TSH over 8!

[Kandahar]

Trying to get actual figures but dr called for review because T4 and T3 OK, so I’m told, but TSH over 8! Any ideas? Lynn

[greygoose]

Get the actual numbers for FT4 and FT3: results and ranges. Just saying 'OK' is meaningless. I doubt your doctor really knows what 'OK' means for thyroid. If they are right at the bottom of the range, they are not 'OK' at all, and that is why your TSH is high.

[SlowDragon Administrator]

Looking at previous posts you are on T3 plus small dose of Levothyroxine

It's extremely unlikely TSH is high

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

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

Do you have Hashimoto's?

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)

If/when also on T3, make sure to take last small dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

[Kandahar in reply to SlowDragon]

Was trying to access Patient Services but they admitted that it wasn’t working properly. So managed to get figures over phone from surgery, so I can contact endocrinologist before seeing GP next week.

Wasn’t able to get all details correctly but was told:

T4 - 4.0 (range 12-22)

T3 - 4.1 (range 3.2-6.8 seems to be called ‘triode...’ sorry didn’t get spelling etc

TSH - 8.18 (range 0.27-4.2)

Am on 25mcg Cytomel alternating daily with 20mcg Thybon Henning. I’ve stopped all Levo. The day before the test, I took half of 25mcg at 7.30am and the rest 8pm, on each occasion at least an hour before food or drink. The test was at 8.40am.

Back in April a Medichecks’ test came up with the following on 10mcg, split during the day and 25 Levo:

Free T4 - 15.3 range same

Free T3 - 5.26 (range3.1-6.8)

TSH - 8.18 range same.

In the meantime, I’ve experimented with varying doses but have stopped all Levo. Feeling pretty good most of the day on one alternating dose at 7.30am. Feel rather tired and low around 4-6pm. Was considering putting in Another 10 around 8pm but advice please. Endo has told me to experiment till feel fine. Was but now getting dry throat and eyes, reluctant, again, to wake up and the afternoon thing. Losing weight very gradually, thank goodness.

Has anyone else had dry eyes and throat? Yours Lynn

[SlowDragon Administrator in reply to Kandahar]

When taking T3 you absolutely have to take EXACTLY same dose everyday

It's not like Levothyroxine which is a storage hormone

Also really want to always stick on exactly same brand of Liothyronine or Levothyroxine

Different brands are not interchangeable

If only on T3, then taking just 25mcg dose of T3 is highly likely inadequate.....as shown by your very high TSH

a typical dose on T3 only is likely to be somewhere between 40mcg to 60mcg

You will either need to add back in Levothyroxine dose slowly or increase T3 dose very slowly...at 5mcg steps

Taking different doses and different brands is likely causing significant issues

Obviously your FT4 is low as not taking Levothyroxine

Though with high TSH ....your FT4 still remains very low