my thyroid results months ago, High t4/tsh low t3, they have tried reducing and increasing my levothyroxine the results are never right, t3 never above 3.1, I have restless legs, insomnia, freqent night time waking, exhaustion, freezing cold feet and hands the list goes on. I had my last blood test after 6 weeks of the new dosage results TSH 5.1 T4 23.1, i reported hyper and hypos symptoms and they want me to carry on with the same dose for another 4 weeks depite me saying i had insomnia, palpitations and restless legs is this right, what would you do? i cant carry on like this
blood cortisol done by GP 309 two weeks later 320, they now want to do another blood test before they are able to refer to endo
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neesie
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It sounds to me as though you might have a T4 to T3 conversion problem... I found a full thyroid profile including TSH, T4 and T3 very helpful. If you have all these results to hand, post them ( with reference ranges) and the fantastic people on here can have a look. If not, it may be worth paying for a private test via Medichecks or another provider. Good luck
This was the blue horizons thyroid panel, probably 6 months ago the GP reults are above, thank you for replying much appreciated. Test Patient Result Normal Range Units Comment
You need an increase in your dose. Unfortunately the people we deal with (GPs usually) seem to know absolutely nothing about how to improve our health or relieve clinical symptoms.
I doubt if they actually know what a TSH means. It means Thyroid Stimulating Hormone and it rises when our thyroid gland is struggling to produce thyroid hormones. The aim is a TSH of 1 or lower with Free T3 and Free T4 that should be in the upper part of the ranges - both rarely tested.
Levothyroxine is T4 alone. It is supposed to convert to T3 but may not do so effectively for us who feel very unwell.
In case you're unaware - this is the process for blood tests for thyroid hormones:-
1. The earliest possible appointment - fasting (you can drink water) and allow a gap of 24 hours between last dose of thyroid hormones (usually levo) and the test and take it afterwards.
2. Ask for B12, Vit D, iron, ferritin and folate to be tested. All should be optimum.
3. Always get a print-out of your results, with the ranges, for your own records and post if you have a query.
4. Our aim is a TSH of 1 or lower with a Free T4 and Free T3 in the upper part of the ranges.
When were vitamin D, folate, ferritin and B12 last tested
Do you know if the cause of your hypothyroidism is autoimmune thyroid disease also called Hashimoto’s diagnosed by high thyroid antibodies
About 90% of primary hypothyroidism is autoimmune thyroid disease, so it’s likely
Low vitamin levels are extremely common when on levothyroxine
For good conversion of Ft4 to ft3 we need good vitamin levels
First thing is, do you have any actual blood test results? if not will need to get hold of copies.
You are legally entitled to printed copies of your blood test results and ranges.
The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results
UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.
In reality many GP surgeries do not have blood test results online yet
Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.
Important to see exactly what has been tested and equally important what hasn’t been tested yet
Far to often only TSH and Ft4 are tested, completely inadequate
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
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)
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
Hi I will post my recent results, i had a test done by Blue horizons and the t4 was 29, t3 3,1 went to the GP with this and got further tests but they have not been able to get things right, so now im taking 100 twice a week and 75 5 times, i had a total thyroidectomy 25 years ago due to thyroid cancer, i have always taken thyroxine in the morning before blood tests, (thanks for the tip) I have had a genetic test done which shows a SNP on the Dio 2 gene so im a poor converter i am taking extra Selenium and vit D, last tests for B12, Vit D, 4 months ago, b12 600, Vit D 87, ferritin in latest results 78
Thyroid function test
Comment: (rich) - Please make routine phone appt (not urgent)
Serum TSH level 5.1 mIU/L 0.27 - 4.2 mIU/L
Report Comment:
Comment: Possible irregular compliance? Advise review this and consider repeat in 8-12 weeks. Dr N Cantley. 01174148432
Serum free T4 level 23.1 pmol/L 12 - 22 pmol/L
Comment: (rich) - Please make routine phone appt (not urgent)
CORTISOLMore information icon
Comment: (rich) - Please make routine phone appt (not urgent)
Serum cortisol 337 nmol/L - nmol/L
Comment: Adrenal insufficiency is unlikely. Please note 9am cortisol should not be used in shift workers and those taking long term steroids or oestrogens. Dr N Cantley. 01174148432
Report Comment:
Comment: NOTE: Cortisol results are unreliable in patients taking prednisolone.
Serum TSH level 5.1 mIU/L 0.27 - 4.2 mIU/L
Comment: (rich) - Discuss at Planned follow up
18-Feb-2021
Serum ferritin 78 ug/L 30 - 470 ug/L
Comment: (CJE) - Normal
CORTISOLMore information icon
Comment: (rich) - Please make routine phone appt (not urgent)
Serum cortisol 309 nmol/L - nmol/L
Comment: If there is ongoing clinical suspicion of adrenal insufficiency a repeat cortisol is advised. Please ensure sample is taken between 8-10am and provide any relevant clinical history. P. Beresford. Tel 0117 414 8415
Report Comment:
Comment: NOTE: Cortisol results are unreliable in patients taking prednisolone.
Hi did you say that you always took your levo before the blood test, because that is the opposite of what you should be doing. The only thing you should have before a thyroid blood test is water. Take your meds after. Jo xx
Hi Neesie if you take your meds before your blood test your t4 and t3 will be raised and your tsh could be lower so the dr might want to reduce your dose. I always think that you want your bloods good after 24 hours because you still want to feel well before your next dose of levo. Hope that helps. Jo xx
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Advice for daughter needed please
Need some advice please! 
