Different labs different results. : FT4: 1.4 (0.... - Thyroid UK

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Different labs different results.

Meanbeannyc profile image
24 Replies

FT4: 1.4 (0.8-1.8)

FT3: 2.8 (2.3-4.2)

TT3: 82 (76-181)

TSH: 0.23 (0.27-4.6)

Same lab

FT4: 1.4 (0.8-1.8)

FT3: 3 (2.3-4.2)

TT3: 86 (76-181)

TSH: 1.2

Same lab again

FT4: 1.4 (0.8-1.8)

FT3: 2.8 (2.3-4.2)

TT3: 82 (76-181)

TSH: 0.34 (0.27-4.6)

Then at another lab:

FT4: 2 (0.9-1.8)

FT3: 2.78 (1.8-4.6)

TSH: 0.57 (0.27-4.6)

Then another lab

FT4: 1.76 (0.7-2.19)

FT3: 2.56 (2.77-5.27)

TSH: 0.47

Struggling to get well.

Upping and downing T3/T4 over the past two years. Never got it right.

112 levo.

Now on 112/5.

Anyone have similar labs?

“Your labs are fine”...

I don’t feel fine. I’d say my energy levels are decent. But very symptomatic still.

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Meanbeannyc profile image
Meanbeannyc
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24 Replies
greygoose profile image
greygoose

FT4: 2 (0.9-1.8)

FT3: 2.78 (1.8-4.6)

TSH: 0.57 (0.27-4.6)

Beanie, don't forget to mention that for those labs, you took your levo and T3 about 2.5 hours before the blood draw. So, they don't count - apart from the TSH. :)

Oh, and you should also mention that all your blood draws are at around 2 pm.

Meanbeannyc profile image
Meanbeannyc in reply to greygoose

Yes this one doesn’t count.

Does anyone else have similar labs though!? Lmao.

greygoose profile image
greygoose in reply to Meanbeannyc

Just added an after-thought, which is important because most people have their blood draw early morning.

Meanbeannyc profile image
Meanbeannyc in reply to greygoose

Goosie. U know I’m a lazy American who cannot wake up before noon. 😘

greygoose profile image
greygoose in reply to Meanbeannyc

Yes, but you're asking other people to compare their results with yours. If they had their blood draw before 9 am then no comparison is possible.

Meanbeannyc profile image
Meanbeannyc in reply to greygoose

Ah goosie u so smart. This is true. ❤️

SlowDragon profile image
SlowDragonAdministrator

You should always test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Important to take 1/3rd of daily T3 dose roughly 8-12 hours before test

This gives most consistent results

Do you have Hashimoto’s? Autoimmune thyroid disease diagnosed by high thyroid antibodies

Essential to regularly retest vitamin D, folate, ferritin and B12

Previous post shows low vitamin D and ferritin

What vitamin supplements are you currently taking

Important to test B12 and folate

Are you on strictly gluten free diet

Meanbeannyc profile image
Meanbeannyc in reply to SlowDragon

I have no thyroid due to thyroidectomy.

Only on vitamin D currently.

I am Not gluten free.

All tests are done fasting 25 hours after levo, except for the one goose mentioned above.

B12 is good. :)

SlowDragon profile image
SlowDragonAdministrator in reply to Meanbeannyc

Was thyroidectomy due to cancer or Graves’ disease or Hashimoto’s?

Are you increasing iron rich foods in diet to improve low ferritin

How much T3 are you currently taking

Meanbeannyc profile image
Meanbeannyc in reply to SlowDragon

Graves.

Currently on 112/5.

No iron rich foods.

SlowDragon profile image
SlowDragonAdministrator in reply to Meanbeannyc

Hashimoto's and Graves’ disease frequently affect the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Important to maintain optimal vitamin levels

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.

approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Many Greaves disease patients also find strictly gluten free diet is extremely beneficial

Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first

healthcheckshop.co.uk/store...?

Assuming test is negative you can immediately go on strictly gluten free diet

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

Meanbeannyc profile image
Meanbeannyc in reply to SlowDragon

I’ve done the celiac serumPanel, which was negative. I’ve been tested for pretty much everything under the sun. All autoimmune diseases. Nutrients. CMP/CBC all the time.

Iron panel etc.

