Serum TSH 0.01 -(0.3. -4.2)
Serum free T 4 26 (12-22)
Serum organic phosphate ok
Serum alkaline ok
eGFR ok sodium ,potassium ,creatinine, urea, calcium all within range Vit D 63 (above 50 adequate)
I have call booked with gp next week can you advise regarding dosage of thyroxine currently on 150mcg no apparent side effects except mild palpitations occasionally and also what other blood tests I require
Many thx
Hello Bluemerlin
In the first instance it's necessary to run a full thyroid blood panel to include a TSH, T3, T4, antibodies, plus ferritin, folate, B12 and vitamin D.
We need to see the results and the ranges in order to assess how well your body is able to convert the T4 - Levothyroxine into T3 which is the active hormone that the body runs on.
Too low a T3 and you may have symptoms of hypothyroidism - too high T3 and you may have symptoms of hyperthyroidism.
However no thyroid hormone works well if your core strength vitamins and minerals are not optimal in their ranges so this is why these also need to be measured, and possibly supplemented, though likely to be in the NHS range and not therefore " seen ' as an issue.
Please refrain from taking your T4 on the morning of the blood test, fast overnight, and get the earliest appointment possible, taking your Levothyroxine after the blood draw.
If you are taking any supplements best to leave them all of for the week beforehand so get accurate measures of what your body is holding on to.
If you doctor is unable to help you there are private companies who can help you with the blood tests and then post the results and ranges back on here for considered opinion and advice.
If you check out the Thyroid uk website, the charity who support this amazing forum, you will see details of the private blood companies, who will help, and so much more information that will become relevant as you start your thyroid journey back to better health.
Just testing TSH and Ft4 is inadequate
For full Thyroid evaluation you need TSH, FT4 and FT3 tested.
EXTREMELY important to regularly test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common on just levothyroxine
Ask GP to test B12, folate and ferritin levels
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)
Private tests are available as NHS currently rarely tests Ft3 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 vitamins By DIY fingerpick 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 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...
If currently taking any vitamin supplements that contain biotin it’s important to stop these a week before ALL BLOOD TESTS as biotin can falsely affect test results
Eg vitamin B complex
Did you take your levothyroxine on the day of the test? How many hours did you leave it before taking your Levo and having the test?
Hi Usually take in the morning and had test first thing then took meds
Your having mild paps and your tsh is low and your ft4 is above range...your hyper.
In this case, even based on the results you have without FT3 tested, you do look to be slightly overmedicated , and you can expect them to ask you to reduce dose slightly. When you say palpitations, if you mean fast heart rate sometimes, that would also indicate dose is a bit too high. (Sorry i never know what people actually mean when they say 'palpitations' )
Don't let them get trigger happy and reduce by too much though if you feel basically OK . (maybe a reduction of 12.5 or 25mcg should be suggested ?)
( If you get an over range FT4 just a few hours after you took the Levo, it may not be overmedication , but since you left 24 hrs it will have been even higher than 26 )
Unless they need to keep your TSH supressed , it's better to have it closer to 0.5 -1 ish if you feel well like that. A slightly higher TSH helps a little bit with conversion of Levo to T3.
Thank you so much for this advice
You should NEVER let FT3 or FT4 rise above top of normal range. As I know from personal experience, overdose can have a variety of unpleasant symptoms which you may think are due to something else. I would suggest dropping from 150mcg, to 125mcg. You can also compute your "full replacement dose" (FRD) to see how that compares to 150mcg. The T4 FRD is in the range 1.5-1.7 mcg/kg body weight. For instance, if you weigh 150 lbs, 150/2.2=68 kg, so your T4 FRD would be in the range 102-115 mcg.
If you do not feel well after you reduce your dose, then you should ask for an FT3 test, look into the matter of whether or not you have Hashimoto's antibodies, and establish a supplement program that includes biologically-appropriate doses of substances critical to thyroid function such as selenium, zinc, iodine.
Advice on blood test result please
Blood test results - advice please.
Blood test results - advice please
High blood pressure and pulse following TT
