Thyroid lab results: Can anyone decipher my lab... - Thyroid UK

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Thyroid lab results

WhitmoreSJ profile image
6 Replies

Can anyone decipher my lab test results as my doctor has said they are in the range however I have been feeling so unwell in November last year my Tsh was 0.5 and I felt absolutely fine.

My July 20 results show my Tsh as 3.2 my t4 as 23.3 and t3 as 4

My tsh has gone from one end of the scale to the other not sure what my t4 and t3 were previously!

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WhitmoreSJ
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SeasideSusie profile image
SeasideSusieRemembering

WhitmoreSJ

So that members can give you accurate information, please add the reference ranges for your test results, eg

TSH: 2.5 (0.2-4.2)

Are you diagnosed with a thyroid condition and taking any thyroid medication?

Did you do the test as we always advise:

When doing thyroid tests, we advise:

* Book the first appointment of the morning, or with private tests at home no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.

* Fast overnight - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Eating may lower TSH, caffeine containing drinks affect TSH.

* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw, if taking NDT or T3 then last dose should be 8-12 hours before blood draw. Adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.

* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (most labs use biotin).

These are patient to patient tips which we don't discuss with doctors or phlebotomists.

fuchsia-pink profile image
fuchsia-pink

Are you (now or back in November) on any medication? Any recent change in dose? SeasideSusie is right - we need your free T4 and free T3 ranges, but a TSH of over 3 is always too high and - if you are already on thyroid meds - should suggest even to a blinkered TSH-obsessed GP that you are under-medicated and need an increase in levo.

If you're not on thyroid meds, sadly the GP is unlikely to prescribe you until your TSH goes waaaay over range and you feel very ill indeed.

greygoose profile image
greygoose

You could try telling your GP that one doesn't need to spend seven years in med school to see that the results are in-range - even you can see that - but so what? The ranges are too wide, so you could not possibly feel the same at the bottom of the range as you would at the top. It's where in the range that the result falls that counts. And, if you still don't feel well, then your results are not in the right place for you. We're all individuals and all need our results in different places.

Ranges were only ever intended to be a rough guide, not rigid restrictions. They are arrived at by taking averages of the local population. But, there's no guarantee that the people tested were free of thyroid problems. Some of them more than likely had mild hypothyroidism or hyperthyroidism. So how you feel is just as important as the numbers.

You are hypo when your TSH gets to 3. So, the TSH range obviously goes too high. And, you are still hypo. Not surprising you have symptoms.

SlowDragon profile image
SlowDragonAdministrator

You also need vitamin D folate ferritin and B12 tested regularly

tattybogle profile image
tattybogle

I notice that your FT4 is 23, which will be over range whatever the actual range turns out to be.

But your TSH has risen a lot since Nov. What was the reason for testing TSH in Nov ?

A possible explanation for what has happened is that your thyroid gland has been struggling - hence the raised TSH (a signal asking for more T4 production), but recently as a bit of thyroid fails it has dumped some T4 into your blood all at once ,hence the High FT4.

Autoimmune thyroid disease (hashimotos/ords) cause this pattern of results in the early stages.

I would suggest you ask GP if they would check thyroid antibodies (TPOab Thyroid Peroxidase antibodies).

If these are raised it shows an increased likely hood of thyroid failing in the future.

They may not be willing to do this yet , because they need to rule out natural fluctuations in TSH due to 'non thyroidal illness', hence they often say "come back in 3 months" which is fair enough.

However if you feel awful, you should make them do their job, and asking about antibodies and possible autoimmune disease will let them know you won't just go away.

SlowDragon profile image
SlowDragonAdministrator

Suspect you are on levothyroxine and took dose before blood test...

Hence high Ft4

Always get tested as early as possible in morning before eating or drinking any thing apart from water and last dose levothyroxine 24 hours before test

Aim of levothyroxine is to increase dose slowly upwards until TSH is under 2 ...Ft4 in top third of range and Ft3 at least 50% through range

All four vitamins need to be optimal levels

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