Follow up to advice given re forthcoming consultant appointMent. Private test results

[lco1]

I have privately ( Blue Horizons ) had tests done in advance as advised. The reverse T3 and reverse T3 ratio are to follow but this is the preliminary report which I would welcome advice as to interpretation .

[SeasideSusie Remembering]

lcol1

Unfortunately you have wasted your money and time having the reverse T3 test done. It's not recommended here and it was previously recommended that you have the Premium GOLD test, nobody would have suggested the Platinum test.

Testing reverse T3 can tell us if rT3 is high but it can't tell us why it's high. There are many reasons for high rT3 only one of which has anything to do with the thyroid and that's when there is an excess of unconverted T4 and you will know this from the FT4 and FT3 results, you don't need a rT3 test to show this.

High rT3 could be caused by low ferritin, by an infection, by low-calorie diets, selenium or zinc deficiency, cortisol issues, stress, dieting, chronic illness, inadequate or low iron, chronic inflammation, high cortisol, or liver issues and any other chronic health issues, and probably several more things.

Other conditions that contribute to increased Reverse T3 levels include:

· Chronic fatigue

· Acute illness and injury

· Chronic disease

· Increased cortisol (stress)

· Low cortisol (adrenal fatigue)

· Low iron

· Lyme disease

· Chronic inflammation

Also selenium deficiency, excess physical, mental and environmental stresses. Also Beta-blocker long-term use such as propranolol, metoprolol, etc. Physical injury is a common cause of increased RT3, also illnesses like the flu. Starvation/severe calorie restriction is known to raise RT3. Diabetes when poorly treated is known to increase RT3. Cirrhosis of the liver. Fatty liver disease. Any other liver stress Renal Failure. A fever of unknown cause. Detoxing of high heavy metals.

Articles

thyroidpatients.ca/2019/01/...

zrtlab.com/blog/archive/rev...

verywellhealth.com/reverse-...

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HbA1C is fine.

CRP is raised, this is an inflammation marker but it's non specific. It shows there is inflammation or infection somewhere.

Ferritin at 64.7 could be higher. Ferritin is recommended to be half way through range and some experts say that the optimal level for thyroid function is 90-110ug/L.

You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet

bda.uk.com/resource/iron-ri...

everydayhealth.com/pictures...

Don't consider taking an iron supplement unless you do an iron panel, if you already have a decent level of serum iron and a good saturation percentage then taking iron tablets can push your iron level even higher, too much iron is as bad as too little.

Magnesium is an unreliable test. About 99% of magnesium is stored in bone, muscles and soft tissues, leaving about 1% in the blood. So testing what's in the blood isn't giving an accurate picture of our magnesium status.

A red cell magnesium test is the better indicator of magnesium status, not the standard serum magnesium test.

Cortisol is OK providing test was done between 6am and 10am.

TSH is OK.

FT4 and FT3 are both very over range suggesting that you are possibly overmedicated.

However, your TPO antibodies are raised and you could actually be having a hyper phase of your Hashi's which would account for the high FT4 and FT3.

What is your current dose of thyroid meds and did you take last dose of Levo 24 hours before the test (and if taking T3 or NDT last dose should be 8-12 hours before test).

Vit D at 61nmol/L is too low.

The Vit D Society and Grassroots Health recommend a level of 100-150nmol/L, with a recent blog post on Grassroots Health mentioning a study which recommends over 125nmol/L.

Are you supplementing this? I can make suggestions if you wish, please ask.

B12 is over range, are you supplementing?

679pmol/L - 920pg/ml and it has been explained to you before that this level is fine.

Folate at 14.7 (8.83-60.8) is too low and should be at least half way through range. Are you supplementing?

[greygoose]

How much levo were you taking when these tests were done? I've looked through your past posts but can't find it mentioned.

[lco1 in reply to greygoose]

I am on 250 dose of thyroxine which they recommended I take in the evening and if no 8mprovement grind into a powder to take I am afraid I just couldn’t take it that way even though I tried. My medication was increased when my results were so high last time. From 225. I do not take any supplements at all apart from calcichew*D40 forte 500mg/400IU chewable tablets two per day.I did not take my thyroxine for 24 hrs before the test.

I do not take T3

I do not eat meat so using liver to increase ferritin is not an option

When I read the results I did look up hyper as well as hypo as even to me I thought hyper was indicated but I would seem to have a combination of the two if using symptoms as a guide

I was aware the gold test was the one recommended however as is sometimes the case these days I made a mistake and had to live with it.

As far as stress is concerned I would think my levels have been high for some years looking after a father with Alzheimer’s for 12 years, during which my husband had a stroke then a triple AA.

I will now make an appointment to see the endocrinologist recommended by Thyoid Uk

[greygoose in reply to lco1]

I am on 250 dose of thyroxine which they recommended I take in the evening and if no 8mprovement grind into a powder to take

Sorry, but what sort of 'improvement' are they hoping to get? Improvement in symptoms?

My medication was increased when my results were so high last time.

Which results were high? TSH or FT4/3? Your FT4 and FT3 are very high, now, so it would look as if you need a reduction in dose - although, as SeasideSusie suggests, those high results could very well be from a Hashi's 'hyper' swing, rather than anything to do with your dose.

