Thyroid Results : Hi, Just wondering if some... - Thyroid UK

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Thyroid Results

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Hi,

Just wondering if some one could explain my results to me, as they seem to be up and down. Doc tells me to just increase or decrease meds. Always feeling so rubbish at the moment.

01/04/2019TSH 0.03 miu/L (0.2- 4.5)T4 16.5 pmol/L (9-24)was on 150mg levothyroxine told to reduce to 100mg

18/06/2019TSH 2.68 miu/L (0.2- 4.5) T4 12.5 pmol/L (9.0 -24.0) on 100mg levothyroxine

22/10/2019TSH 6.25 miu/L (0.2 -4.5)NO Results for T4 on 100mg levothyroxineTold to increase to 125mg

18/02/20200.06miu/L (0.35-4.94)13.9 pmol/L (9.0-19.00) on 125mg levothyroxineAt the moment

Thank you

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6 Replies
SlowDragon profile image
SlowDragonAdministrator

Just testing TSH and Ft4 is completely inadequate

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

Have you had thyroid antibodies tested?

Ask GP to test vitamin levels and antibodies if not been done

You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative

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

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3 £29 (via NHS private service )

monitormyhealth.org.uk/thyr...

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all primary hypothyroidism in Uk is due to Hashimoto's.

Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten.

So it's important to get TPO and TG thyroid antibodies tested at least once .

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

List of hypothyroid symptoms

thyroiduk.org.uk/tuk/about_...

Do you always get same brand of levothyroxine?

Many people find different brands are not interchangeable

Thank you for your reply.

No never had antibodies tested or vitamins. Waiting to hear from Doctor so will mention to him when I finally speak to him. Find my doctors are not very helpful, they just say take this pill and hopefully you will be ok. Will look at the private testing though, so thank you.

Yes this what I always do before having tests. Yes always have same brand I think but will double check this.

SlowDragon profile image
SlowDragonAdministrator in reply to

Your most recent test shows Ft4 is only 49% through range

Helpful calculator for working out percentage through range

chorobytarczycy.eu/kalkulator

You likely need dose increase in levothyroxine

Far too many GP’s only look at TSH

On levothyroxine it’s frequently low

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 is in top third of range and FT3 at least half way through range

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"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)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor



please email Dionne at

tukadmin@thyroiduk.org

When you get full testing likely to see low Ft3 and/or low vitamin levels

in reply toSlowDragon

Thank you

SlowDragon profile image
SlowDragonAdministrator in reply to

Your results on 150mcg did NOT show over medication. Ft4 was well within range

Such dramatic dose reduction likely to have reduced vitamin levels significantly

Never ever agree to dose reduction without getting FULL Thyroid and vitamin testing first

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Starr666

Hi Cbart, Starr666 here. If you are just new welcome. Can see your problem, you want it to work and you just feel it's not. Perseverance is the key, there is loads of things to go through, but, you will. I will be here when you want to vent your spleen. Don't let the @&$%&!*£,get you down.

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