Latest blood test results: Hi all I started... - Thyroid UK

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Latest blood test results

Wired123 profile image

Hi all

I started taking T3 in November in addition to T4 that I’ve been on for 12 years.

I have Hashimoto’s.

Doctor asked me to reduce my T4 in December and I’ve retested at the weekend.

Bloods are a bit strange. Naturally T3 and T4 are lower than expected given the drop in T4 dose. Strangely TSH has not moved much which is odd. I certainly feel I need more hormone.

The other interesting results are creatinine and phosphate.

Any thoughts appreciated.

Please note that the tests are carried out per my Endo’s protocol which is to take bloods 5 hours after morning T3 dose. Last T4 dose is 29 hours before blood draw (the morning of the day before).

Others have suggested a different protocol but I must follow the instructions of a private Harley Street Endo.

Vitamin D, Iron, B12 and Folate are fine so I have not posted the results.

19 Replies
SeasideSusie profile image
SeasideSusieAdministrator

Dk123

Bloods are a bit strange. Naturally T3 and T4 are lower than expected given the drop in T4 dose. Strangely TSH has gone down further which is odd. I certainly feel I need more hormone.

Yes, the FT4 and FT3 have reduced due to drop in Levo dose so no surprise there.

Your TSH has not reduced, 0.05 is higher than 0.03 and the difference is so small it's not worth consideration, nothing is static so there's always going to be small differences.

Personally I would try and keep to 24 hours between last dose of Levo and blood draw. If there's nothing you can do about the timing of your T3 dose then you'll have to accept that. I would say you need a touch more Levo, I've found even 5 or 6 mcg can make a difference.

Sorry, I can't comment on the creatinine and phospate results.

It’s ironic that despite being a qualified accountant I couldn’t work out whether my TSH had gone up or down! It’s this brain fog, lack of concentration and confusion that hampers me in my day job too as I make basic errors like this all the time!

I’m just surprised that T3 and T4 have moved so much but TSH hasn’t really changed. Would have expected TSH to be a bit higher this time round with drop in hormone

SlowDragon profile image
SlowDragonAdministrator

Weird way of testing

You might want to look at increasing T3 to 3 x 5mcg T3

Roughly 8 hour intervals between doses

See if Ft4 keeps dropping at next test too

Low creatinine

Are you vegetarian or on low protein diet

healthline.com/health/low-c...

medicalnewstoday.com/articl...

Low phosphate

Which brand of levothyroxine are you currently taking

Or are you taking any vitamin supplements with mannitol in?

healthline.com/health/hypop...

Wired123 profile image
Wired123 in reply to SlowDragon

He’s a 60 year old Endo and was a very senior consultant in a London hospital so clearly must be a reason he tests like this.

Not vegetarian or low protein.

Taking Almus/Accord T4 and Sigma T3. Not on any vits with manitol.

Wired123 profile image
Wired123 in reply to SlowDragon

I was in favour of increasing T4, seems like you feel I should keep T4 as it is and add in more T3 instead.

I actually felt my best the second week when I started T3. 150mcg T4 and 5mcg T3 for the first week then upped to 10mcg. It was the second week which was magic and then it went backwards quite quickly.

So if I was a betting man I would say 150 T4 + 5 T3 is my sweet spot as once the T3 built up in my system, by week 3 I went backwards.

My physio also commented how much more flexible and supple my muscles were at day 14, but then by day 21 he commented that I had got tighter and stiffer than before I commenced T3.

SlowDragon profile image
SlowDragonAdministrator in reply to Wired123

Alternatively stay on same dose as you are and see what levels are like in further 6-8 weeks

If Ft4 drops further you likely need to tweak levothyroxine dose upwards

See what endocrinologist says

Trouble with adding any T3 is TSH drops dramatically

You might need 150mcg levothyroxine and just 2.5mcg T3 x 2 or 3 x 2.5mcg

Do you wear a Fitbit or equivalent. If yes, has resting heart rate gone up, down or unchanged

Wired123 profile image
Wired123 in reply to SlowDragon

Heart rate went up dramatically after introducing T3 and then dropped even more dramatically when I reduced T4.

So I suspect something needs to change either 150mcg T4 with 5mcg T3 or lower the T4 and either 10/7.5mcg T3.

This is where the Endo’s experience and judgement comes in, but I want to consider as much as I can before I see him so I can fight my corner rather than just passively agree to his views.

