understanding my results

[vickilou]

Hi everyone could someone please help me explain my latest blood test results. Serum TSH level 4.56 miu/L 027.-4.20 Serum T4 level 21.1pmol/L 12.0-22.0 i have just had my levothyroxine lowered from 125ml one day and 100ml the next to 100ml everyday. please help dont understand them.

[greygoose]

Why on earth did they lower your levo dose? There is absolutely no justification for that in those results. Your TSH is too high, and your FT4 is in-range. How do you feel?

[vickilou in reply to greygoose]

Hi greygoose, ive just had a hysterectomy 4 weeks ago, i had to have 5 bags of blood before operation as my HB level was on 60. Since operation i have been getting better, but my instincts are telling me my bowels and hair are not good as they should be. Another doctor at surgery made me very poorly indeed a few years ago by reading my results wrong so i dont trust doctors.

[greygoose in reply to vickilou]

It has been known for doctors to get things upsidedown, and think that the higher the TSH, the less levo you need, instead of the other way round. Who knows what goes through their little heads!

When I see results like that, I think oh! possibly poor conversion. And, that is possible since it's not long since your op. Takes time for things to settle down again. So, maybe on your next test, they will increase your dose again.

[vickilou in reply to greygoose]

But they are saying 6months next test, i could be very poorly again in that time. I don't trust them whatsoever.

[vickilou in reply to vickilou]

my last tests which they class as normal were on 4th march 2019 0.59mui/L 025-5.00 i do wish i understood my results, but even i can see the difference in the numbers this time.

[greygoose in reply to vickilou]

Well, there's not much to understand in that 4th March one. A TSH on its own tells you next to nothing.

But, compare it to your latest one:

TSH level 4.56 miu/L 027.-4.20

You can see it's much higher than the 4th March one:

0.59mui/L 025-5.00

That means that you are now more hypo than you were on 4th March last year - they didn't test the FT4 and FT3 but I would imagine they were much higher.

When everything is working like it should, the higher the FT4/3, the lower the TSH. TSH - Thyroid Stimulating Hormone, it stimulate the thyroid to make more T4 and T3. It's a pituitary hormone, and when the pituitary senses that there is enough T4/T3 in the blood, it reduces it's production of TSH.

The higher the TSH, the more hypo you are, because the FT4/3 will be low. Your FT4 in that latest test is not low, it's quite high, so that's why I think you probably aren't converting the T4 to T3. T4 is basically a storage hormone, and has to be converted to the active hormone, T3, which is needed by every single cell in the body to function correctly.

So, from that, I'm sure you can deduce that the most important number is the FT3. But, the NHS will only rarely test that! I don't know if that's a deliberate ploy or sheer ignorance.

To know if you convert well, you need the FT4 and the FT3 tested at the same time, and compare them. If the FT3 is a lot lower in range than the FT4, then you don't convert very well.

I don't know if that makes much sense, so if you have questions, please don't hesitate to ask them.

[greygoose in reply to vickilou]

Well, that is very wrong! Two months maximum. Obviously, at that surgery, they know nothing about thyroid!

[vickilou in reply to greygoose]

No not at all hence my worries.

[greygoose in reply to vickilou]

Hence why you have to learn about your own disease, so that you can stand up to them when they do stupid things. If you just accept it all and don't disagree, they will take it you do agree to the changes. Challenge them and things might change.

[vickilou in reply to greygoose]

Hello again greygoose, i phoned the doctors and told them i was not happy with them lowering my dose of levothyroxine due to me gaining weight, losing hair and bowel problems. She informed me that my T4 is in higher range and is certainly adequate for having enough thyroxine going round my system. Therefore the TSH coming up as abnormal on my blood test results does not mean i need an increase in levothyroxine, therefore i am to take the lower dose but, she said if i am worried i can be tested again in 3 months instead of 6.

[greygoose in reply to vickilou]

She's an idiot. She knows zilch about thyroid. I wonder if she's ever heard of T3? It's T3 you need enough of, because T3 is the active hormone. T4 is not going to affect your symptoms, however much you have, if you can't convert it to adequate T3. Maybe it's time you got some private tests done? Then, if your FT3 comes back low, you can rub her nose in it!

[vickilou in reply to greygoose]

Yep i definitely will do that, i know my own body ive had this underactive thyroid all my life and upto recently had a very good doctor, who used to ring me and tell me to either up my dose or lower it accordingly. My official complaint is getting longer all the time. But will get tests done for proof . Thank you so much, i hate them making me feel i am wrong.

[greygoose in reply to vickilou]

Yes, I would hate that, too.