hi you've helped me a lot before, can you help me again please?
I've had my blood test results back. What do you think?
Stupidly I can't remember whether I took my thyroxine before I went!
My results are as follows,
T4 17.4 (range 12.00 to 22.00 pmol/L)
T3 3.7 (range 3.10 to 6.80 pmol/L)
TSH 0.05 (range 0.27 to 4.20 mu/L)
My GP wants me to reduce my dosage of 125mg to 100mg on alternate days. I was told to do this a few years ago, but someone told me you shouldn't do that. That you should have the same dosage every day.
I'm really not sure what to do.
Many thanks
Thyroid function test results
Thyroid function test results
Thyroid function test results latest and previous
Thyroid function test
Needing opinions on last lot of results of thyroid function test
sueoathall
Stupidly I can't remember whether I took my thyroxine before I went!
Unfortunately, that's not very helpful when interpreting your results.
If you took your Levo before the test then you have a false high FT4.
If you left the advised 24 hour gap between last dose of Levo and test then your FT4 result is accurate and quite low in range at only 54%. Most people on Levo only tend to feel best when FT4 and FT3 are in the upper part of their ranges.
So, the important question is
* How do you feel?
Your GP wants to reduce your dose on the basis of your low TSH which is wrong. TSH is not a thyroid hormone, it's a pituitary signal to the thyroid. The thyroid hormones are FT4 and FT3 and it's these that tell us what we need to know, and out of the two FT3 is the most important because T3 is the active hormone that every cell in our bodies need. Over range FT3 can suggest overmedication, low in range FT3 tends to cause symptoms.
FT4 and FT3 should be more or less balanced and yours aren't as FT4 is 54% through range and FT3 is only 16.22% through range. This suggests that you don't convert T4 to T3 very well and the cause of this could be low nutrient levels. It would be helpful to have the following tested:
Vit D
B12
Folate
Ferritin
If these levels are optimal then it would suggest that your conversion is poor and you may need T3 added to your Levo. Come back with test results and ranges and we can comment.
Resist any suggestion of lowering your Levo, it's unlikely to make a significant difference to your TSH but it will lower your FT4 and FT3 levels which will make you symptomatic of hypothyroidism.
The following article may help you to convince your GP not to reduce your dose:
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the professional magazine for doctors):
"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).*"
*He recently confirmed, during a public meeting, that this applies to Free T3 as well as Total T3.
You can obtain a copy of the article by emailing Dionne at
tukadmin@thyroiduk.org
print it and highlight question 6 to show your doctor.
thank you so much for your lengthy reply. Very interesting.
I will look into it . Thanks again