TSH and T4

[Lilly12255]

My TSH is above 3 while my T4 is above maximum range. What to think?

[SeasideSusie Remembering]

Lilly12255

My first thought is when did you take your last dose of Levo before the test? Last dose should be 24 hours before blood draw otherwise you get a false high FT4 result.

Then I'd wonder if you'd had coffee or other caffeine containing drink before the test, this can affect TSH.

Also, do you take Biotin as a stand alone supplement or in another supplement such as B Complex? If so did you leave it off for 7 days before the test? Biotin gives false results when the lab uses Biotin in the testing procedure, which most labs do.

[Lilly12255 in reply to SeasideSusie]

I did not take supplements for 4 days prior and my last levothyroxine was 25 h before the test. The test was done at 8:30am on empty stomach. Did not drink anything either.

[SeasideSusie Remembering in reply to Lilly12255]

Lilly12255

So one assumes that your results are a reflection of your normal level of circulating hormones.

[SlowDragon Administrator]

When were vitamin D, folate, ferritin and B12 last tested

What vitamin supplements are you currently taking

Are you still only on 75mcg levothyroxine

[Lilly12255 in reply to SlowDragon]

Yes I am on 75mg. Vitamin d was also tested same day. Will add results when they appear. Other things were tested last year. Though I take folate and B12 supplements, so they will probably be fine thanks to the supplements

[SlowDragon Administrator in reply to Lilly12255]

All four vitamins should be tested at least annually

How much B12 and folate are you currently taking

When were Iron and ferritin last tested

What’s your diet like, are you vegetarian or vegan

[fuchsia-pink]

How do you feel? And what is free T3?

Some people need free T4 to be over-range to have half-acceptable levels of free T3. And if you feel fine with such a high TSH - well that's great! If you're not feeling great and the GP won't test free T3, then it's really time s/he did ...

[fuchsia-pink in reply to fuchsia-pink]

Ah have just seen your next post - you're not getting free T3 tested.

It certainly IS possible on the NHS, but often the lab will only process the request if your other results are out-of-kilter - and these are! So time to get their collective finger out.

Alternatively a basic TSH, free T4 free T3 private test isn't expensive so may be worth doing privately, and if the GP is snotty about accepting a private test result (and some are) - then that's their incentive to do their own test!

[radd]

Lilly12255,

It is impossible to make any sensible assumptions on these results without FT3 levels included.

Ask your GP for a retest (even if FT3 is not included at this stage) to eliminate assay interference (false results due to other factors involved).

If numbers are repeated you would need to get FT3 tested either through your GP or private testing. My GP's surgery gets FT3 tested for me because I am medicating T3. Otherwise I think it is tricky and labs usually refuse GP's requests.

Are you under an endo?

[Lilly12255 in reply to radd]

I was under UCLH but as my tsh level cane down to 2. They discharged me last year

[radd in reply to Lilly12255]

Lilly12255,

Well to save having to pay for a private test at this stage ask GP to retest for definitive levels as these are so wonky.