Subclinical Hyperthyroidism

[AlphaInsanity1]

I have just received a letter from my doctor stating that I now have 'subclinical hyperthyroidism' . I was originally diagnosed with hypothyroidism. I have been taking 75mcg of Levothyroxine and 5mg twice a day of Liothyronine. Is this normal? I ask this as recently I have been getting heart palpitations but I am not sure whether this is due to stress or thyroid issues? My results are as follows;

TSH 0.04mU/L

Free T4 16.8pmol/L

Free T3 4.48pmol/L

Any advice would be appreciated?

[Marz]

Without ranges it is difficult to interpret your test results. I am guessing your FT3 is NOT over range so you are not Hyper. Your GP is only looking at the TSH - SIGH !

[tattybogle]

I do wish GP's would stop confusing people by using incorrect terminology. If a hypothyroid patient has thyroid blood results that suggest they might be on slightly too much medication , then the correct term is 'overmedication' .. not 'sub-clinical hyperthyroidism' .

'Sub clinical hyperthyroidism' would be the correct term if you saw those type of results in a person NOT taking any thyroid hormone replacement (ie below range TSH but fT4/3 within range)

As to the question of whether you are slightly overmedicated . that depends on knowing the ranges for the fT4 /3 tests used , .. and also on your symptoms.

Looking back at your first post 5 months ago which has results from your GP, i see the ranges used by that lab were as follows

"So the ranges of the blood tests are;

T3 (2.0 -4.4) mine was; 4.66

T4 (11 -23) mine was; 11.8

TSH (0.27 -4.5) mine was 0.23"

so IF the ranges used this time are the same ( you do need to check each time , as they can change even if done at the same Lab as last time) then your current results

TSH 0.04mU/L

Free T4 16.8pmol/L

Free T3 4.48pmol/L

.. show a higher level of T4 .. and the fT3 is still very slightly over-range.

but since we know you take T3 , then the low TSH is explained by that , and does not mean you have hyperthyroidism ..

Check the ranges first , so we know what's what .. (many ft3 tests use a range that goes up to 6.8 , but a few do use the lower /narrower range)

[SeasideSusie Remembering]

Alphalsanity1

I get this every time I do a MonitorMyHealth private test. They just look at the TSH and tell you you're subclinically hyperthyroid regardless of where in the range your FT4 and FT3 are.

As Marz says, without the reference ranges we can't interpret your results but going by most ranges we see here I expect both your FT4 and FT3 are within range.

I despair of doctors ever understanding that it's the actual thyroid hormone that tells us what we need to know and that we're only overmedicated if FT3 is over range. It's OK to have a low or suppressed TSH as long as it's not undetectable, and that comes from the British Thyroid Foundation and Dr Anthony Toft, past president of the British Thyroid Association and leading endocrinologist - good enough for me.

[CapnM in reply to SeasideSusie]

hello, what does this mean ....."as long as it's not undetectable," thanks

[SeasideSusie Remembering in reply to CapnM]

CapnM

Undetectable = not able to be detected.

This is the quote from the British Thyroid Association:

Occasionally patients only feel well if the TSH is below normal or suppressed. This is usually not harmful as long as it is not completely undetectable and/or the FT3 is clearly normal.

The machines used have lower and upper limits, these vary depending on the machine. For example, the lower limit for my GP's TSH test is 0.02 so if a result is 0.02 or above it is detectable. If it is lower than 0.02 it can't be measured so the result comes back as <0.02 and that means it's undetectable by that machine because it doesn't measure low enough. The machine Medichecks uses does measure lower and I've had results back from them as <0.005 (undetectable) so 0.005 is as low as their machine measures.