The kind and generous people on this forum have taught me all I know about thyroid generally. Thank you! Now, I really would be grateful for your views on my personal condition.
Diagnosed with Graves Disease in 2014 I underwent RAI Therapy in 2016.
From the outset my blood results were anomalous. My doctor dismissed the anomaly as insignificant but increased my Levothyroxine dose progressively to 150mcg a day.
My latest Medicheck results are:
TSH: 1.15 (0.27-4.2)
Free T3: 3.54 (3.1-6.8
Free Thyroxine: 23.3 (12-22)
I appreciate these results are reasonably good but cannot understand why the Free Thyroxine is high and wonder if I should be concerned.
Thank you so much
Written by
weewillywinkie
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Your conversion rate is very poor.often due to low vitamin levels
Improving low vitamin levels to optimal levels may help improve conversion rate
First step is to get vitamins tested - ask GP
EXTREMELY important to test vitamin D, folate, ferritin and B12
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
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
What vitamin supplements are you currently taking?
Did you allow a 24 hour gap between last dose of hormones and the test?
Did you get the earliest appointment, fasting (you can drink water).
As you will have realised both of the following are 'out' i.e. FT3 is too low and should be nearer the upper part of the range and FT4 is slightly above range.
Shows very poor conversion.....Assuming you didn’t take levothyroxine in 24 hours before blood test?
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
Professor Toft recent article saying, T3 may be necessary for many, especially after Thyroidectomy or RAI.
I see you have just joined and have posted about this book twice. Nothing on your Bio to help us understand how this book helped you. Do you have a thyroid problem ?
If you don't have a thermometer in your pocket or purse, then you cannot control your thyroid problems. Why? Read the book. If you think this is a shout-out for a life saving book, you bet it is. Also, read Wilson's Syndrome and found it to be very accurate especially for people like myself that bloodwork for thyroid is useless. Trying to train doctors to recognize that when you're on thyroid replacement, your pituitary no longer needs to ask for thyroid hormones. Thus, TSH will be low. They still freak out when they see low TSH on bloodwork.
Maybe if you try to sound less like an advertiser/promoter or a motivational speaker then people won’t automatically assume you are just trying to sell a book.
And while the information in the book may be very helpful, what you mentioned about it is already common knowledge to many members of this forum.
Tigerzzz, You appear to be new here, and immediately on joining, have posted several comments urging people to buy a specific book. What connection do you have to the author and/or publisher of this book?
Multi-Generational thyroid problems. Hypothyroid, hyperthyroidism, Graves, goiters. All of us have been helped by the book I suggested, 'Solved, The Riddle of Illness'. When we understand that the current status quo of the medical field is to keep us sick but alive, then we realize we have to fight back for our health. The human body temperature is 98.6 PERIOD, falling no more than one degree at rest. Doctors will push the lie that temperature is different for everyone. NO, it is not unless you are ill. Once you understand that, and are thyroid deficient, you'll keep a thermometer with you at all times. Read the book. Fight back.
I think the 107,000 members here have done a good job in fighting back by sharing knowledge and information.
May I suggest you complete your Bio so members can easily check when you post.
Perhaps sharing your treatment would be helpful.
Have just read that Dr Broda Barnes was behind the writing of the book. Hundreds of us here are aware of his work and have been treated by Docs who trained at his Institute ...
I too have Graves Disease and went through RAI thyroid ablation back in 2005.
I became very unwell some 8 years later and have learnt of my situation back to front.
I wouldn't be too worried about your T4-Levothyroxine being over range if it enabled you to get an acceptable level of T3- but this isn't happening and your conversion of T4 into T3 is very low, and presume you are suffering symptoms.
A fully functioning working thyroid would be supporting you, on a daily basis with approximately 100 T4 + 10 T3. and as you are on monotherapy with Levothyroxine you have ' lost ' this initial 10 T3 that your thyroid would have been supporting you with.
Levothyroxine is a prohormone and the body needs to be able to convert this T4 into T3 which is the active hormone that the body runs on, and I read the average person uses about 50 T3 daily to function.
So, as you will probably now realise you have been down regulated by about 20% of your overall wellbeing, and overtime, no doubt this can pull you down and then have feelings of being ' under par ' .
I just feel that if there has been a medical intervention and the thyroid either surgically removed or ablated with RAI and burnt out in situ , both T3 and T4 should be on the patients prescription for if, and probably when, both these essential hormones will need to be prescribed to bring the T3 and T4 into balance and to a level of wellbeing acceptable to the patient.
Some people can get by on T4 - Levothyroxine alone, some people at some point in time simply stop converting the T4 into T3 and some people simply need both these vital hormones dosed and monitored independently to bring them back into balance.
Your ability to convert the T4 into T3 can be compromised if your vitamins and minerals are not ' optimal ' and not just anywhere in the NHS range.
RAI is known to ' trash ' the body's vitamins and minerals so would strongly suggest you get ferritin, folate, B12 and vitamin D checked out.
It is imperative that you are dosed and monitored on T3 and T4 blood test results, and not a TSH blood test reading as it is known that in Graves Disease the TSH is an unreliable marker, and used in isolation means diddy squat.
When on monotherapy with Levothyroxine the aim is to dose to the relief of symptoms and generally people feel better when their T3 and T4 are in the upper quadrant of the ranges, with there being a ratio of about 1/4 T3 to T4.
You might like to take a look at the Elaine Moore Graves Disease Foundation website.
This lady has the disease and went through RAI back in the late 1990's. She is a medical researcher, and finding no help with her situation wrote a book to help others who might be in a similar position. She now runs a well respected website, and much like this amazing site there is an open forum where anyone can ask questions of the community.
There are full details on my profile page if you care to look at my thyroid journey, and thanks in the most part, to this site, I'm now ' back in the room ' and my health much improved.
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thyroxine high 
High TSH & High Free T4
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High Free T4 with hypothyroidism?
High TSH, High free T4, very high vitamin B12