Do you know how Hashi's works?

[lco1 in reply to greygoose]

January 2019 thyroid function test TSH 37,4 serum T3level31 serum free T4 level31The doctor who was not my usual one increased dose and said come back if I didn’t feel any better and they would review in 6 months so in June 1919 results were TSH level1.2 but I can find no results for any T3T4 tests on that report.

I was told as TSH now acceptable continue with medication at present level. This to be reviewed but COVID arrived next test Jan 21 TSH 9:1

No doctor has ever mentioned Hashimotos s only through this forum have I considered it. I will spend time doing research and looking up hyper swing.

I have been on the same brand of thyroxine for many years ALMUS changing pharmacy twice to retain consistency.

[greygoose in reply to lco1]

No, you won't hear doctors mentioning Hashimoto's becaquse they don't call it that. If they have any idea what the high antibodies mean - and most of them don't - they call it Autoimmune Thyroiditis.

But what happens is this:

The immune system attacks the thyroid, mistaking it for the enemy, and slowly destroying it. That's why you're hypo. During the attack, the dying cells release their store of hormone into the blood, causing the levels of FT4 and FT3 to rise sharply. But, it is only temporary. With time, the excess hormones will be used up or excreted, and you should become hypo again. Have you ever had low FT4 or FT3?

Do you always get your blood tests done at the same laboratory? Obviously, the doctors you have seen know very little about thyroid, or they would be questioning that very high TSH with the high Frees, because that is not normal. What they shouldn't be doing is keep increasing your dose.

[SlowDragon Administrator]

Post from 2 months ago

I recently had another test in Jan 2021 not as high but ( 9.1 ) My doctor has referred me to a different specialist. He spoke to me on the phone and recommended I take medication in the evening for eight weeks then do another blood test. I did as he requested and the level today came back as 1.8 so normal.

So your levels are very unstable

Which brand of levothyroxine are you currently taking

Do you always get same brand levothyroxine at each prescription

High thyroid antibodies confirms autoimmune thyroid disease also called Hashimoto’s

About 90% of primary hypothyroidism is autoimmune thyroid disease

Many, many people with Hashimoto’s find strictly gluten free diet helps or is essential

Request coeliac blood test BEFORE considering trial on strictly gluten free diet

What vitamin supplements are you currently taking

Vitamin D, folate and ferritin all on low side

Presumably you supplement B12

[lco1 in reply to SlowDragon]

I do not take B12 supplement or vitamin supplementsI always take levothyroxine brand ALCUS same now for at least ten years

I don’t know if it makes a difference but I do not eat meat and only fish about once a week when my husband nags me about protein.

[SlowDragon Administrator in reply to lco1]

So high B12 can be falsely high if other B vitamins are too low

Likely to need to supplement to maintain optimal vitamin levels

Vitamin D at least around 80nmol and around 100nmol maybe better

Folate and ferritin at least half way through range

[lco1 in reply to SlowDragon]

I am at my daughters at the moment but I think they did a vitamin levels test in January I will look it up tomorrow . Thank you for all the help everyone is giving. Have looked today and no vitamin test it was liver function which came back normal

[JAmanda]

How do you feel? Your results really clearly show you’re taking too much medication as you’re over range on T3 and t4. I think I would be reducing my dose to 200 I think. Not sure how you were before on a lower dose but you could try splitting it into two doses or taking it at night. Then retest in six weeks. Just the cheaper test of T3 t4 and tsh.

[lco1 in reply to JAmanda]

I realise now I am feeling a mix of symptoms from the hyper and hypo list. I am tired but can’t sleep sometimes too hot others too cold inappropriate to the ambient temperature. My heart rate is often well over a hundred and a recent consultants appointment for a colonoscopy after being hospitalised when I became tacicardic during a bout of diorrhea and sickness resulted in the consultant expressing concern about my heart rate which he said should have come down as he had sedated me. He asked me to go to my GP to get it checked. I did mention to the GP and she confirmed still way higher than should be and suggested going for tests ECG at the hospital. So far no appointment.However Jan 2020 I had an echocardiogram as a prequel to a knee replacement just before lockdown because the pre op review had commented on high heart rate. That test was completely normal.

I am often unable to find words in conversation. Constipated but cd be the painkillers . My fingernails are very brittle and skin very dry

Nervous and anxious and often irritable

Looking at this list I look a wreck but during 2018/9 I managed to lose 4 stone in weight and started a fitness regime with a personal trainer so I could have knee replacement. I have put back about a stone during lockdown but have kept up the exercise despite sometimes feeling tired and aching afterwards. The exercise has significantly improved my asthma .

[JAmanda in reply to lco1]

I changed my meds myself without waiting on doctor appointments but for me I was always under medicated so I knew I could take more. If I were in your shoes I’d be reducing meds whilst you wait on doctor.

On a separate note I’m finding powdered collagen has really helped my hair and nails.

[Eddie83]

Your FT3 and FT4 are over range top. You are overdosing yourself. My FT3 has been over range top in the past, and it is not a good feeling. What step(s) have you taken, to try to reduce your TPO antibodies?

[Thalia_sredaf]

Your FT3 and FT4 tests are elevated. I would expect your RT3 to be elevated as well.