Please explain my blood test results

[Fedupwanttocry]

I have been hypothyroid for twenty years and have battled throughout with doctors. It took me years to convince my GP to put me on levothyroxine (always told my TSH was in range) and then years more to get the dose increased to where I felt well. My TSH has been 0.02 (suppressed) for years, and so I am constantly advised to lower my dosage of levo, but if I do so I feel unwell. I currently take 175 of levo and feel OK.

My annual blood test was last week. I decided to NOT take my levo for three days prior to the test to see what happened.

My results came back as TSH = 0.02 (again) and T4 =16.2.

GP said TSH suppressed (again) and T4 in mid-range.

I had expected my TSH to go up, and my T4 to go down. Can anyone explain these results please?

[diogenes Remembering]

Taking T4 for so long and having suppressed TSH is not unusual. My wife has never had detectable TSH for nearly all her time of 50 years on 150-100 T4 daily and is still in reasonably good health for 80 yrs old. Having suppressed your TSH for so long, the pituitary will not respond to dropping T4 as it has been subject to suppression for so long. It isn't the TSH you or the doctor should be concerned about. It is the FT4 and FT3 levels that determine health not TSH. So adjusting dose is independent of TSH and strongly dependent on how you feel and operate daily.

[greygoose]

Very much doubt you need to reduce your levo if your FT4 is only mid-range. The majority of hypos need it higher than that, with or without and FT3 result.

[Fedupwanttocry]

Thank you. I have asked my GP previously for a T3 test and it was written on the request when my blood was sent off. It can back with a message along the lines of 'hospital refused to do it as deemed not necessary'.

I have wondered if taking some T3 might help me as I still have symptoms of hypothyroidism such as hair loss, weight gain, slow pulse, constipation.

I have even asked an endocrinologist if I could try T3 but I was refused.

How do I go about trying some myself? Where do I get it and how much should I take?

Just as an observation, my pulse rate dropped to 57 on my third day without T4. With T4 it is in mid 60's.

[SeasideSusie Remembering]

Fedupwanttocry

If you feel fine on your 175mcg then leave things as they are.

I'm like you, and as Diogenes has said about his wife. I have been on Levo for 45 years, I've kept a record of my results since 1994 and in all that time my TSH has been suppressed and just barely scraped into the bottom of the range on 3 occasions, one when an Endo didn't like my TSH suppressed and insisted I reduce my Levo but that, of course, reduced my FT4/FT3 to rock bottom and I was extremely unwell.

Like you, I have "tweaked" my dose if I have a GP test but that is to make sure that FT4 isn't at the top of the range and brings it down a bit by leaving off my Levo for a couple of days but it wont affect the TSH (my normal FT4 level is about 75% through range and that's fine for me).

You might want to do a full thyroid/vitamin test with Medichecks (ULTRAVIT test) or Blue Horizon (PLUS ELEVEN test) when you take your Levo as normal (but take last dose of Levo 24 hours before the test) to see where your levels normally lie and to make sure that you have optimal nutrient levels. I do this once a year.

[SlowDragon Administrator]

Would recommend getting FULL thyroid and vitamin test privately to see exactly what’s going on

Make sure to be on constant unchanging dose levothyroxine for 6-8 weeks prior to blood test

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

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

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)

Is this how you do your tests?

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

thyroiduk.org.uk/tuk/testin...

For thyroid including antibodies and vitamins

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random