My mother had her blood results today and was told by the practice nurse that her thyroid is normal. I’m fuming!!!
She is on 75mcg per day and has all the classic symptoms. She’s been on this dose for about 20 years.
TSH 4.48 (0.45-4.5)
T4 11.0 (7.5-21.1)
T3 4.8 (3.8-6.8)
Doctor has agreed to increase T4 to 100mcg after my intervention.
Only thing I’d like to establish is whether she also has a T3 conversion issue and hence needs T3 too.
Any other advice gratefully received.
T4 11.0 (7.5-21.1) 25.74%
T3 4.8 (3.8-6.8) 33.33%
She's so under-medicated that it's difficult to say if she has a conversion problem. You would want her TSH down to at least 1 to be able to tell. But, so far she isn't showing any signs of it. You'll probably be better able to tell after her next labs. 
you can't really tell if conversion is an issue until TSH is optimal. Then you can look at fT3 in relation to fT4.at the moment fT3 looks relatively good compared to fT4, ie fT4 roughly 25% through range , and fT3 roughly 33% through range .
But this is probably because the high TSH is increasing the efficiency of production / conversion of T3 to compensate for the low T4. (this is the body's way of keeping going despite low thyroid hormone level)
Conversion would probably look a lot different to this when on enough levo to get TSH lower.
So see what effect dose increase has on results before worrying about T3.
Thank you both, you are right we need to get the T4 up TSH down before we think about T3 and of course high TSH improves conversion.
The GP suggested waiting 12 weeks before Re-test, twisted his arm into 6 weeks. Absolute madness over in the NHS
Obviously she also needs vitamin D, folate, ferritin and B12 tested
What vitamin supplements is she currently taking
Which brand of levothyroxine is she currently taking
GP refuses to test the rest of the stuff. Think will try to tackle the thyroid first in any case as such a high TSH needs to be taken care of first.
She takes some supplements so will get her a medichecks test as well to check those levels you mention.
Don't forget to stop anything containing biotin a week before testing. Medichecks aren't consistent with this - in some places they say stop for a week, in others they say stop for 2 days - I'd err on the side of caution and stop for a week.
Also, stop iron a week before doing any iron-related tests like ferritin.
Also, there are special instructions for testing B12 at Medichecks :
Do not take vitamin B12 for two weeks prior to this test.
My blood test result, is it normal? 
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Advice on ‘normal’ test results 
