top of the range, but this is still very much too high. When someone finally bothered to look at the spread of values on groups of patient records that pretty much eliminated most people with any type of hypothyroidism, the top of the range was more like 1.5. Quite a difference.
Hi
Well on my last app with the endo for which I had to get out of my hospital bed after recovering from thiyroid storm and travel to another town to see him has he would not come to the hospital to see me. I had a heated conversation with him because he was quoting TSH numbers at me I gently lead over his desk.. Bearing in mind I was just recovering from thiyroid storm.. I said sir surely my TSH, T3. T4 could not be the same as yours.. As yours could not be the same as Tom, dick, and Harry's we are all different we react different what's good for you may not necessarily be good for me!!! Well I may as well have been talking in clingon because I received no answer to that other than" well what do you want me to do" he said in quite an annoying voice... I said "your job sir" we didn't get on and ive not seen a endo since then eventhough I've had total TT... Discusting how we are treated because this illness is not a bad cold or the flu its for life.. wish they could expirience it for a couple of months see how they feel then.. 😠😠😠😠
I think it would be a good idea if more doctors had hypothyroidism. Keep in mind that Hilary Clinton recovered her health through NDT. It saved lives since 1892 and has now been withdrawn in the UK through misinformation, leaving only levothyroxine and many on this forum cannot recover and I'm sure there are many unwell hypothyroid people who don't have online access being prescribed other medications for their remaining symptoms rather than a decent thyroid hormone replement.
Gp has done a FBC everything is normal.. How can I post the results by photo as its to much to type.. Can I just do another post about FBC... I'm lost 😳
Go up to your first post in this thread, click on the downward arrow V next to the word MORE and click on EDIT. That will bring up your post in a message box. Scroll down to ADD A PHOTO. Upload your picture then click SUBMIT.
Make sure the results/ranges are big enough to read and that no personal information (name, date of birth, NHS number, etc) are showing.
OK, so there's no sign of iron deficiency anaemia with your FBC. However, you can have iron deficiency without anaemia.
I'd ask your GP to do an iron panel, see what your serum iron is like. If that's already good then iron tablets could take that too high, so you'd need to see what your GP thinks about getting your ferritin higher in range. Don't be fobbed off with "it's normal" because it's only 0.8% through it's range, even your GP will have to agree that less than 1% through range is low!
You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet
apjcn.nhri.org.tw/server/in...
Hi thanks
I actually took some advice from people on here and got some liver pate today👍 I will be asking a lot of questions seasidesusie and thanks for your advice..I have actually took to my bed I'm sick of this thought I'd be feeling a bit better after my TT...but with gps acting like this reducing my dose due to my suppressed TSH what chance do we have of getting well..I feel like they have waisted 7 months of my life now it's back to the drawing board...but this time I will be in charge I've done it their way and look where it's got me they can do it my way now....👍🏻👍🏻👍🏻
I despair that they will ever understand that FT4 and FT3 need to be tested and not just dose by TSH.
Hopefully you'll have no trouble getting an increase in dose, do let us know how you get on.
You also need vitamin D tested ......likely very low when hypothyroid
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