The only thing other than thyroid is the vitamin D and my cortisol is wacky.

My dose is pretty high for my weight going off the 1.6xkg rule. I am

Approx 115-120 lbs. on 112.

SlowDragon profile image
SlowDragonAdministrator in reply to Meanbeannyc

Only 5% of thyroid patients are coeliac

But roughly further 80% find strictly gluten free helps or is essential

The ONLY way to know if that includes you is to try it for minimum 3-6 months

Obviously your vitamin D was too low

Ferritin too

What’s the actual results on B12 and folate

All your results suggest under medicated

Most people on levothyroxine plus T3 need both Ft4 and Ft3 at least 60-70% through range minimum

Obviously essential to test leaving correct time gaps, especially with T3 as it’s very time variable in test results

Meanbeannyc profile image
Meanbeannyc in reply to SlowDragon

Yeah. Undermedicated on T4 or T3? LOL

SlowDragon profile image
SlowDragonAdministrator in reply to Meanbeannyc

First step is always to get all four vitamins at optimal levels

Trial strictly gluten free diet

Then looking at tweaking T3 dose/ levothyroxine dose

One step at a time

Meanbeannyc profile image
Meanbeannyc in reply to SlowDragon

FT4 will drop when T3 is added so how do u even keep both in the higher range?

SlowDragon profile image
SlowDragonAdministrator in reply to Meanbeannyc

5mcg T3 is unlikely to be enough

More likely 2 or 3 doses of T3 needed per day. At equal intervals.

Eg 2 x 5mcg at 12 hour intervals

Or 3 x 5mcg at 8 hour intervals

But almost any dose T3 will significantly reduce TSH ....even 5mcg

On current dose T3

Last 2.5mcg T3 should have been 12 hours before test....was it?

Meanbeannyc profile image
Meanbeannyc in reply to SlowDragon

Only one of those tests have T3 in it and it’s the one with the above range T4. I was on 112/2.5.

I cannot tolerate 15mcg T3. I was on 100/15 a while back

SlowDragon profile image
SlowDragonAdministrator in reply to Meanbeannyc

How were you taking 15mcg T3 as 3 x 5mcg at equal 8 hour intervals

On adequate dose T3 it’s very common to have extremely low TSH ...well below bottom of range

See Diogenes reply in this post

healthunlocked.com/thyroidu...

the best paper on this that I have seen indicates that a TSH of 0.03-0.5 is best on therapy. Above that is insufficient and below MAY or MAY NOT indicate slight overdosing

academic.oup.com/jcem/artic...

Interestingly, patients with a serum TSH below the reference range, but not suppressed (0.04–0.4 mU/liter), had no increased risk of cardiovascular disease, dysrhythmias, or fractures. It is unfortunate that we did not have access to serum free T4 concentrations in these patients to ascertain whether they were above or within the laboratory reference range. However, our data indicate that it may be safe for patients to be on a dose of T4 that results in a low serum TSH concentration, as long as it is not suppressed at less than 0.03 mU/liter. Many patients report that they prefer such T4 doses (9, 10). Figure 2 indicates that the best outcomes appear to be associated with having a TSH within the lower end of the reference range.

Meanbeannyc profile image
Meanbeannyc in reply to SlowDragon

I want a higher dose but they won’t give it :(

“Your lbs are fine, your symptoms are in your head”

Meanbeannyc profile image
Meanbeannyc in reply to SlowDragon

It was not 12 hours before.

It was a few hours before.

I was taking T3 every 5 hours

SlowDragon profile image
SlowDragonAdministrator in reply to Meanbeannyc

So then it was too long between last dose and next dose following morning

Ask for reinstatement of 3 x 5mcg dose

But first work on improving low vitamin levels and trialing strictly gluten free diet

Meanbeannyc profile image
Meanbeannyc in reply to SlowDragon

I have cytomel. I can just take it. LOL.

What’s very weird is that my energy levels are great! Just very symptomatic with the muscle pain and carpel tunnel, blurry vision etc

SlowDragon profile image
SlowDragonAdministrator in reply to Meanbeannyc

Carpel tunnel usually improves as Ft3 improves

Muscle and bone pain likely linked to low Ft3 and low vitamin D

Gluten free diet frequently dramatically reduced pain levels too

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