I’ve just had a medicheck thyroid blood test and the results are TSH 0.006
T3 5.48 (3.1-6.8)
T4 31.3 (12-22)
July 20, GP results,
TSH 0.02
T4 11 (9-22)
After the July results I upped my medication from 150mg to 175mg to try and improve my T4 so am I now over medicated? I feel ok but can’t handle stress very well and feel tired, but always feel tired. Should I reduce my medication back to 150mg or, if I was over medicated, would my T3 be over? Many thanks for any advice x
Essential to test vitamin D, folate, ferritin and B12
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
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 vitamins including folate (private blood draw required)
medichecks.com/products/thy...
Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test
Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test
bluehorizonbloodtests.co.uk...
If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3
£29 (via NHS private service ) and 10% off if go on thyroid uk for code
thyroiduk.org/getting-a-dia...
monitormyhealth.org.uk/thyr...
Medichecks - JUST vitamin testing including folate - DIY finger prick test
medichecks.com/products/nut...
Medichecks often have special offers, if order on Thursdays
Thank you for your reply. I take Thorne B12, vitamin C and iron and magnesium. I had a thyroidectomy for Graves Disease in 2018. I’ve had medichecks blood test to see what my T3 is doing but noticed my T4 was out of range and wonder is I am over medicated. My gp always insists I’m over medicated as my TSH is always undetectable, even when T4 is low, so I’m trying to keep away from him, hence medichecks blood test.
Did you take levothyroxine before blood test...or was last dose 24 hours before test
I did take it before but I’ve done that with every blood test x
So that's a false high Ft4 result
Next test make sure to take last dose levothyroxine 24 hours before test
The same thing happened to me
Medichecks showed my T4 to be over range at 22.8 I have been on 100 thyroxine for 8 years after a TT after speaking to my dr she dropped my thyroxine down consequently I felt awful had hospital blood test three weeks after medichecks test and it showed T4 14.3
Had to them persuade dr to put my medication back up
Just starting to feel better again .
Personally I don t think medichecks test was accurate Feel that a venous draw give better result
Piedo
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
Important to regularly retest vitamin D, folate, ferritin and B12 too ...these need to be optimal
Were you taking a B vitamin (or a hair and nails supplement) that contains biotin?
Hi there, I do take Thorne B12 but I’m not sure if they contain Biotin as I haven’t got them to hand at the moment.
Hey there again
No, you are not overmedicated as your T3 is still in range and it's the T3 that gives you the symptoms, too low a level, though probably in the " range ' will give you symptoms of hypothyroid and too high a level over the " range " the hyper symptoms you first had.
Taking the T4 before the blood test distorts what we are looking at and doesn't give a true picture of how well you are converting the T4 into T3 - the active hormone that the body runs on.
Conversion into T3 can be compromised if ferritin, folate, B12 and vitamin D are not maintained at optimal levels so these need to be checked out.
But realistically since you haven't a fully functioning working thyroid and " lost " your own natural production of T3, you may well struggle to find optimal health on monotherapy with just T4 - Levothyroxine, as essentially you have been down regulated by some 20% of your overall wellbeing.
I managed to achieve a T3 of 5.50 when on monotherapy with T4 and felt marginally better but it didn't last long and within a few months, on the same dose, I slipped back down to the mid 4's becoming more fatgued and unwell.
Having been refused both T3 and NDT on the NHS I started by upping my T4 :
I increased my T4 up from 125 mcg daily but all I got was unbearable headache :
I added a little T3 to a lowered T4 dose and my brain turned on and I woke up relaxed.
I then trialed Natural Desiccated Thyroid and found this " softer " on my body and that is where I have stayed and I'm about 18 months into self medicating and so much better @ DIY :
I'm with Graves and after RAI thyroid ablation in 2005, managing lingering Graves, thyroid eye disease and hypothyroidism.
Thank you so much for you reply again. Funny you should say about the headaches, I keep getting terrible headaches That are really debilitating and I’m sure it’s the medication. Do you think I should lower it to 125mg? I have looked into NDT but was aware that there was a delay in getting it. I’m not sure if this is resolved now.
Hey there again,
Well if you are feeling no better on this higher T4 dose there's little point continueing the experiment is there.
So you could introduce either T3 or NDT : sourcing both can be difficult, especially recently with reduced world wide air traffic.
Some people prefer adding T3 as you can then adjust each thyroid hormone independently to where you feel at your best.
NDT has a fixed ratio of T3/T4 at around 1/4 and if this ratio works for you - job done - but read of people needing to add in a little extra T3 or T4 to their NDT for optimal well being.
It also becomes somewhat personal and whether to split your dose or not, it's all trial and error, and yes, I hit a bump or two along the road, but definitely in a better place than when on monotherapy with Levothyroxine.
All you can do is become confident in your knowledge and this may in turn be a route to be explored if you get nowhere within the system.
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