Help with results

[LadyWard]

Please can you look at these I can’t remember what the T4 and FT4 mean. I am on 100mcg Levo each day, I feel fine, just a bit tired in the evenings. I have slipped a-bit as always used to wait an hour before I ate or drank anything, now I don’t if I’m perfectly honest Maybe why my TSH has gone up?

Like I said Apart from getting tired about 9.30 at night I feel fine, intact my hair has thickened up and up my skin is good. Do I need to do anything x

[SeasideSusie Remembering]

Ladyward

T4 = Total T4 = the total amount of T4, both bound to proteins and unbound (free). It's not a particularly useful test.

FT4 = Free T4 - this is the test that is more useful as it is the free T4 that is available to the cells.

Your FT4 is very low in range at 13.3 (12-22), it's just 13% through the range.

Your FT3 is also low in range at 3.7 (3.1-6.8), it's just 16.22% through the range.

You haven't said what your TSH was before but say it's gone up, that will be because the FT4 and FT3 are low in their ranges. Your TSH is too high in range for a treated hypo patient. Most of us feel best when TSH is 1 or below with FT4 and FT3 in the upper part of their ranges.

These results actually show undermedication but you say you feel fine except for feeling a bit tired in the evening.

I have slipped a-bit as always used to wait an hour before I ate or drank anything, now I don’t if I’m perfectly honest

Well, that's not a good idea. The reason it's advised to wait an hour before eating or drinking anything but water is so that nothing affects Levo's absorption. Often food contains things we shouldn't consume near to taking thyroid hormone, eg iron, calcium, even soya (which is often added to some foods and we don't realise unless we read every label), and any food in the stomach means the thyroid hormone is delayed on it's journey to the small intestines where it's absorbed. Also, coffee affects absorption of Levo.

It's very likely that by not leaving that time gap your Levo isn't being absorbed as well as it used to be and is the reason why your TSH has risen and your FT4/FT3 are low. It would be a good idea to go back to leaving an hour after eating, and drink water only, to see if it helps. If not then maybe you need an increase in your dose of Levo.

However, your raised TPO antibodies confirm autoimmune thyroid disease, aka Hashimoto's, and Hashi's causes fluctuations in test results and symptoms.

[LadyWard in reply to SeasideSusie]

Thank you so much x

[SlowDragon Administrator]

Previous post 6 months ago you had low ferritin and Vitamin D

healthunlocked.com/thyroidu...

Have you had coeliac blood test done?

Are you currently on strictly gluten free diet

You are still on HRT?

HRT frequently means you will need increase in levothyroxine

Current results suggest you need dose increase in levothyroxine