Are my results in optimum range

[Dippybird2]

Hi everyone I just wondered if anyone can give me their views on my latest blood tests and if I should go back to my doctor and if so what I should say. I had been feeling unwell during lockdown with all the usual excessive tiredness, Brittle dry hair and nails, putting on weight , Aches and pains etc etc. I had a blood test done at end of July but at this point only TSH as that is all my surgery routinely do. It came back at 4.62 (range 0.35 to 5.5). I felt it was way to high as I am already diagnosed as Hashimoto’s hypothyroid and have been on Levothyroxine for several years now. I moved a few years ago and at my old surgery would have been well out of range as they were (0.35 to 3.5) Anyway my doctor said to repeat test in 8 weeks which I did and I convinced them to also do T3 and T4 which they did. They say all are normal but I’m not so sure as in know different areas use different ranges. When j questioned the different range use to my old surgery my doctor said it’s because they do different tests in different laboratories. Is this correct or is it the same test but they just use different ranges. Confused!!

Results are:

TSH 0.47 (range 0.35-5.5)

T4 19.8 (range 10.5-5.5)

T3 4.7 (range 3.5-6.5)

My TSH seems to have gone from one end to the other in the space of 8 weeks. On this second one I had test done In morning before taking Levothyroxine as I had read on here that was best to do. On first test I had it done in afternoon and Levothyroxine had been taken as normal. I would appreciate any views on results and whether you agree they are all ok. I think having read in previous comments in here and someone’s excellent explanation of a Hashimoto’s storm that I may have had this but still unsure of what to do next. I do take adcal (vitamin d) and selenium as extras. Adcal is prescribed as at my previous surgery tests showed I was well deficient In Vitimin d. I have found so much useful information on here and thank you all in advance.

[greygoose]

They say all are normal but I’m not so sure as in know different areas use different ranges. When j questioned the different range use to my old surgery my doctor said it’s because they do different tests in different laboratories. Is this correct or is it the same test but they just use different ranges. Confused!!

Well, it's the same test, but on different machines. And the ranges goes with the machine. But, however it's done, a TSH is still a TSH. And, and FT3 is an FT3. So, if you want to compare results with different ranges, what you have to do is work out the percentages:

chorobytarczycy.eu/kalkulator

Handy calculator for working out percentages.

Your FT3 is only 40% through the range, so you are under-medicated.

T4 19.8 (range 10.5-5.5)

However, there's something rather wrong with the range for the FT4. You cannot have the bottom number of a range higher than the top number.

And, even if you did put a zero too many in there, and your range is actually 1.5-5.5, that would make your FT4 a lot over-range. And, I cannot imagine that that is right. So, you really need to check that.

I do take adcal

Adcal is a rotten thing to take. It contains far more calcium than it does vit D, and is therefore unlikely to raise your vit D, whilst probably taking your calcium over-range, which is not a good thing at all. You would be better off buying your own vit d, and it's cofactors magnesium and vit K2-MK7.

[Dippybird2 in reply to greygoose]

Sorry T4 is a Typing error. Should be 10.5-21. I didn’t know that about Adcal so I will definitely DJ something about that. Thank you.

[greygoose in reply to Dippybird2]

OK, so your FT4 is 88.47% through the range. Which is high compared to your FT3, and indicates that you are a pretty poor converter. So, increasing levo is not really the solution. You need to obtain T3 from somewhere, I'm afraid.

What about your other nutrients: B12, folate, ferritin? Have they been tested? Because they could also be low.

[Dippybird2 in reply to greygoose]

I asked my doctor to test for that to based on things that I had read on here but he said they don’t do it for thyroid problems and would only do it if something else indicated a need to do it. I’m thinking of calling their bluff and saying ‘so if you say all my thyroid tests are normal what other tests are you going to do to see why I am experiencing the symptoms I have’ probably won’t work from what ive read on here but if that fails I will have to start putting money aside to get a private test done. Again I just don’t know how I’m going to be able to afford T3 but I’m definitely going to have to do some research on how and where to get it and just suck up the expense the best I can as I can’t carry on like this. I really do appreciate all your help though. I’m learning all the time. Do you know why my TSH would change so drastically within 8 weeks?

[greygoose in reply to Dippybird2]

TSH - Thyroid Stimulating Hormone - is a pituitary hormone.

When the pituitary senses that there's not enough thyroid hormone in the blood, it secretes TSH to stimulate the thyroid to make more hormone. The less thyroid hormone there is, the higher the TSH.

But, when the pituitary senses there is enough, it drops it's production of TSH, because you don't need it anymore. The higher the levels of thyroid hormones, the lower the TSH. So, when you started taking levo, the pituitary sensed it and reduced its output of TSH. How fast or how slow that happens is one of the vagaries of hypo treatment. The TSH is not a very good indicator of thyroid status once you're on thyroid hormone replacement.

To find out where to buy T3, write a new post asking people to PM you their trusted sources.

[SlowDragon Administrator]

Do you know if you have autoimmune thyroid disease also called Hashimoto’s

How much levothyroxine are you currently taking

Do you always get same brand of levothyroxine?

When was vitamin D last tested

Test here

vitamindtest.org.uk

Do you take adcal at least four hours away from levothyroxine?

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

Ask GP to test vitamin levels

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

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

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...

[Dippybird2 in reply to SlowDragon]

Yes I have Hashimoto’s. I currently take 125 mg Levothyroxine. I always have same brand. Vitamin D has not been redone for over 5 years. I was taking adcal at night and Levothyroxine in the morning as I was advised about taking together by doctor but I have just swopped them over as I read on here that it is better to take Levo at night. I’m definitely going to try and push my doctor for more tests if u can but if not I will have to get them done separately. I didn’t realise how little I know about it all until now but I’m learning all the time and trying to make sense of it all. Thank you.

[SlowDragon Administrator in reply to Dippybird2]

So as you have Hashimoto’s strictly gluten free diet is ALWAYS worth trying

Are you currently strictly gluten free ?

Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

You do not need any obvious gut symptoms

While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first

healthcheckshop.co.uk/store...?

Assuming test is negative you can immediately go on strictly gluten free diet

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

ncbi.nlm.nih.gov/pubmed/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

ncbi.nlm.nih.gov/pubmed/300...

The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

restartmed.com/hashimotos-g...

Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.

Retest thyroid and vitamin levels 6-8 weeks after adding new vitamin supplements and then trialing strictly gluten free diet

Only change one thing at a time

[Dippybird2 in reply to SlowDragon]

Again thank you very informative. I am not gluten free at the moment but I am definitely going to try this.