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 did this test
Assuming you did ....
Your conversion of Ft4 to Ft3 is EXTREMELY poor
FT4 is 118% through range
Ft3 only 1% through range
Helpful calculator for working out percentage through range
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.
All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels
Presumably you knew you have Hashimoto’s ?
Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten intolerance. Second most common is lactose intolerance
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find strictly gluten free diet reduces symptoms, sometimes significantly. Either due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first
Assuming test is negative you can immediately go on strictly gluten free diet
(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)
Trying strictly gluten free diet for 3-6 months
If no noticeable improvement, reintroduce gluten and see if symptoms get worse
comments from medicheck's doc re. T3/T4 seems to say that I am both hypo and hyper ? or that I am taking too much of Levothyroxine?
Oh, you've got to laugh! It's really not worth asking for the Medichecks doctor's comments, because they don't know anything more about thyroid than your common or garden GP. They've had no extra training. And, they come out with rubbish like this!
What is happening is that you aren't converting all that T4 to T3. So, your FT4 is over-range and your FT3 is right at the bottom of the range. In fact, you are a very, very poor converter. And just testing TSH won't tell you that, so it would be a very bad idea to allow your doctor to dose by the TSH. But, I doubt he knows enough about thyroid to understand that. You need a referral to an endo that will prescribe you T3 to add to a reduced dose of levo.
Did you know you have Hashi's? Hashi's people are often bad converters, so there's probably not much you can do about it - except add T3. But, you could try a gluten-free diet, and taking selenium. That could improve your conversion a little.
“...What is happening is that you aren't converting all that T4 to T3...”
Will need to do some reading to understand it!
T4 is basically a storage hormone, bit like have staples in the larder - tinned food, flour, eggs, sugar, etc. - so that there's always something to eat.
T4 has to be converted to T3 the active hormone, needed by every single cell in your body to function correctly. How that happens is complicated, but you don't need to worry about that at this stage. The main point is, with you, it isn't happening very well. Finding out why is a huge task, one that your doctor would not be willing to embark on, even if he were capable. As I said, you could try taking selenium to see if that helps. Selenium is one of the elements necessary for conversion. If it doesn't, then it would be best to cut your loses and seek out a source of T3.
It is still possible to get T3 prescribed on the NHS, if you find an open-minded/knowledgeable endo - not necessarily private - private doctors aren't always better. Or, you could look into buying your own on-line - although that is getting harder and harder. You could try posting a new question asking people to PM you their trusted sources.
I feel like giving up...
Why would you do that? There are thousands of people on here who have fought their way through. No reason why you can't do the same.
Meuh… I'm not into patient-blaming. If your FT3 is low, your brain isn't going to be firing on all cylinders. I believe in having a temper-tantrum, screaming, crying, breaking something if you must, then just getting on with it. It perks you up no-end.
The Medichecks clinicians are not thyroid experts and I always ignore their unhelpful comments. They once said to me you have "normal thyroid function" even though I have a multinodular goitre and high antibodies because of Graves' (if only what they said was true). I just use them to check my thyroid levels and my vitamin levels and nothing else.
From your results I’d say you are a poor converter T4 to active T3.
Without T3 being optimal mid to top of range you will struggle.
I had very similar results with my T4 over the range and T3 right at the bottom of its range. And my TSH was suppressed due to too much levothyroxine. After going private only i was prescribed T3 medication. It was like a miracle. I also had the DIO2 Gene test which came back positive. This showed the reason why I was hardly converting T4 to active T3. I’d go and see a private only Endocrinologist as seeing an NHS/private Endocrinologist they mostly will not prescribe T3 medication as private or NHS they still follow NHS rules. So private only you could have a T3 trial for 3 months to see how you improve. Then go to NHS with those results and hopefully they will agree to prescribe on the NHS. This is what happened to myself. I now get T3 from the NHS. If you need details of my private only Endocrinologist please message me.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Blood test results - confused!
Blood test results back - is this now confirmed as Hashimoto's? Very confused...
Hypothyroid new blood test results - high antibodies
Blood test results - please advise.
