TSH high but T3 & T4 the same

[notdoingwell]

Hello Everyone,

The latest results of my blood tests are as follows:

T3 ................... 3,2 ( 3,1 - 6,7 )

T4 ....................13,47 (12,00 - 21,90)

T.S.H………………3,85 ( 0,27 à 4,20)

Vitamin D2+D3…. 112,3 nmol (75 à 150)

PTH ................... 40,9 pg/m ( 15 à 65)

Previous test from February - 10/02/2020

T3 3,4 (3.1 – 6.7) T4 14,27 (12 – 21.9) TSH 0,96 (0.27 – 4.20)

I'm taking 75mg thyroxine and half a tab of Cynomel(0.0125mg) after advice from the group.

Right now I'm tired and depressed (but who isn't?), putting on weight and my hair is thinning dreadfully. I look 10 years older than in February.

I take daily supplements of Magnesium, Selenium, Zinc. (And monthly Vitamin D)

The tests were done as usual – early morning- no meds for 24hours.

I’m just wondering if you think I’m undermedicated again and should I top up Levoothyroxine to 100mg or would that be too much?

Note to Admins: I’m not sure what the correct protocol is, do I start a new question or find the old thread and continue it? I haven’t been on the thread of messages I started in 2019 for a while, so I’m starting this as a new question.

But let me know if you think I should go back to the other.

SeasideSusie

shaws

Catseyes235

@silverfox

SilverAvocado

[SeasideSusie Remembering]

notdoingwell

Starting a new thread is fine if you give some background and maybe link to your previous post.

The tests were done as usual – early morning- no meds for 24hours.

Last dose of Levo should be 24 hours before blood test, last dose of T3 should be 8-12 hours before test, splitting dose and adjusting time the day before if necessary, as explained by SlowDragon in reply to your previous post

healthunlocked.com/thyroidu...

If you left 24 hours since last dose of T3 then you have a false low FT3 result.

You appear to be currently undermedicated to have a TSH of 3.85 and a lower FT4 than previously (I wont comment of FT3 because it's likely that could be a false low result). You have Hashi's, your results/symptoms will fluctuate with the Hashi's activity, so at the moment you appear to be more hypo than when previously tested which could be down to your Hashi's. I would say that you currently need an increase in your thyroid meds, and I would suggest a higher dose of Levo for now (I'd say 25mcg), that should bring your TSH down and increase your FT4, it may well increase your FT3 as well depending on how much natural conversion you have. Retest 6-8 weeks after increasing your Levo to check your levels and see how you feel.

Vit D is OK and within the recommended range that the Vit D Society and Grassroots Health suggest, i.e. 100-150nmol/L.

I can't comment on PTH result as it's not my "thing".

Are you sure you need zinc? Zinc and copper should be balanced and we Hypos are often high in one and low in the other, so testing to know if and what we need to supplement is a good idea.

As you take Vit D are you also taking Vit K2-MK7, one of D3's important cofactors, which directs the extra uptake of calcium from food to bones and teeth where it's needed and away from arteries and soft tissues where it can be deposited and cause problems such as calcification of arteries, kidney stones, etc. 90-100mcg K2-MK7 is enough for up to 10,000iu D3.

I'm not medically trained, just replying based on my own experience and reading.

[SlowDragon Administrator]

I would agree with SeasideSusie that you should increase levothyroxine by 25mcg and retest in 6-8 weeks

Aiming for Ft4 at least half way through range and TSHat least below 2. Often TSH will be well under one when adequately treated

When were B12, folate and ferritin last tested

[SlowDragon Administrator]

Typically on levothyroxine plus T3 TSH will be very low when adequately treated......well under 1

Ft4 and Ft3 at least 50% through range

[SilverAvocado]

I agree with others. These thyroid results are very clear cut and suggest undermedication.

Both the freeT4 and freeT4 (I'm assuming these are free hormone tests although they aren't labelled?) are well below the halfway point and at the very bottom of the range. Most people will need the freeT3 high in the range, in the top third to feel well, and this will often mean a high-ish freeT4, too. Though once you're taking T3 the results of the freeT4 test aren't as important.

TSH is raised. For most people this will need to be suppressed or in the very bottom of the range for them to feel well.

This is quite an undermedicated set of results, so it's sad to see you beating yourself up as everyone else feeling just as bad. Thyroid illness is a serious illness and the symptoms are pretty nasty. It can be hard to really accept being sick and to be able to stand up for yourself, for example taking time out to rest or reducing how much you expect to be able to do in a day. But these symptoms are very real.