Blood Test advice required please : I have... - Thyroid UK

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Blood Test advice required please


I have received my first set of thyroid results from Medichecks and they are as follows :-

TSH 0.47 (Range 0.27 - 4.2)

Free T3 3.91 (Range 3.1 - 6.8)

Free T4 21.5 (Range 12 -22)

July results from GP test

TSH 0.08 (Range 0.35 - 3.5)

Free T3 4.8 (Range 3.8 - 6.0)

Free T4 16.5 (7.5 - 21.1)

I started HRT patches in July 2020.

From reading other posts I can see that HRT can effect thyroid levels even though I am using patches and not tablets. As my results show my T4 has gone up and my T3 has gone down, does this mean I should increase my Levothyroxine and is it safe to do so as I am nearly at the top of the range for T4 ? Or should I be asking my GP to refer me to an Endo for a T3 trial. Any help would be appreciated as feeling pretty lousy at the moment Many thanks

11 Replies

More likely to benefit from the addition of small doses of T3 prescribed alongside levothyroxine

Email Dionne at Thyroid UK for list of recommend thyroid specialist endocrinologists who will prescribe T3

NHS and Private

Meanwhile while waiting to see an endocrinologist, you could trial increase in levothyroxine. Some people find high Ft4 over range ok, others can’t tolerate it

Ft3 is obviously far too low

Confide55 in reply to SlowDragon

Thank you, I will email Dionne as recommended. I increase my Levi dose yesterday but this made me very jumpy and agitated, so don't think that is right for me. I can't understand why my T3 is so low as I was doing ok.

This is what has been happening to me. The more Levo I took the worse my conversion became and the lower my T3 went. I pushed my T4 over the top of the range earlier in the year and the T3 dropped to worse than formal. Brought T4 back in line and T3 rose a little but it's never enough. I'm just trying out T3 added to a slightly reduced T4.

I should add that if I push my T4 to the top or over range, I feel much worse. Probably because my T3 goes down.

SlowDragonAdministrator in reply to FancyPants54

I found same ....I can’t tolerate pushing Ft4 over range

So adding T3 is next step

Should I reduce my Levo to reduce my T4, could that be why my T3 is so low ?

You could try it and see. If it were me I would. Personally I'd reduce it by 25mcg a day, but you are not me, so you might want to try 12.5mcg a day reduction first. Hold for 6 weeks and retest and see what difference it has made to both FT4 and FT3.

But either way, this looks like you need some T3. Your conversion is poor.

Hello Confide

A fully functioning working thyroid would be supporting you daily with trace elements of T1, T2. and calcitonin + a measure of T3 and T4, said to be about 10 T3 + 100 T4.

T4 - Levothyroxine is a storage hormone that needs to be converted by your body into the active hormone T3 : T3 is what the body runs on and is said to be about 4 times more powerful than T4 with the average person using about 50 T3 daily just to function.

Your ability to convert the T4 into T3 can be compromised if your core strength vitamins and minerals, especially ferritin, folate, B12 and vitamin D are not maintained at optimal levels.

As you can see from the above you have " lost ' your own T3 production which equates to about 20% of your overall well being.

Initially the body will try to compensate but given time you may well find yourself just not as well as you might have thought you would be, and dealing with other new health issues which can be associated with under medication of thyroid hormone replacement.

The thyroid is a major gland, the body's engine, and responsible for full body synchronisation including your physical, mental, emotional, psychological and spiritual well being, your inner central heating system and your metabolism.

Personally I believe when there has been a medical intervention and the thyroid removed by surgery or ablated with RAI both T3 and T4 should be on the patient's prescription for if, and probably when, they will both be needed to restore balance of T3 and T4 and at high enough levels that the patient finds acceptable rather than the computer.

If you don't know of the Elaine Moore Graves Disease foundation website you might like to take a look. Finding no help with her symptoms post RAI thyroid ablation Elaine started researching this poorly understood and badly treated auto immune disease herself. Now around 20 years later and with several books published Elaine offers world wide advice to all Graves sufferers, and much like this amazing forum, offers an open forum and one to one advice when she is available.

P.S. I'm with Graves and following RAI in 2005 became very unwell about 8 years later. I was refused both NDT and T3 by my surgery and hospital and I now manage lingering Graves, thyroid eye disease ( caused by the RAI ) and hypothyroidism and self medicate and buy my own full spectrum thyroid hormone replacement and am much improved.

My recent blood tests showed my T4 almost top of range and T3 only just in range. I have been asking my endocrinologist for a T3 trial for some time with no success. I had excellent advice from this forum and went into battle at my next appointment! He agreed something was not right (at last!). I also had low B12 and VitaminD results, I have been started on B12 injections and Vitamin D supplement. We have agreed that if these steps do not show better conversion of T4, we will discuss further. He has said there is room for a slight raising of my T4 dose but as I am already almost top of range, I will resist any increases . I am hopeful that if my next blood results show a similar low conversion, I will be able to have a trial of T3. I am very grateful for all the helpful advice from everyone here which has enabled me to keep battling on!

I don't actually have an endocrinologist, I saw one when first diagnosed, but he turned out to be a diabetes specialist and totally disinterested, but you believe these professionals. I had RAI as told by him this was what was needed. Saw him 8 wks later and he signed me off and said any further issues you have speak to your GP. My GP freely said he has limited knowledge of the thyroid, so I am a bit stuck !

SlowDragonAdministrator in reply to Confide55

Get list of recommended thyroid specialist endocrinologists from Dionne

Likely to need to go privately initially

Ideally pick an endocrinologist who is private and NHS

Though a few members have managed to transfer to T3 on NHS after spectacular improvements on T3 initially via private consultation

pennyannie in reply to Confide55

Well, pretty much the same problems that I had, though my doctor professed thyroid to be one of her interests and specialisations.

I was refused NDT by this doctor in around 2014 and became very unwell and found myself on this forum, reading up, and looking for answers in around 2016:

I managed a referral to hospital because my dentist thought I then had Sjogrens Syndrome as I had no saliva and in unbelievable pain. Tests were negetive but I was found to be low in ferritin. Endoscopy aborted as I had no saliva and colonoscopy gave me the same intense pain as was in my mouth and referred to as a conundrum.

I ended up totally exhausted and thought maybe that Graves I had has come back and purchased Elaine Moore's first book which detailed all my symptoms though my doctor refused her copy :

I requested T3 and T4 blood tests, none had been done since being discharged into primary care for some 10 years earlier and I was made to pay for them and told I was very lucky to have any T3 when these results came back showing T3 at 25% and a T4 at 100 % through ranges.

I managed a referral to endocrinology but was declined a trial of T3 in 2018 and told I was over medicated, and to drop my dose of T4 down as my TSH was at 0.01.

I then took it upon myself to trial both T3 and NDT and been on NDT for coming up to 2 years and am much improved looking after myself.

P.S. Can I just add should you wish to reply to a certain individual you need to press the reply button under their reply to you - otherwise your reply will not be seen by them unless they choose to hunt for it : if you use the reply button the recipient is notified by the forum.

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