Interpreting thyroid results

[Ali0]

Hi

I am struggling to get my GP to discuss my test results....it seems the system says reduce your meds so that’s all he’s going to do ...he’s never met me and does not ask about symptoms. I had to quote NICE guidelines to get him to test T3/T4. Am about to change practices but hope I’ll get more information here about what the results mean and what next steps should be.

TSH <0.05 [0.2 -4.0]

Serum free T4 20.7 pmol/L [10.00 - 20.0]

Serum T3 1.6 nmol/L [0.9 - 2.5]

Currently on 125mg levothyroxine. The system says reduce to 100mg,

Can anyone help?

Ali

[Lalatoot]

You need to add the ranges to the results so we can interpret them.

[Ali0 in reply to Lalatoot]

Sorry..thought they were generic ....have edited above.

[Ali0 in reply to Lalatoot]

TSH <0.05 [0.2 -4.0]

Serum free T4 20.7 pmol/L [10.00 - 20.0]

Serum T3 1.6 nmol/L [0.9 - 2.5]

Currently on 125mg levothyroxine. The system says reduce to 100mg,

[SeasideSusie Remembering]

Ali0

They're basing the reduction on your TSH as this is suppressed, which is wrong. TSH is not an idicator of thyroid status. TSH is not a thyroid hormone, it's a pituitary hormone that sends a signal to the thyroid. FT4 and FT3 are the thyroid hormones.

If you can add the reference ranges that came with your results (these vary from lab to lab) we can give you further information which may help.

If you have online access, the reference ranges should be with the results. If not then ask receptionist for a print out of your results and the ranges will be on there, don't accept verbal or hand written results as mistakes can be made.

[Ali0 in reply to SeasideSusie]

Thanks ...have edited the above.

[Ali0 in reply to SeasideSusie]

TSH <0.05 [0.2 -4.0]

Serum free T4 20.7 pmol/L [10.00 - 20.0]

Serum T3 1.6 nmol/L [0.9 - 2.5]

Currently on 125mg levothyroxine. The system says reduce to 100mg,

[fuchsia-pink]

So it's not just the TSH that is suppressed, your free T4 is slightly over-range as well. But your free T3 is only 43.75% range - so you're a classic "poor converter". If the GP reduces your levo, your free T3 will drop even lower.

So I'd strongly resist a dose change - and if you don't feel tip-top point out to him just how low your free T3 is - and remember it's the free T3 which is most important, as this is the active thyroid hormone, needed in every cell in your body. If you feel brave, you may say that these results suggest that it's time to consider T3 meds, and an appointment to an endo ....

But bear in mind that lots of endo's don't "do" T3, for all sorts of reasons (too expensive; too difficult to measure because of the short half-life; too difficult to get to grips with when you're really a diabetes man etc) - so you may also want to get the list of T3-friendly endos form Dionne at Thyroid UK - [e-mail] - and/or a sep post asking if anyone can recommend an endo near to where you live. You don't have to see the nearest person to you, but obv must be reasonably convenient. Good luck x

[Ali0 in reply to fuchsia-pink]

Thanks. That’s really helpful. They texted to say the pharmacist will ring to talk about the change of medication which doesn’t fill me with confidence. I have little faith in this GP practice.

A few years ago I had another GP who openly admitted he didn’t understand thyroid .....took me off 25mg levothyroxine and onto a higher dose of liothyronine ....made me completely manic. Think I’ll change practice and then ask to see an endo .... I am really nervous about the meds being changed by someone who isn’t an expert in the illness. Can ruin your ability to function,

Thanks for your help.

[fuchsia-pink in reply to Ali0]

My endo gives me lio - but is very much a diabetes man. If you've had lio in the past, that may help in getting it restored, as you've obviously been through the hoops to get it before [or I may be being wildly optimistic here - hope not!]

I get my meds from the NHS but expertise and support in all matters thyroid from this forum

[Ali0]

Yes.wish I’d found this ages ago.. More helpful than GPs by a country mile. Before I just knew something was wrong but had no way to challenge the doctor or get him to take it seriously.

[Nanaedake]

Is it T3 or FT3 that was measured?

[Ali0 in reply to Nanaedake]

It just says Serum T3 level 1.6 nmol/L [0.9 - 2.5]

[humanbean in reply to Ali0]

I suspect that might be Total T3, because I've never seen that reference range for Free T3. A Total T3 result isn't as useful as Free T3. I've seen Total T3 being reported in more and more posts on the forum.

I get the impression that doctors and labs are deliberately messing with their patients. They know we want T3 measured so they do the wrong damn test!

[Ali0 in reply to humanbean]

I clicked on the link to show what the test was and it linked to an FT3 page ....are you saying this is wrong as FT3 results would be be in that range, that they haven’t done the right test and I need to go back again? They seem completely useless tbh ....all about not seeing patients, cutting costs and very little to do with health.

[humanbean in reply to Ali0]

The most common reference range for Free T3 that you tend to see on this forum from people in the UK is :

3.1 - 6.8 pmol/L

Your result is 1.6 nmol/L [0.9 - 2.5] (Note the different units of measurement)

If I convert your result and reference range to pmol/L - the same units of measurement usually used for Free T3 in the UK - it becomes

1600 pmol/L (900 - 2500)

In my opinion you've been given a Total T3 result. But I must make clear that my opinions are not indisputable facts.

If the test you've had done was an NHS one then I think your chances of getting a Free T3 test on top of a Total T3 test are probably very, very small. And I know some doctors and endos have argued that Total T3 is just as good as Free T3.

I think diogenes has said the same under some circumstances, but I can't remember what they were.

[Ali0 in reply to humanbean]

This is infuriating. I suspect you are right as I just checked on the Thyroid UK site for ref ranges and they have TT3 as 0.9-2.5 nmol/L or 60-175 ng/dL and FT3 as 4-7.8 pmol/L or 3.1-6.3 pg/mL

The NICE guidelines are specific about testing FT3 And FT4 when TSH is outside ref range. I had to remind him of this to get the test. Frankly want to complain about them but guess I need to get back on the phone first thing and ask them to do the proper test and ideally refer me to an endo who actually knows what they’re doing ...

[Ali0]

Sorry * FT3 results wouldn’t be in that range