I am not at all confident in what I’m talking about, but I guess these would be the things I would ponder if they were my numbers:

- were you having a hashis spike on or around 12/12 or is there another reason for this result to look like an outlier? It looks like the addition of T3 has raised fT4, but the logic we see on the boards is that the inclusion of T3 usually drops fT4. (I think.) Someone will be able to correct or confirm. I find it odd because it is counter-intuitive (I would have thought that the body didn’t need to bother converting so much fT4 into fT3, so it would make instinctive sense if fT4 rose with the addition of fT3) but that’s between science and the marvel of the human body and for wiser minds. Anyway, if we stick to the logic that T3 can reduce fT4 (until told otherwise/unless told that we all respond very differently, so we perhaps can’t be hard and fast about it?) then the general point about potential weirdness with 12/12 result is valid. I didn’t think about that when you posted about it in Dec.

- slightly high fT3 number 12/12 could be due to endos testing protocol, so I’m blithely ignoring it, rightly or wrongly...

- would that 12/12 dose have settled if you’d stayed on it for longer / tested a couple of weeks later for any reason.

- TSH is actually playing ball to an extent as 0.05 is a higher number than 0.03, so it seems to reflect the drop in medication.

- 31/01 looks like quite a big drop in fT4 for such a tiny drop in dose... I find that astounding and have no clue whatsoever what it is about. (I hope someone can give us some clues or that you can tell us if the endo says anything enlightening about it?) Other than that, again working with the T3 drops fT4 theory, it better reflects what we might expect to see when we compare it to 31/10, than your 12/12 result... ?

- finally, I quite often ask myself what I think my “perfect” numbers would be. In my case, I think it would be fT3 about 50% through range and fT4 quite high. Do you have an instinct what your ideal might look like? Do you think high fT3 is more or as important for you as high fT4, etc? I suppose I’m just wondering - if we decide there isn’t anything awry with the 12/12 result - what it is worth trying next and I suspect your instincts will tell you?

I'd favor an increase in the T4.

Wired123 profile image
Wired123 in reply to jrbarnes

And keep T3 the same or lower it?

jrbarnes profile image
jrbarnes in reply to Wired123

I would keep the T3 the same unless you feel 10mcg T3 is too much after a week or so.

It’s an interesting one as some feel T4 should be increased others feel T3 should be.

Guess there’s no knowing till we try

Hi all I just thought I’d update you all on my Endo appt yesterday.

He was actually quite happy with my bloods on a regime of 150, 150, 100 T4 (averages to 133mcg per day) plus 2x5mcg T3 per day.

He’s agreed that since I don’t feel well on that dose that I should up T4 to 150mcg Mon-Fri and 125mcg at weekends and continue on 2x5mcg T3 daily.

Previously I was on 150mcg T4 and 2x5mcg T3 daily, so he’s basically dropping 50mcg T4 a week which is hardly anything really.

I’ll retest in 6 weeks.

He also thinks after a few weeks I should experiment and reduce T3 to 5mcg per day and see how I feel.

Simplyred57 profile image
Simplyred57 in reply to Wired123

I’m in the same position endocrinologist told me to reduce thyroxine from 100 to 75 and stay on 06.25 T3 as my T3 is really high even on such a small dose, I reduced gradually and now 3 weeks in I’m feeling really low and undermedicated, I’m so tempted to up my thyroxine back up to 100 and drop the T3 but not sure if I should give it a few more weeks to see if it settles - are you feeling any better ?

Wired123 profile image
Wired123 in reply to Simplyred57

I’m definitely better on the higher dose of T4, so am glad I’ve upped it.

I may reduce T3 soon to see what that does.

Simplyred57 profile image
Simplyred57 in reply to Wired123

Yes think my T4 needs to be higher im going to get my bloods done next week a bit earlier than he wanted but I feel terrible on the lower dose.

Wired123 profile image
Wired123 in reply to Simplyred57

Yes I think it’s worth trying the lower dose to see if your body can get used to it, but if you’re feeling terrible then clearly you need to go up.

I went up as soon as I had my bloods so at least you have the bloods as a reference point and can start taking yourself to a better dose.

Blood tests only tell half the story, it’s all about how we feel.

Simplyred57 profile image
Simplyred57 in reply to Wired123

Yes I’m having my bloods done next week , I think Your right , you should go with how you fee, I’m interested to see the results though as when I first started on T3 and reduced my dose to 75 from 100 it went from 21 down to 14 , and I definitely need my T4 high I think ?

Wired123 profile image
Wired123 in reply to Simplyred57

Agree I reduced my T4 at Endo’s recommendation but I felt cr@p so he let me increase it back up.

These idiots just follow a script most of the time!

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