Can anyone please help interpret recent results please?

[Wendyrmn66]

Diagnosed hypothyroidism in Dec 2020.

TSH was 18 at the time.

Titrated levo as per guidelines from GP over 4 months. Now on 125mcg.

No real benefits to date.

Just had recent bloods Would someone kindly interpret please? I had them taken approx 12 hours after last dose.

TSH- 0.81

T4- 18.6

T3- 4.1

So my T3 has actually gone down and is now only 27% through range.

Still have aches and pains but not as bad as before.

Hair is awful 😢

Weight loss NIL

Should i ask for 25mcg increase as this would be in line with my weight.

Thanks so much in advance

[Wendyrmn66]

Also diagnosed fibromyalgia last month at Reumatology as they couldn't find anything else wrong with me. I don't believe in fibro either.

[SeasideSusie Remembering]

Wendyrmn66

Please add the reference ranges for your results, these vary from lab to lab so we need your lab's ranges to interpret your results.

As you say your FT3 has gone down, what were the previous results.

To compare results accurately, tests must be done under the same conditions each time. We always advise:

* Test no later than 9am (TSH is highest early morning and lowers throughout the day)

* Nothing to eat or drink except water before the test

* Last dose of Levo 24 hours before the test, any longer gives a false low FT4, if taken before the test it will give a false high FT4.

For thyroid hormone to work properly we need optimal nutrient levels have you had Vit D, B12, Folate and Ferritin tested?

[Wendyrmn66 in reply to SeasideSusie]

Yes thank you. 😊 I had test 12 hours following dose.

Im muddled off nights. And GP wont let us choose time so I'm going for new private test.

I had my last results on another thread I'll try get them 🔧

[Wendyrmn66 in reply to SeasideSusie]

Previous from April

Results

[SeasideSusie Remembering in reply to Wendyrmn66]

Are ranges the same for both tests?

[Wendyrmn66 in reply to SeasideSusie]

Yes they are both the same ranges thanks Susie

[SeasideSusie Remembering in reply to Wendyrmn66]

Wendyrmn66

So a quick look through your previous post and it seems as though you had an increase of 25mcg Levo following these results:

TSH: 2.09 (0.27-4.2)

FT4: 16.8 (12-22)

FT3: 4.7

and now your results are:

TSH- 0.81 (0.27-4.2)

FT4- 18.6 (12-22)

FT3- 4.1 (3.1-6.8)

So after an increase in dose we'd expect to see a lower TSH and a higher FT4. As you took our Levo 12 hours before the test (apparently for both tests??) then you have false high FT4 levels.

Your FT3 level is a bit lower with the new test.

Good conversion of T4 to T3 needs optimal nutrient levels. I can't see anything about your actual levels other than

I had low vit D last Dec commenced 3000iu daily.

Ferritin etc all normal.

Normal doesn't mean optimal. You really need to know your current levels because this may be contributing to your low FT3. And, of course, we don't know your true FT4 level because you took your Levo 12 hours before thetest rather than 24 hours.

[Wendyrmn66]

The 1st results shown were taken 24hours after meds. The 2nd lot were 12 hours. I need to get repeat with private healthcare .

I will ask for ferritin etc.

Much appreciated

👍

[pennyannie]

Hello Wendy ;

Just as a point of reference ;

The accepted conversion ratio when on T4 - Levothyroxine only is said to be 1 / 3.50 - 4.50 T3/T4 - with most people feeling at their best at around 4 or under :

So to find your conversion ratio simply divide your T3 into your T4 :

So if I take the first set of figures taken after 24 hour gap in medication I get 4.70 and 16.80 which comes out at a conversion ratio of 3.6 - showing good conversion.

Since your T4 is just 48% through the range the logical solution is a dose increase in T4 and a further blood test in 6-8 weeks time, to reassess your symptoms and your T3 and T4 levels, and likly, if still with symptoms, another dose increase in T4 to build you up to the top quadrant of the range.

We generally need our T4 up at around the top quadrant of the range as this naturally converts to a higher level of T3 as it is too low a level of T3 that gives your symptoms of hypothyroidism, and generally speaking T3 needs to be higher, rather than lower, to effect the relief of some symptoms.

Optimal ferritin, folate, B12 and vitamin D are needed to support your core strength and help in the conversion of the T4 into T3.

We are all different but know I feel better maintaining my ferritin at around 100, folate ar around 20, B12 active at 75 + and vitamin D at around 100.

[Wendyrmn66]

Thanks for that pennyannie!When you say 'core strength' do you mean abdominal core strength?

🤔 forgive me if i missed something!

[pennyannie in reply to Wendyrmn66]

No - just your main core body strength and resiliance which you need optimal in order to be keep and stay well and now also to assist your body in the conversion of the T4 into T3 which is the active hormone that the body runs on.

When hypothyroid your metabolism slows down.

This in turn can mean that your digestion slows, and this in turn makes it more difficult for you to extract your essential nutrients from your food, no matter how well you eat.

So optimal vitamins and minerals are essential to support you during this phase - you may well find once on the optimal dose of T4 that your metabolism is restored, as that is what we are all aiming for, and supplementing these core strength vitamins and minerals becomes superfluous but until that time we have to ensure that we are supplementing what's missing.

I think I read of hair loss ?? - this can be linked to too low a level of ferritin - just a thought :

[Wendyrmn66]

OMG and so it goes on ! I'll get the lot done again thank you xx