New Blood test reading

[maplewood]

Hi everyone I am currently taking 75mg levothyroxine liquid. My latest bloods show TSH 4.5 ref range 0.35 to 4,7. T4 is 9.5 ref range 7.8 to 21.0. What should my T4 be?. My results say speak to doctor who i am assuming will tell me to increase to 100mg. I do not know where my T4 needs to be though. Anyone know where it should be. Thank You x

[SlowDragon Administrator]

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"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)."

(That’s Ft3 at 58% minimum through range)

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor



please email Dionne at

[e-mail]

Most important result is always Ft3, followed by Ft4

Important to regularly retest vitamin D, folate, ferritin and B12

These need to be at good levels to help improve conversion of Ft4 to ft3

[SlowDragon Administrator]

SERUM FERRITIN 21 (20-100),

B12 186 (115-1000),

previous post from few months ago shows really terrible ferritin and B12

Have these been retested.

Have you had vitamin D and folate tested

What vitamin supplements are you currently taking?

[maplewood in reply to SlowDragon]

Taking all of them at the moment and i have been told to take them for six months before they will review. Thanks x

[maplewood in reply to maplewood]

Ps My T4 seems to be at the low end still is there something I can do to get that a bit higher? Thanks x

[SlowDragon Administrator in reply to maplewood]

Yes, obviously in need of dose increase in levothyroxine

Levothyroxine is Ft4 level

[SlowDragon Administrator in reply to maplewood]

Exactly what vitamin supplements?

Iron must be four hours away from levothyroxine and well away from other vitamin supplements

How low was vitamin D, how much vitamin D are you currently taking

Are you getting regular B12 injections

Plus daily folic acid

[maplewood in reply to SlowDragon]

Folic acid 5mg x1, cyanocobalamin 1mg x1 , fultium 800iu x1, Ferrous Fumarate 210mg x1. No injections.

[SlowDragon Administrator in reply to maplewood]

800iu is Unlikely anywhere near high enough dose vitamin D

Suggest you retest vitamin D now

monitormyhealth.org.uk

Ferrous fumerate, many people need 2 or 3 doses per day

Iron and ferritin should be retested regularly by GP when on iron supplements

Strongly recommended getting all four vitamins retested alongside thyroid levels

Bloods should be retested 6-8 weeks after EACH dose increase in 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

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)

Is this how you do your tests?

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

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 down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/thyr...

Come back with new post once you get results

[carroll9988]

Hi your tsh should be under 2 and at best under 1. Your t4 should always be at higher end of blood reference range. Ask them to test your t3 too. X hope this will help