thyroid conversion: Please do these look ok, im... - Thyroid UK

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thyroid conversion

ninja1 profile image
27 Replies

Please do these look ok, im feeling very hypo but medichecks say all in range.

TSH 3.98 0.27-4.2

T3 3.2 3.1 - 6.8

T4 16.1 12 -22

I had these done in July but now I feel really underactive. I dont think the T3 looks very in range. Should I get them done again.

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ninja1
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SeasideSusie profile image
SeasideSusieRemembering

ninja1

At the time those tests were done you were undermedicated and you were in need of an increase in your dose of Levo.

The aim of a treated Hypo patient on Levo only, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges, if that is where you feel well.

It would be a good idea to get a new test, post results on the forum for us to comment.

Always advised here, when having thyroid tests:

* Blood draw no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If looking for a diagnosis of hypothyroidism, an increase in dose of Levo or to avoid a reduction then we need the highest possible TSH

* Nothing to eat or drink except water before the blood draw. This is because eating can lower TSH and coffee can affect TSH.

* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw, if taking NDT or T3 then last dose should be 8-12 hours before blood draw. Adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.

* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (most labs use biotin).

These are patient to patient tips which we don't discuss with phlebotomists or doctors.

ninja1 profile image
ninja1 in reply to SeasideSusie

These were done at Medichecks The doctors report said "I am pleasedto report that all your results for your thyroid profile are within normal ranges.

ninja1 profile image
ninja1 in reply to ninja1

I have ordered the advance iron test from medichecks. Ive always used them but I just took what they said as being good I wonder why they didnt say contact GP they normally do if something is borderline. I have been feeling more and more poorly since July. Its like I am not functioning.

SeasideSusie profile image
SeasideSusieRemembering in reply to ninja1

I have ordered the advance iron test from medichecks

Do you mean the Iron Home Blood Test at £39 or the Advanced Tiredness and Fatigue Blood Test at £115?

Iron tests must be done after a 12 hour fast and if you take any iron supplements they need to be left off for 7 days before the test.

ninja1 profile image
ninja1 in reply to SeasideSusie

No i already had irons done its new I think its called Advanced Thyroid Function blood test it also includes antibodes and B12 folate Vit D cost £79 but 10% discount code from thyroid uk

SeasideSusie profile image
SeasideSusieRemembering in reply to ninja1

Ninja1

Don't bother with any doctor's comments from any of the private labs. They are always going to toe the same line as NHS doctors -they say that TSH in range means everything is fine, and they totally ignore the FT4 and FT3 results.

TSH is not a thyroid hormone, it's a pituitary hormone which sends a signal to the thyroid to make hormone when it detects there is not enough. It's the FT4 and FT3 which are the actual thyroid hormones.

If the pituitary detects there is enough thyroid hormone the TSH is low. If the pituitary detects there's not enough thyroid hormone the TSH rises. At 3.98 your TSH was almost at the top of the range, your pituitary is telling your thyroid to make more hormone or - because you take Levothyroxine it is asking for a higher dose.

TSH, when on thyroid hormone replacement, should never be more than 2 - see

GP online

gponline.com/endocrinology-...

Under the section

Cardiovascular changes in hypothyroidism

Replacement therapy with levothyroxine should be initiated in all patients to achieve a TSH level of 0.5-2.0pmol/L.

Your TSH was much higher than this, your FT4 was only 41% through range and, as you say, "I dont think the T3 looks very in range" it is a measly 2.7% into the range. So yes, no wonder you were feeling "very hypo", that's because you were.

So in answer to your question

Should I get them done again.

Yes, as I mentioned above.

ninja1 profile image
ninja1 in reply to SeasideSusie

I rely on the private tests because of the NHS TSH only rule but i will ignore the docts report in future and post them on here. Thank you so much for your help. I feel so rubbish at the moment

SeasideSusie profile image
SeasideSusieRemembering in reply to ninja1

When you order the kit you can choose to not have comments. Always use this option then you get your results quicker, often the day they receive the sample.

ninja1 profile image
ninja1 in reply to SeasideSusie

Thats nice to know i will do that as they seem to take longer these days probably due to all the Covid blood tests. I will follow all your advice before the test and post the results when they come back. Thank you

LincsLady profile image
LincsLady in reply to SeasideSusie

Thats a good tip - I was going to ask how long they take with comments. Wondering if I can change my response now they have arrived at lab.

SeasideSusie profile image
SeasideSusieRemembering in reply to LincsLady

LincsLady

Wondering if I can change my response now they have arrived at lab.

I don't know for sure but I doubt it. It will be marked on their record that you haven't requested "no doctor's comments" so I think it will automatically be passed on for comments. If you contact them by email or web form there's no saying they will respond to it promptly, and I don't know if you can contact them by phone.

Their interpretation of results isn't worth having, you'll get better interpretation by posting on the forum.

LincsLady profile image
LincsLady in reply to SeasideSusie

Thank you - I emailed them and they have now posted up my results straight away. Will do a new post now to get some help as some are a little worrying.

SeasideSusie profile image
SeasideSusieRemembering in reply to LincsLady

Oh that's good news 👍I'm surprised they responded so quickly!

DippyDame profile image
DippyDame in reply to ninja1

"Within normal range"....nothing normal about it!They should say " within reference range".It means just that....within the ref. range.

It doesn't mean the readings are optimal for you, which they are not! If they were you would feel well!

Doctor's comments on labs are not helpful, don't request them!

You are undermedicated and need more levo (25mcg) and further testing, you have room to raise FT4.

If your conversion is good (seems reasonable) this will raise FT3

If it doesn't raise FT4 and FT3 to approaching 75% through ref range then you may benefit from a little T3.

