I have a couple of questions about aspects of my blood tests I don’t understand ..

[Steni]

A couple of questions;

1. I am taking all my drugs together at the same time ie T4 and T3 - is this wrong? I did so because many people on here said they also did that without problems- obviously the T3 is being absorbed hence the high reading.

2. I have heart disease called non obstructive artiodclosus ( or words to that effect ) . Last night someone on here said too much T3 was bad for the heart - should I be worried now And drop one of the T3 tablets I take

3. What is meant by a FULL thyroid test ( recommended by Seaside Susie I think ) what will it show that my latest results don’t ?

4. I still have symptoms so I’m guessing that the current dose is not right for me even though the TSH is low ( I think this is a good thing?) and there is plenty of FT3 ?

5. Finally if I am over medicated would I not have symptoms of this - I don’t ?

Thank you so much for all advice and sharing of knowledge.

[greygoose]

1. Taking T4 and T3 together is fine. But, don't take any other medication or supplements at the same time as thyroid hormone.

2. It is, but I don't think what you've got is anything to do with T3. And, I think you ought to find out if you have Hashi's before changing your dose. BTW, didn't ask before, but do you take biotin, either on it's own or in a multi/B complex?

3. A full thyroid test is what you've got there - TSH, FT4, FT3 - plus antibodies - TPO and Tg antibodies - plus vitamins and minerals - vit D, vit B12, folate, ferritin.

4. Once your TSH gets below one, it's neither a good thing nor a bad, because TSH doesn't cause symptoms. It's T3 that causes symptoms when it's either too high or too low. So, it could be too much T3 that is causing your symptoms.

5. You need to be careful with symptoms, because so many of them can be both under and over-medication symptoms. What symptoms do you have?

[Steni in reply to greygoose]

Thank you very much for your reply- my reply is below;

1. I don’t take anything else at the same time so that’s good.

2. No the heart problem is a result of smoking I believe. I have no symptoms but the endocrinologist I saw when I was first diagnosed wanted me to have heart scan - which revealed this problem. I don’t take biotin - that’s the second time it has been mentioned tonight , should I take it?

3. Great - one of the other commenters advised me to pay to have one done so I thought I should just check.

4. But a low TSH is what we’re aiming for right?

5. Yes it’s just that the symptoms I still have are not over medicated with T3 type symptoms. No shakiness or rapid heartbeat or weight loss, or frequent trips to the loo, just the same old brain fog etc etc.

6. I don’t know if I should cut down the T3 or not presumably that will be the advice from the GP when I speak to him ( he’s away at the moment) 🤷‍♀️

[greygoose in reply to Steni]

1. Good.

2. Should you take biotin? I'll answer that question when you've had your B12 and folate tested. But, the reason people mention it is that if people are taking biotin it can skew your blood test results. If you're not taking, then that's not the problem, your FT3 is just well and truly over-range.

3. Great idea to get full thyroid testing - and doing the testing correctly, i.e. early morning, fasting and leaving a gap of just 8 to 12 hours between your last dose of T3 and the blood draw.

4. No, a low TSH is not the aim as such. We take it in steps. First, you need to be taking enough thyroid hormone to get your TSH down to 1 or under. After that, it doesn't give you enough information to guide your dosing. Once the TSH is under 1, it's the FT3 the most important number.

5. Symptoms are a very personnel thing. One woman's under-medicated symptoms can be another woman's over-medicated symptoms. Don't expect to have the same symptoms as other people. The only way to know for sure is your symptoms are due to over-medication is to reduce your T3 and see if it helps. But only reduce by 1/4 pill at a time! Not a whole pill. 1/4 pill every two weeks whether you're going up or down.

6. Yes, obviously it will be the advice - or order! - your GP will give you. They know nothing about the subtilties of thyroid dosing, or that some people need their FT3 over-range in order to get enough T3 into their cells. They don't seem to understand that a blood test is just that: it tells you what's in your blood. But, thyroid hormone doesn't do anything in the blood, it has to get into the cells to be active. And, there are no test to find out what's getting into your cells, only trial and error will tell you that. So, best not to get the GP involved there, until you've sorted it out. If you can.

PS - no, they blood tests you've had can't show if you have Hashi's because they're not the right tests. Testing TPO and Tg antibodies might show if you have Hashi's. But, then again, they might not. Have you ever had an ultrasound?

[Steni in reply to greygoose]

Thank you as ever - so if you say some people need their T3 to be high / ‘over range’ how do I know if I’m one of them?

[greygoose in reply to Steni]

Only by listening to your body. There are no tests that can tell you that, I'm afraid. But, first, you need to know exactly what your levels are.

[Steni in reply to greygoose]

Ps - do the blood test result show if I do have Hashis?

[waveylines]

I think it was me who mentioned the potential for heart damage with over the range T3 levels. I didnt say though it had caused your heart damage. And your T3 result shows its well over the range so you should reduce the T3 dose.

Have you had your b12, folate, ferritin, vit D & iron checked. These are important in helping uptake & conversion of our thyroid hormones.

[Steni in reply to waveylines]

Thank you of course I didn’t think for a moment you had said it was the cause of my heart issues. I think my mentioning of my heart got lost in translation. I’m going to be reducing the T3 I think.

[silverfox7]

Biotin is usually in something else so we can’t get away from it but at the moment I can only think of shampoo. The advice though is to stop taking it a week before testing as it distorts readings.

[Jodypody]

When I was overdosed I didn’t lose weight (🙄) my heart didn’t race, I didn’t have more frequent trips to the loo. I was however quite “scatty” I was quite stressed at the time and it was summer (I had forgotten to reduce after winter) I dropped from 4 and a 1/4 to 3. Drastic I know but I slept like a teenager! I’m back up to 3.5 now which seems to be my sweet spot ish. I’m on NDT so T3 is the main driver. I would suggest a slight decrease and see how you feel. You could always go back up or take a top up in the evening of your usual dose. How long before the blood test had you taken your dose?

[Steni in reply to Jodypody]

Hmm that’s interesting , I’m going to cut down !

[Marz in reply to Steni]

When did you take the last dose before your bloodtest ?

[Steni in reply to Marz]

27 hours before

[Marz in reply to Steni]

Only asked in case T3 was taken closer to test giving a higher result ...

[Steni in reply to Marz]

It seems T3 must in fact be very high as the result was based on T3 having been taken 27 hours earlier!

[Marz in reply to Steni]

Agree !