Hi again. I have just had results from a repeat blood test from a month ago as from my earlier post GP would not accept Medicheck blood tests done on 20.4.20
I am confused as last month my TSH was 0.667 (0.27-4.2) and it’s now 0.48 (0.34-5.6) my t4 was 13.7 (12-22) and it’s now 10.5 (7.5-21[). surely if my t4 has decreased my TSH should increase ? That’s what I don’t understand. Any help would be greatly appreciated
Previous post shows GP has dramatically reduced your levothyroxine
healthunlocked.com/thyroidu...
Highly likely to have extremely low vitamin levels as direct result of dose reduction in levothyroxine
Low vitamin levels frequently results in low TSH and poor conversion of Ft4 to Ft3
Your Ft4 is far too low ...likely Ft3 extremely low
Low Ft3 leads to low vitamin levels
What vitamin supplements are you currently taking?
How much levothyroxine are you currently taking
Do you always get same brand of levothyroxine?
Absolutely essential to get FULL Thyroid and vitamin test
For full Thyroid evaluation you need TSH, FT4 and FT3
Tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially with Graves’ disease
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 as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
List of private testing options
thyroiduk.org/getting-a-dia...
Medichecks Thyroid plus ultra vitamin
medichecks.com/products/thy...
Medichecks often have special offers, if order on Thursdays
Thriva Thyroid plus vitamins
Blue Horizon Thyroid Premium Gold includes vitamins
Ft4 is only 22% 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 patients 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...
Also note what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)
All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels
Hi
All my vitamins are ok. My folate has come back up. My T3 last month was 6.27 which is at the top of range. I take my Levo at 5am and I didn’t take it the day of blood tests. Neither did I have anything to eat or drink just water. I have took notice of you haha. I only take 100mcg Levo. It defo needs increasing. Will have battle on with doc as result sYs normal. There is one thing that is still low and that’s my neutrophils. Can this be related. My white cell count was too but this has now come back up.
Looks likely
oatext.com/isolated-non-aut...
Many be linked to low B12, folate or ferritin?
If GP refuses to increase dose levothyroxine you will need to go elsewhere
Thankyou slowdragon. That made interesting reading. I was thinking neutropenia but didn’t know if it was connected. I am ready to tackle the Gp. If no joy I will just ask to be referred to an endo.
Email Dionne at Thyroid UK for list of recommend thyroid specialist endocrinologists who will prescribe T3...if necessary...but you may just need levothyroxine increased
I will do thanks. Wish me luck
Hi slowdragon
Have just spoke to GP and under duress she has agreed to increase my Levo by 25mcg giving me 3 months supply and retest in 8 weeks. She said if my TSH decreases they will have to reduce back to 100mcg. She said all my results were very normal and the symptoms of aching joints and muscles do not relate to thyroid problems more fibromyalgia and will investigate this after blood results in 8 weeks if my TSH is suppressed. I told her that my endo said not to worry about TSH being suppressed just to concentrate on T4 and T3 but she didn’t agree. Don’t think she knows about thyroid problems.
Wilky21
I am confused as last month my TSH was 0.667 (0.27-4.2) and it’s now 0.48 (0.34-5.6) my t4 was 13.7 (12-22) and it’s now 10.5 (7.5-21[). surely if my t4 has decreased my TSH should increase ? That’s what I don’t understand.
Just pointing out that you can't compare results when reference ranges are different. You have to work out percentage through range and compare the percentage.
TSH:
0.667 (0.27-4.2) = 10.10% through range
0.48 (0.34-5.6) = 2.66% through range
Were both your tests done at the same time of day? Had you eaten before the test? Did you drink anything other than water before the test? If there was a difference in time then this can cause a big difference in TSH result, and the other things mentioned can also affect TSH.
FT4:
13.7 (12-22) = 17% through range
10.5 (7.5-21[) = 22.22% through range
Again, time of test can make a difference. When did you take your last dose of Levo before both of these tests?
Hi i always take my Levo at 5am and I had not taken one before tests or had anything to eat or drink just water. I also had it taken at the same time as last time Thankyou for your reply
t4 was 13.7 (12-22) 17% and it’s now 10.5 (7.5-21[) 22.22%
Your FT4 hasn't gone down, it's gone up. They are two different ranges, so you have to work out the percentages to see the real difference. Yours was 17%, now it's 22.22%. So, it's quite normal that the TSH has decreased.
Handy percentage calculator:
That’s an interesting point. I dont know how to use that calculator what do you put in
In the first window you put the FT4 result. In the following two you put the bottom number of the FT4 range, and the top number of the FT4 range. You do the same for the FT3, if it's been tested. Then, you click on 'Oblicz' and the percentage pop up underneath.
linda96
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