Further full thyroid testing will indicate the way forward

ninja1 profile image
ninja1 in reply to DippyDame

I should receive my test kit tomorrow and I will post them when they come back. Thank you for your help and advice much appreciated

SlowDragon profile image
SlowDragonAdministrator in reply to ninja1

Only test early Monday or Tuesday morning and then post back via tracked postal service

What vitamin supplements are you currently taking

If taking any supplements that contain biotin stop these a week before blood test as biotin can falsely affect test results

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

When adequately treated on just levothyroxine, most people will have Ft4 at least 70-80% through range and Ft3 at least 60% through range

Clearly your Ft4 and Ft3 are both far too low at moment

ninja1 profile image
ninja1 in reply to SlowDragon

Im not taking any supplements, i dont get on well will fillers, I quite often have to take a clarityn after taking supplements. Does anyone know what the best brand of levothyroxine works best

JAmanda profile image
JAmanda in reply to ninja1

You can just completely ignore Medichecks doctors reports and just use the results as a guide to the levels so you can take a decision, based on your symptoms, whether to lower or raise your meds.

SlowDragon profile image
SlowDragonAdministrator

See GP and request 25mcg dose increase in levothyroxine

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

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

What were most recent vitamin D, folate, ferritin and B12 results?

ninja1 profile image
ninja1 in reply to SlowDragon

Thank you. My temp is 36.4 and I keep shivering is this part of being hypo I’ve felt so unwell since last week. I will post new results when I get them

SlowDragon profile image
SlowDragonAdministrator in reply to ninja1

Guidelines on dose levothyroxine by weight is approx 1.6mcg levothyroxine per kilo of your weight per day

TSH should be under 2 as an absolute maximum when on levothyroxine

gponline.com/endocrinology-...

Replacement therapy with levothyroxine should be initiated in all patients to achieve a TSH level of 0.5-2.0pmol/L.

NHS England Liothyronine guidelines July 2019 clearly state on page 13 that TSH should be between 0.4-1.5 when OPTIMALLY treated with just Levothyroxine

Note that it says test should be in morning BEFORE taking levothyroxine

Also to test vitamin D, folate, B12 and ferritin

sps.nhs.uk/wp-content/uploa...

Aim is to bring a TSH under 2.5

UK guidance suggests aiming for a TSH of 0.5–2.5

gp-update.co.uk/SM4/Mutable...

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

(That’s Ft3 at 58% minimum through range)

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor



please email Dionne at

tukadmin@thyroiduk.org

Horsey07 profile image
Horsey07 in reply to ninja1

My daily average temperature is 36.1. Low basal temperature can be another symptom of hypothyroidism.

ninja1 profile image
ninja1 in reply to SlowDragon

I am doing them on Monday, I will post when I get them back

sobs1962 profile image
sobs1962

This is just typical of what UK doctors are doing to thyroid patients, quite honestly, they don't have a clue and it's time they admitted it instead of doing us more harm than good. It makes me so angry 😠 😡!!

Hellonwheels profile image
Hellonwheels in reply to sobs1962

Not just in the UK... Several EX-doctors tried to keep me "in-range" here in the US. I (quite literally) fired seven doctors to find ONE that would check everything regarding thyroid, and treat based on Free T3 and Free T4. I went from 50mcg Synthroid and TSH of 5.5 to (after trial and error for a year) 90mg Armour and 37.5mg Liothyronine. My TSH is .0001, my Free T4 is just barelky UNDER the range, and my Free T3 is in the top 1/3 of range. More Synthroid/levo or other T4 containing meds make me worse than having nothing at all, and although nothing outwardly appears wrong with my THYROID, suppressing TSH and keeping T4-T3 conversion at a minimum seems to be the only course that makes sense for my body... all of us are different, and I wish you folks in the UK could just switch doctors like I did...

birkie profile image
birkie

Hi ninja1❤️

I'm replying to you with my experience of hyperthyroidism (graves) eventually diagnosed in September 2018, my journey started in about 20017 or there abouts, the symptoms were obviously overactive thyroid but for some reason my gp kept saying it was the menupause 🤦‍♀️.. He never did constant blood work and only did TSH which he said was in range, in 2018 I became so unwell I again went to my surgery with awful symptoms, again I asked him to check my thyroid function as I was sure it was my problem, he was not happy, this continued right up until July when I begged him to please do another thyroid pannle, first he said no as your last one was in range, I contemplated getting it done privately, I broke down crying in his office where he said in a very firm voice "I will do this last thyroid function but if it is negative you will just have to accept it and stop bothering me!.. No lie they were his words, the test was in range then one month later I collapsed at home my son got me to my gp surgery on an emergency appointment I saw a different gp who diagnosed me right there, took bloods my T3 was 24.2 my TSH was suppressed no T4... So after I started to recover I looked in to these so called in range TSH my normal gp did and found 2 short suppressed but the others were just by a nats wing in the golden nhs range.. But I was still very ill, eventually being rushed in to hospital in thyroid storm and eventually loosing my thyroid 😠 so as seasideSusie says doctors will tow the line in blood tests being in range, also I'd like to see this in range thing changed as not all humans are the same one TSH at let's say 3.58 maybe OK for a certain amount of the population but others may suffer with this range.. Umberelling the population is wrong that's why many of us don't get a diagnosis 😠😠😠 and I'd like gps and endocrinologists to look at how we are feeling instead of saying "well you can't be feeling unwell you thyroid bloods are all in range" poppycock!!! 😠😠😠🤦‍♀️🤦‍♀️🤦‍♀️🤦‍♀️

ninja1 profile image
ninja1

Thank you it’s such a minefield

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