Thoughts on these figures?

[HDub]

I've got the results from latest thyroid tests:

Tsh 18.9mlU/l (0.27-4.2)

Free T4 12.2pmol/L (10-23)

Free T3 2.8pmol/L (3.1-6.8)

I'm still waiting on the result of the coeliac test.

The endocrinologist has upped my dose to 225mcg, and I'll have a follow up appt in 6-8weeks.

Those numbers seem all over place to me - anyone had numbers like them? Did you ever find out why they like it?

[shaws Administrator]

You are on an insufficient dose of levothyroxine.

You don't have any history of your journey with hypo on your Profile.

The aim is a TSH of 1 or lower with Free T4 and Free T3 in the upper part of the ranges.

Your results are:-

Tsh 18.9mlU/l (0.27-4.2) - far too high

Free T4 12.2pmol/L (10-23) - too low

Free T3 2.8pmol/L (3.1-6.8) - far too low

You need immediate increase in your dose to bring TSH to 1.

No wonder you don't feel well.

Do you allow a gap of 24 hours between last dose of hormones and blood dra?

It should be the earliest possible blood draw.

Do you have a fasting blood test (you can drink water)

FT4 and FT3 should be nearer the top of the ranges.

[Twitchen in reply to shaws]

Endo says my TSH at 2.32 is excellent, so just curious why you are suggesting 1 or lower? Having said that, I never feel brilliant

[Jazzw in reply to Twitchen]

I’d suggest your Endo is not a thyroid specialist. Probably very good with diabetes.

Anyway...

Many people do not feel well unless their levels are at the bottom of the TSH range or below and at the top of the ft4 range or a little above. Source: Thyroid UK (the charity which owns this forum).

The appropriate dose of Levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range – 0.2-0.5 mU/l. In this case, free thyroxine is likely to be in the upper part of it’s reference range or even slightly elevated – 18-22pmol. Most patients will feel well in that circumstance, but some need a higher dose of Levothyroxine to suppress serum TSH. Source: Dr Anthony Toft (a leading thyroid specialist, now retired) via an article in Pulse magazine.

Simply testing TSH is never enough—you need to know your FT4 and FT3 levels to gauge whether you’re on sufficient thyroid hormone replacement.

[HDub in reply to shaws]

No gap, I took meds in morning as normal (empty stomach, no coffee for about 45 mins).

I'm hoping the extra 25mcgs help

[FancyPants54 in reply to HDub]

So you took your meds in the morning and then went for your thyroid test?

You shouldn't do that. You have given yourself a false FT4 reading. It probably means your FT4 is even lower than this result. Next time book the earliest appointment the surgery can do, before 9am at least, and don't take your meds until after you leave the surgery. That will give you a more reliable test result to work with.

[Twitchen]

That TSH figure sounds way too high. Do hope upping the thyroxine helps you feel better.

[HDub in reply to Twitchen]

Thank you. The brain fog is the worse, and I'd love to be able to think clearly.