Help understanding thyroid test results

[lynn07]

Just had these recent test done can anyone help me understand them thanks.

[greygoose]

Hi lynn07, welcome to the forum.

Can you tell us if you are diagnosed hypo and if you are taking any thyroid hormone replacement, please? If so, what and how much. Because that will change the interpretation of the results.

On the surface, you have very high inflammation, so something is not quite right. And, as inflammation raises ferrritin levels, your ferritin is probably a lot lower than that result.

Your vit D could be higher, but your B12 is good.

Antibodies are inconclusive - is this the first antibody tests you've had?

TSH is a tad on the high-side - have you had that tested before? What time of day was the blood draw?

And, your FT3 is low - looks like you're a poor converter.

[lynn07 in reply to greygoose]

Hi thanks for your reply. I was diagnosed with a underactive thyroid 23 years 6 months after my 1st child.

several years down was told it was Hashimoto ! Have been on Levothyroxine ever since

my dose at its highest was 175 mg then over years been lowered to 150mg then 125mg.

This year 17th July blood test was TSH 0.19 (range 0.27-4.2) and T4 22.5 (12-22) no T3 Done doctor said my thyroid was over active and told me to reduce levothyroxine to 100 mg

my folate was also low 2.6 (range 3.9 -26.9) so advise to take folic acid . my cholesterol has also been very high over the years currently 7.8 but I do not want to take statins. I did this

recent test as doctor would not test my T3 . My hair is really falling out when I wash it at a alarming rate !and I just feel so exhausted all the time I am 59 years old.

[greygoose in reply to lynn07]

OK, so you know you have Hashi's, so absolutely no point in repeating antibody tests. Whatever the levels, even if they go down into range, like yours, you will still have Hashi's. Antibodies fluctuate all the time, but Hashi's doesn't go away.

This year 17th July blood test was TSH 0.19 (range 0.27-4.2) and T4 22.5 (12-22) no T3 Done doctor said my thyroid was over active and told me to reduce levothyroxine to 100 mg

Oh dear, another doctor that knows nothing about thyroid. You are hypo, under-active thyroid, so you cannot suddenly become over-active. It doesn't work that way. You could be over-medicated, but you are only over-medicated if your FT3 is well over-range. As they didn't test your FT3, your doctor could not possibly know you were over-medicated, whatever he many think.

These private labs show that you are a very poor converter, and therefore not likely to be over-medicated on 125 mcg levo only. Now, at 100 mcg, you are very under-medicated and likely to feel worse. Not surprising you have high cholesterol and are losing your hair.

Cholesterol levels are linked to T3 levels - low T3 = high cholesterol. Bring your FT3 up and your cholesterol will go down.

my folate was also low 2.6 (range 3.9 -26.9) so advise to take folic acid

Bad idea. For a start, folic acid is not the best form of folate to take. And, secondly, just taking one B vitamin is not likely to help because they all work together and need to be kept balanced. Might be a better idea to take a good B complex with at least 400 mcg methylfolate, like Thorne Basic B Complex.

[lynn07 in reply to greygoose]

Thank you for your help so need to get my doctor to let me try t3 and sort my vitamin levels out.

[greygoose in reply to lynn07]

You certainly need to sort your vitamin levels out, you can do that yourself. But, your GP cannot prescribe you T3. You will need to see a T3-friendly endo, I'm afraid.

[DippyDame]

Welcome!

Your T4 to T3 conversion is poor, the first thing to do is to optimise vit D, vit B12, folate and ferritinIf things don't improve you may very well eventually benefit from the addition of T3.

But before then...

Low FT3 may have caused TSH to rise as the pituitary releases its hormone TSH in an attempt to stimulate the thyroid to increase production of thyroid hormone....in this case it does not mean you need to reduce levo.

However, it appears that your GP is interpreting this TSH rise as an overactive thyroid when, instead, it is the pituitary gland's attemp to raise low T3... which is low because your conversion is poor.

Reducing levo won't solve this, but additional levo, or maybe in time, the addition of a little T3 probably will. You have room to increase levo, some people need their FT4 close to the top of the ref range to raise FT3 sufficiently. Currently your FT4 is 78% through the ref range...which may be seen as OK, but can still require to be higher

You are not overmedicated so long as your FT3 remains in range...this is the most important result, not TSH.

The pituitary will then sense the dose increase and will stop signalling the thyroid to produce more hormone...in turn your TSH should drop. When medicated TSH should be 1 or just under.

Had FT3 been tested on 17 July I suspect it would have been low.

T4 certainly wasn't being converted to T3 at all well....high FT4!

Until medics begin to understand the importance of testing both FT4 and FT3 concurrently patients will continue to suffer! It is madness!

Hope that rant makes sense!

