Blood tests results

[Victoria2603]

My blood tests confuse me.

FREE T3 2.58 - range 2.4 - 4.00

FREE T4 0.80 - range 0.93 - 1.70 (low)

TSH 0.031 - range 0.270 - 4.2. (low)

I am currently taking. 75mcg Levothyroxine and. 25mcg T3

The T3 is suppressing the TSH I believe, but the T4 is still low. If I increase the levothyroxine the TSH will be lower. The T3 is just in range so also not optimal. My vitamin D is very good at 77. My concern too is that I am not able to get any any T3 so I expect that to drop further. Any suggestions, advice would be helpful.

[fuchsia-pink]

I wouldn't worry about low THS (although I accept that it will likely give your GP kittens if it goes too low). TSH is a message from the pituitary to the thyroid telling it to work harder (ie so TSH goes up) if you aren't producing enough thyroid hormone. As such it's a useful if crude primary diagnosis tool to see if you are hypo in the first place. But you know you're hypo and are taking meds to deal with this. As such, your actual thyroid hormones are much more important, as these tell you if you're taking enough thyroid hormone - and these blood results strongly suggest you aren't.I'd increase levo to start with, as this will increase free T4 and hopefully some of this will convert to free T3. An extra 25 mcg a day to start, and re-test after 6 - 8 weeks.

Are your key nutrients good - ferritin, folate, vit D and B12?

[SeasideSusie Remembering]

Victoria2603

Taking T3 will lower, even suppress TSH, that's just what it does so your TSH result is not unexpected.

Taking T3 also tends to lower FT4 but yours is below range and most people on combination hormone replacement would need FT4 in range (where in range is very individual).

Also, for someone taking 25mcg T3 one would expect to see your FT3 level higher.

When did you take your last dose of Levo and T3 before this test? Last dose of Levo should be 24 hours before blood draw, last dose of T3 should be 8-12 hours before blood draw. Any longer gives false low results, any nearer gives false high results. So it's important to know when you took your last doses to see how accurate your results are.

My vitamin D is very good at 77

Is the unit of measurement nmol/L or ng/ml? If it's nmol/L then it's not actually very good,it's not too bad but it could be a lot better, especially during the winter. The Vit D Council recommends a level of 125nmol/L and the Vit D Society and Grassroots Health recommend a level of 100-150nmol/L. If it's ng/ml then it's over the recommended level of 40-60ng/ml.

[Victoria2603 in reply to SeasideSusie]

I took both my T3 and T4 the previous day, so about 24 hours I'd say.

[SeasideSusie Remembering in reply to Victoria2603]

Victoria2603

So you have a false low FT3 result. Your FT4 result will be showing your normal cirulating level if you left 24 hours.

What about the Vit D - is it nmol/L or ng/ml?