Can someone please explain my results to me? I have done some research on hypothyroidism and there are varying views on levels. I have not felt myself for 3 years...but apparently I am in the normal 'range' . I think I might have a Reverse T3 problem but that is not something my Doctor wants to look into?
TSH 0.23
Free T4 11.8
Free T3 4.66
Hello Alphalnsanity and welcome to the forum :
Do you have the " ranges " for these blood test results as without them, it's hard to comment as everything will be a guess ?
Ranges vary from lab to lab but on first look I would " guess " that your T3 and T4 are not high in the ranges and that is where they need to be for you to feel less symptomatic.
However your TSH " looks " to be very low, and if your doctor only looks at the TSH s/he maybe reluctant to increase your dose.
What is your dose and what were you diagnosed with three years ago ?
No thyroid hormone replacement works well unless ferritin, folate, B12 and vitamin D are maintained at optimal levels through the ranges, so this might be an area to look into:
If you go into the Thyroid uk website who are the charity who support this amazing forum you will find details of private companies who will run the necessary blood tests for you if your doctor isn't able to help you with a full thyroid panel to include antibodies and the afore mentioned vitamins and minerals and when you have this blood test result post the results and ranges back on the forum and you will receive considered opinion and everything will be explained to you if anything looks amiss .
Thank you very much for your response!! So the ranges of the blood tests are;T3 (2.0 -4.4) mine was; 4.66
T4 (11 -23) mine was; 11.8
TSH (0.27 -4.5) mine was 0.23
My Vit B12 is 574 (197-771)
My Vit D is 65.9 (80-125)
My DHEA is 1.46 (3-6)
My folate is 10.2 (2.0-18.7)
I am now taking DHEA, Vit D and Iron tablets as supplements. I do not know what my ferritin levels are?
Yes - my Doctor was reluctant to increase my dosages due to the fact she thought I would become hyperthyroid.
3 years ago I was diagnosed with hypothyroidism. I was given 50mcg of Levothyroxine. After 3 months the Doctor's said everything was back to normal. However all my symptoms were still there.
2 years on my symptoms had got worse so they increased the Levothyroxine to 75mcg. All symptoms remained.
3 years on I complained that my symptoms were still there (mainly tingly and numbness in fingers, brain fog, weight gain, thinning and loss of hair). So the Doctors changed it to;
50mcg of Levothyroxine
5micrograms 2x day of Liothyronine
The results above are from being on this combination for 3 months.
Hey there -
OK - when taking any form of T3 it can suppress the TSH and lower the T4 - it's just what Liothyronine does in some people.
How were you diagnosed hypothyroid - is there an auto immune thyroid disease here and you have had positive antibody levels identified in the past ?
Once hypothyroid you can't become hyperthyroid - but you could be over medicated which is rectified by adjusting your T3/ T4 thyroid hormone replacement.
T4 is a storage hormone and needs to be converted by your body into T3 the active hormone that 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 T4 is barely in range at less than 10% through the range and your T3 is at just over 100% through the range and most people feel better when both T3 and T4 are in balance through the ranges and up nearing the upper quadrants of each range.
These results could be because of a timing issue, blood draw to last medication : it's recommended to have the blood drawn as early as possible in the morning, fast over night, just taking water, and refrain from taking T4 for around 24 hours and T3 for around 8 hours. Any thoughts there ?
I do know that I need to maintain my ferritin at around 100 for optimal T4 conversion :
and we have no level here, but note you are supplementing.
I aim to maintain folate at around 20, serum B12 at around 500 + ( active B12 75+ ) and vitamin D at around 100 :
I am sorry but I am now out of my depth as I have no experience of DHEA results but it is way below the range - what has your doctor suggested on this aspect of your care ?
Thank you for your response..you are a wealth of information!🙂
I was diagnosed from a blood test after going to the Doctor with symptoms. They think it was brought on after my diagnosis of having early menopause aged 37.
I was diagnosed with hypothyroidism aged 44. I also have osteoporosis. They commented that once having one autoimmune disease - you are more likely to get another. I also have a low platelet count of 99 (normal 150-400).
As far as positive anti body levels? I am not sure? But I did have to carry a 'antibody' card in hospital before I had a hip replacement. It stated my blood type and Antibody D on it.
The blood results could be a timing issue. I took the 5mcg of Liothyronine, that morning - but did not take the Levothyroxine (as I had run out). The bloods were drawn in afternoon at around 1pm. I did not eat in the morning. So yes - this might be why?
Regarding the DHEA I have been taking 1x 10mg for 6 months (through a private Doctor) - but have not been back since - due to cost and covid.
As far as Ferritin and Folate levels are concerned - how do you keep them at optimal levels? Is that through supplements?
Thank you for all your information. It is really appreciated.
Hey there -
Ok I eat clean and cook from scratch and once my ferritin was up at around 80/90 I maintain with Asda frozen chicken livers : they are clean and mild to taste and 1 tub a week seems to keep me topped up at the moment.