Also, your cholesterol level should drop as you become correctly medicated...my level certainly did. I didn't want to take statins either!

How did you feel on higher doses of levo?

Your current symptoms suggest undermedication but convincing a GP might involve some effort.

Good luck, please keep us posted.

[lynn07 in reply to DippyDame]

Hopefully can get my doctors to let me try t3 When I was taking 125 levo felt no different to how I feel now to be honest have felt out of sorts for years and this is probably why not coverting

Thanks for your help

[DippyDame in reply to lynn07]

OK, you've done the groundwork on T4 then, and it's clearly not working.Time for the next stage

You're right...time to trial T3!Titrate T4/T3 and see how that goes...it will take time

You may find my thyroid journey (my profile) of interest.

It took me nearly 50 years to find out why my health just kept getting worse!

GPs can't prescribe T3, you need to be referred to an endo who can.

The last resort is to self medicate....

[pennyannie]

Hello Lynn

Optimal conversion of T4 into T3 when on Levothyroxine only - is said to be 1 / 3.50- 4.50

T3/T4 with most people feeling at their best when they come in at around 4 or under :

To find your conversion ratio you simply divide your T3 into your T4 and I'm getting 5.12 showing your conversion of T4 into T3 struggling and not working well.

No thyroid hormone replacement works well until ferritin, folate, B12 and vitamin D are maintained at optimal levels and conversion can also be compromised by inflammation, any physiological stress ( emotional or physical ). dieting, depression and ageing.

So I notice your inflammation is over range, and your body upset - could this be because of food intolerances, as Hashimoto's patients tend to also suffer leaky gut and you can learn more on this by reading the research of Dr Izabella Wentz who herself, manages this AI disease.

Your ferritin is a little bit high , but could be because of the inflammation.

Your vitamin D could be a bit higher:

I now aim to try and maintain my ferritin at around 100, ; vitamin D at 100 : active B12 75 + and folate at around 20:

[lynn07 in reply to pennyannie]

Thank you for your help

[Meanbeannyc in reply to pennyannie]

Everyone talks about this division of T3 into T4 to determine conversion rate..

My FT3 is 0

Percent through the range and I’m not getting how to do the division. Can you figure it out for me please @pennyannie ?

[pennyannie in reply to Meanbeannyc]

I don't know quite what you mean .

Should I return to your post of a week orso ago, where I replied to you but you never got back to me ?

[Meanbeannyc in reply to pennyannie]

Wow. I apologize. I usually am very good at replying! I live on this board and on my phone. Will review last post

[pennyannie in reply to Meanbeannyc]

Looking back I see you are taking T3 and T4 so this ratio does not apply :

Also your assay readings and ranges look very different to those that we see in the UK and on which this conversion ratio is based on.

Your T3 is in range at 2.10:

Having had a quick look your ferritin i much too low for any thyroid hormone to work well, and vitamin D also looks low - once your core strength vitamins and minerals are optimal I look to dropping your T4 and then adding back in more T3 :

[Meanbeannyc in reply to pennyannie]

Ah ha. New endo has made me start taking vitamin D. Has been making a world of a difference…

I was very ill on the prescribed tablets 10,000 D2 IU, new endo suggested lower amount D3/K2 combo in a liquid solution. Has been great!

[pennyannie in reply to Meanbeannyc]

Maybe liquid T4 might also be worth consideration:

Maybe you have gut issues :

But this is someone else's post and we shouldn't be continuing your health issues on their post.

[Meanbeannyc in reply to pennyannie]

I have an rxFor same dose (112mcg) in tirosint!

I shall try it.

Anyway. Thank you for your response and your courtesy to OP.

[radd]

lynn07,

Welcome to our forum,

Because your CRP is raised there’s a chance your ferritin level might be looking artificially adequate because is also an inflammation marker. You need to ask your GP for an iron panel to get a truer idea of iron levels and eliminate anaemia. Hair loss is common with inadequate iron, which is common with low FT3 levels, and as you have other nutrient deficiencies indicating gut issues, iron deficiency is a strong possibility.

You should not be thinking of trialing T3 meds as others have suggested until iron levels are known to be optimised because addressing all deficiencies will encourage Levothyroxine conversion & possibly raise FT3 levels enough. You can not assess conversion abilities with deficiencies of the co-factors required for good thyroid function, and T3 meds can be intolerant of low iron making a person feel very ill, (also low adrenal reserve which can accompany long term inadequate thyroid hormone replacement).

Folate is too low and should be replaced with methylfolate and not folic acid. Cholesterol often raises in the absence of sufficient thyroid hormone to metabolise & clear it, and usually reverses once thyroid hormones are optimised and effectively working. Also cholesterol ranges have become less meaningful as accompanying risk factors now provide the biggest guide to where our cholesterol levels should lie, although 7.8 does sound high.