Can anyone tell me what my results mean?

[borahae]

So I was diagnosed with subclinical hypothyroidism. I was on 50mg levo for three days a week leading to the blood test. These are my results:

TSH: 5.1 (0.5 - 4.0)

FT4: 18 (10 - 20)

FT3: 6.1 (3.5 - 6.0)

My results from BEFORE taking any levo are:

TSH: 4.7 (0.5 - 4.0)

FT4: 16 (10 - 20)

FT3: 6 (3.5 - 6.0)

So it seems my levels have gotten worse. Also can anyone tell me why my FT3 is so high if I'm hypo?

My doctor is now telling me to increase to 50mg 4 times a week.

[helvella Administrator Thyroid UK]

How long was left between your last dose and the blood draw for your latest test?

A partial answer: The body will (usually) do what it can to maintain T3 levels. It is quite common to see FT3 maintained or rise as FT4 drops.

[borahae in reply to helvella]

Hello, thank you for replying. It has been 2 months. However, my FT4 rose instead of dropped

[helvella Administrator Thyroid UK in reply to borahae]

I think I am not understanding!

Are you saying your last tablet was taken two months before the latest test results?

I read your post that you were taking 50 micrograms three times a week. So that would have been between zero and 48 or so hours. But I must be misinterpreting.

[borahae in reply to helvella]

Oh sorry! I misread your question. I believe it was two days between my last dosage and blood test.

[helvella Administrator Thyroid UK in reply to borahae]

Easily done.

Yes, I am surprised that your FT4 is not bad, your FT3 is good or even high, yet your TSH is still over range.

Do you take any other medicines or supplements such as vitamins?

Are you on any particular diet?

Do you have any other diseases/disorders?

[borahae in reply to helvella]

But it seems my Ft3 and Ft4 have risen from last time. I thought they should go down if my TSH goes up?

I only take vitamin D. As for my diet it has been pretty much the same since childhood, though I do not eat as much fruits or vegetables as recommended.

I don't really have any disorders that may affect my thyroid other than anxiety and insomnia I guess.

[helvella Administrator Thyroid UK in reply to borahae]

I would look at it the other way round.

If your FT4 and FT3 go up, your TSH would be expected to fall. And, obviously, it has not fallen, it has gone up a little.

Bear in mind that TSH in particular varies through the day. The difference between 4.7 and 5.1 is less than might be seen within a day.

Also, if you start to get used to a dose, and TSH comes down, then pause your dose, TSH will tend to rise fast.

Taking 50 micrograms three times a week is not a regime that seems sensible to me. You are on a roller coaster of taking 50, then nothing, 50, nothing, 50, nothing, nothing.

Even on a much higher dose, I much prefer taking exactly the same every day. That is, 112.5 every day rather than alternating 100 and 125.

I'd consider splitting the tablets.

[borahae in reply to helvella]

Thank you for replying. May I ask whether my results are too concerning?

I have really bad health anxiety and tend to obsess over very little things. I really don't want this to ruin my holidays, as I tend to get overly anxious whenever I see my blood test results and see that something isnt right.

[helvella Administrator Thyroid UK in reply to borahae]

They are far, far closer to what most of us would expect when healthy than most of the results we see here!

The TSH is close to where I was when diagnosed. I started on 25 (every day!), then upped, slowly, ending up on 112.5.

[SlowDragon Administrator]

Important to regularly retest vitamin D folate, ferritin and B12

Have these been tested yet

Have you had thyroid antibodies tested for Hashimoto’s also called autoimmune thyroid disease?

About 90% of primary hypothyroidism is autoimmune thyroid disease

Low vitamin levels are extremely common when hypothyroid

Standard starter dose of levothyroxine is 50mcg everyday .

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

Your results are odd as Ft4 and Ft3 look good.....but TSH is too high

Maybe low vitamin levels

What vitamin supplements are you currently taking

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

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Ask GP to test vitamin levels and thyroid antibodies if not been tested yet

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)

Aim of levothyroxine is increase dose slowly upwards in 25mcg steps until TSH is under 2. Most people on levothyroxine will have TSH well under one when adequately treated. Most important results are always Ft3 and Ft4

[borahae in reply to SlowDragon]

I only take vitamin D as of now. I have been tested for antibodies two years ago and it was negative. I believe my B12 and ferritin are also in range.

[SlowDragon Administrator in reply to borahae]

Suggest you get hold of actual results and ranges

We need OPTIMAL vitamin levels

B12 range is typically 180-680 approx.

Anything under 500 can be too low for anyone on levothyroxine

Ferritin- need at least half way through range

You need BOTH Tpo and Thyroglobulin antibodies tested

Often they only test TPO

[borahae in reply to SlowDragon]

Thank you for replying. For some reason my doctor only gave me the results for my thyroid levels. I will get the others checked next time.

[SlowDragon Administrator in reply to borahae]

Because most doctors don’t understand the gut and low vitamin connections with being hypothyroid