Flash fried and whizzed down into a pate I store in the fridge, taking a spoonful a day, with a dollop of mayo to help this medicine go down.
Once my B12 was at an optimal level for me I now supplement with Ingennus Super B complex - just 1 tablet daily.
I think I'm in a routine now which seems relatively easy for me :
I am with Graves Disease and post RAI thyroid ablation managing lingering Graves, thyroid eye disease and hypothyroidism. I also supplement adrenal glandular as I read they also " pick up " the RAI and can also get damaged.
I was refused a trial of T3 by my hospital and refused NDT by my doctor so now I self medicate with Natural Desiccated Thyroid ( the old fashioned treatment ) thyroid hormone replacement which as I understand it contains all the same known hormones as that of the human thyroid gland, since my gland is now totally destroyed by the RAI treatment that I now deeply regret having.
Thank you for your input. I have read a lot on NDT and it seems the right way to go. Thank you for your help.
Alphalnsanity1
As pennyannie has mentioned, please add the reference ranges for your results.
Just being "in the normal range" doesn't mean that you are optimally medicated, and we also need optimal nutrient levels. Seeing all these test results, with their reference ranges, may throw some light on your problem.
As for Reverse T3, that is a red herring, it's not worth testing, the test is very expensive and takes a long time to return the results.
High Reverse T3 can be caused by many things, only one of which is to do with the thyroid and that is when there is an excess of unconverted T4 and that would be shown by an over range FT4 level with a low FT3 level (so no need to test RT3). Other conditions that contribute to increased Reverse T3 levels include:
· Chronic fatigue
· Acute illness and injury
· Chronic disease
· Increased cortisol (stress)
· Low cortisol (adrenal fatigue)
· Low iron
· Lyme disease
· Chronic inflammation
Also selenium deficiency, excess physical, mental and environmental stresses. Also Beta-blocker long-term use such as propranolol, metoprolol, etc. Physical injury is a common cause of increased RT3, also illnesses like the flu. Starvation/severe calorie restriction is known to raise RT3. Diabetes when poorly treated is known to increase RT3. Cirrhosis of the liver. Fatty liver disease. Any other liver stress Renal Failure. A fever of unknown cause. Detoxing of high heavy metals.
Articles
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verywellhealth.com/reverse-...
Thank you very much for this insight. I think the problem is - I assumed that as soon as I started taking thyroxine - all would be well! But that hasn't been the case. If anything my symptoms have got worse over the last 3 years - not better. Doctors seem to be reluctant to give out Liothyronine (T3). However, I have read that one doesn't work without the other i.e. both Levothyroxine T4 and Liothyronine T3? There seems to be differing options on thyroid issues with old school and modern theories differing greatly?
Alphalnsanity1
I assumed that as soon as I started taking thyroxine - all would be well! But that hasn't been the case.
The trouble is that doctors don't explain things to us, and that could be because they have very little training in thyroid conditions so haven't a clue and think that a little white pill is going to make everything alright.
If anything my symptoms have got worse over the last 3 years - not better.
Because you weren't adequately treated.
I was given 50mcg of Levothyroxine. After 3 months the Doctor's said everything was back to normal. However all my symptoms were still there.
2 years on my symptoms had got worse so they increased the Levothyroxine to 75mcg. All symptoms remained.
Your doctor mistakenly believed that once your results were within range then that was good enough. I'm assuming your over range TSH came down to within range and your doctor was satisfied with that and disregarded any symptoms you may still have had. Unfortunately a lot of doctoring is done by ignoring the patient and only looking at test results - if they're within range there is nothing wrong with the patient!
What should have happened is 6-8 weeks after starting Levo you should have been retested and had an increase of 25mcg, followed by another test 6-8 weeks later and another 25mcg increase, this should have been repeated until your symptoms abated and your TSH, FT4 and FT3 levels were where they needed to be for you to feel well.
The aim of a treated Hypo patient on Levo only, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges, if that is where you feel well.
To leave you on 50mcg - a starter dose - for 2 years is neglect, and 75mcg is only one step up from the starter dose.
Doctors seem to be reluctant to give out Liothyronine (T3).
Two reasons - most doctors, even those who do prescribe it, don't understand it and don't know how to interpret the test results nor what they should be aiming for. Second reason is that it's expensive and the NHS in general doesn't want to pay for it. Unfortunately the NHS has been willing to pay stupid money for something that costs pennies in Europe.
However, I have read that one doesn't work without the other i.e. both Levothyroxine T4 and Liothyronine T3?
Not necessarily. Many hypothyroid patients (the majority really) do well enough on Levo only. However, T4 is a storage hormone and has to be converted to T3 which is the active hormone that every cell in our bodies need. So we have to be able to convert T4 to T3 well enough. For this good conversion to take place we need optimal nutrient levels so it's essential that we test Vit D, B12, Folate and Ferritin. If any low levels or deficiencies they need addressing. Again, this is something that many doctors have no knowledge of. If all our core nutrients are at optimal levels and our conversion remains poor then it's time to consider adding T3.
T3 (2.0 -4.4) mine was; 4.66
T4 (11 -23) mine was; 11.8
TSH (0.27 -4.5) mine was 0.23
50mcg of Levothyroxine
5micrograms 2x day of Liothyronine
The results above are from being on this combination for 3 months.
Is your T3 result Free T3 (FT3) or Total T3?
Do you have the test results from before you had T3 added which prompted T3 being prescribed? Levo doesn't always have to be reduced when adding T3, it depends on how high it is in range already.
When did you take your last dose of Levo and T3 before doing this test? Last dose of Levo should be 24 hours before test, last dose of T3 should be 8-12 hours before test. This is so that your results show the normal circulating level of hormones. Taking your doses too close to the test will give false high results of FT4/FT3, taking them any longer than that will give false low results.
Do you take biotin or a B Complex? If so did you leave it off for 7 days before the test? This is necessary because when biotin is used in the testing procedure (which most labs do) it can give false results.
Let's assume that your test was done under the correct conditions, that your T3 test is FT3 and that your results are accurate. In that case your FT3 is too high and your FT4 is very low in it's range.
If those were my results (and I take a combination of Levo and T3) I would be wanting FT4 higher in range and FT3 within range. I would be reducing the T3 dose to 1 x 5mcg daily to bring my FT3 level down. I'd increase the Levo dose to 75mcg which would have the effect of raising FT4 level and, depending on how much natural conversion there is, it should also raise FT3 level. Retest 6-8 weeks later and reassess. Further tweaking of doses is probably inevitable.
My Vit B12 is 574 (197-771)
Is this pg/ml or ng/L or pmol/L?
If pg/ml or ng/L (which are both the same) then the following applies:
According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
B12 and folate work together.
My folate is 10.2 (2.0-18.7)
Folate is recommended to be at least half way through range, so that is 10.35+
Do you take a B complex? It would improve your B12 level and there's room to take your folate higher too. Good quality B Complex supplements are Thorne Basic B or Igennus Super B.
My Vit D is 65.9 (80-125)
Is this nmol/L. If so then the Vit D Society and Grassroots Health recommend a level of 100-150nmol/L. What Vit D supplement are you currently taking - is it oral spray, tablets, capsules, softgels? What dose are you taking? Are you taking D3's important cofactors?
To reach the recommended level from your current level, you could supplement with 4,000-5,000iu D3 daily.
Retest after 3 months.
Once you've reached the recommended level then you'll need a maintenance dose to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3.
D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking D3 as tablets/capsules/softgels, no necessity if using an oral spray.
Magnesium helps D3 to work. We need Magnesium so that the body utilises D3, it's required to convert Vit D into it's active form. So it's important we ensure we take magnesium when supplementing with D3.
Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds if taking magnesium as tablets/capsules, no necessity if using topical forms of magnesium.
naturalnews.com/046401_magn...
drjockers.com/best-magnesiu...
Don't start all supplements at once. Start with one, give it a week or two and if no adverse reaction then add the next one. Again, wait a week or two and if no adverse reaction add the next one. Continue like this. If you do have any adverse reaction then you will know what caused it.
I am now taking DHEA, Vit D and Iron tablets as supplements. I do not know what my ferritin levels are?
My DHEA is 1.46 (3-6)
I can't comment on DHEA supplementation but I assume it's prescribed?
Are your iron tablets prescribed? If so is your doctor monitoring you regularly?
Are you taking your iron tablets 4 hours away from your thyroid meds?
You are a wealth of information! Thank you so much. My results where Free T4 and Free T3 (not total). The endocrinologist has called me today and suggested the same as you. Upping the T4 to 75mcg and lowering the T3 to 1x5mcg.
My B12 levels were measured in ng/L. I do not take a specific B complex. But I take a Methyl Multinutrient which has 400ug of B12 init. However - I might now have a look at the others you have suggested.
I take a D3 & K2 in one - as droplet form under the tongue. I have only just started taking this, last week. I do not take Magnesium. But I shall now get some.
My iron tablets are not prescribed. I actually take droplet form under the tongue (7mg) . I take all my supplements 4 hours after my thyroid meds. When is it best to take thyroid medication? In the morning or before you go to bed?
So, the gist is you have to be optimal in:
B12
D3
Magnesium
Folate
Ferritin (iron storage)
Selenium
Yes?
I am determined to sort out my thyroid issues this year and become 'optimal'. Your knowledge has been invaluable to me. Thank you very much.
Just another thought -
By " old school " are you referring to Natural Desiccated Thyroid which was used successfully for over 100 years to treat hypothyroidism but which has tended to be over shadowed now by Big Pharma and synthetic T3 and T4 products ?
Yes...that was what I was referring to.
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