Latest results : Well I don’t really understand... - Thyroid UK

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Kowbie profile image

Well I don’t really understand my t3 seems to have shot up , these are my results,

Tsh 0.01. mU/L. (Range. 0.27 -4.2)

Free T35.47. pmo/L. (Range 3.1-6.8)

Free thyroxine 23.400 pmo/L. (Range (12-22)

Thyroglobulin antibodies 13000 iu/ml (Range (34)

Thyroid peroxidase antibodies 13.40 iu/ml (range 34)

Hope I’ve put them down properly , took 8/45 morning no thyroxine 24 hours

Nothing to eat and only water , have still been taking vitamins and have just bought Thorne b complex #12 folate and a different d3 it’s lamberts d3 and k2 ,I don’t understand my t3 is up but have still been sleeping a lot and not a lot of energy and don’t seem to be able to walk very far ( hips hurting so much) and am on pain patches as well recently I’ve noticed my hands seem to have a bit of a tremor sometimes the whole body thankyou for reading and wait for your advice ,kowbie

55 Replies

hi , as well as your fT3 being higher , your fT4 has also gone up quite a bit since last test .. it was 16 or 17 then. now it's 23 . and over the top of the range .

A 'fine tremor' in your fingers is one of the classic signs of overmedication,

I had a fine tremor once and at the same time i also had some unexplained pain that GP thought might have been kidney stone, but an ultrasound of them was fine.

My dose was reduced from 150 to 125mcg and the tremor stopped and so did the ?pain in the kidney area .

I think you should consider reducing your Levo dose a little to see if the tremor stops.

Perhaps all the things you have changed like improving vitamins / selenium / taking Levo properly .. are now meaning that you are getting more T4 and better conversion to T3 from the same Levo dose .. meaning you might now have a bit too much ?

Having fT4 over range does make some people feel overmedicated, even if their fT3 is still in range.

And if fT4 goes too high (for you ) it doesn't get turned into T3 anymore ... it gets turned into Reverse T3 (like a safety valve).... so by lowering T4 slightly now (when it's gone very high) you might not actually lower your fT3 level much ... if that makes sense.

or .... the other reason your fT4 and fT3 have gone up could be that your thyroid has recently dumped a load of T4 and T3 into your blood due to an autoimmune attack.. your TGab antibodies are very high.. and even though your TPOab are not high , some people with autoimmune hypothyroidism just have high TGab without having high TPOab.

If this is the cause, then it still might be a good idea to reduce you dose for a while at least... the levels will go down in time and you may then need to go back to taking your current dose again.

It's also possible that something else is causing the tremor , and the high fT4 has nothing to do with it ... some people are fine with over range fT4 , in fact some feel better like that ... but it is quite easy to find out by reducing the dose slightly for a few weeks and see if the tremor disappears ... if it does then it shows your dose had become too high .

Kowbie profile image
Kowbie in reply to tattybogle

Tattybogle I just wanted to Thankyou so much for your reply a lot of it makes sense , I take 200 thyroxine at the moment I do have some 25 s what if I took 175 but then cut the other 25 in half that would be 1871/2 for 6 weeks to see how it goes ,I do appreciate your input thanks a lot Pauline

tattybogle profile image
tattybogle in reply to Kowbie

Hi pauline (this page explains the T3 /rT3 thing properly in case you're curious thyroidpatients.ca/2018/12/... ubiquitination-the-glass-ceiling-of-t4-monotherapy )

Yes, that would work ,i think aiming for a dose of around 187 .5 for 6 weeks would be good. (reducing by 25mcg might be too much of a drop)

You can get there slowly by just taking 187.5 /day from now on .

or you can get there quicker by dropping just one days full dose , (or dropping 100mcg from just one day).. and then carry on with 187.5 everyday from then on.

If you do it the slower way it may take a week or so before your levels drop by much, so don't expect the tremor to go in the first few days. it might take a while to go away gradually.

Kowbie profile image
Kowbie in reply to tattybogle

Thankyou I have done that , I only took 100 today , thanks again for your advice

Kowbie profile image
Kowbie in reply to tattybogle

Well I’ve read quite a lot of it but to be honest it’s really just gone over my head , I’ll perhaps have another go at it but I don’t seem to be able to take it in , but thankyou

tattybogle profile image
tattybogle in reply to Kowbie

yea , don't worry you don't need to know how it works .it took months and months for this stuff to very slowly make any sense to my brain ....

you just need the concept that "beyond a certain point more T4 does not always equal more T3 "

Kowbie profile image
Kowbie in reply to tattybogle

Oh ok could I ask you as my levels have come up why would I still be feeling tired and not a lot of energy, can I have your thoughts on this please thanks

tattybogle profile image
tattybogle in reply to Kowbie

i think we feel tired and no energy when thyroid hormones are too low OR too high for us ...i also think that when anything is changing in the thyroid balancing system we will often feel tired and have no energy . When it's working as it should (before we go hypo and start adding T4) the whole complex thyroid balancing system is designed to do it's best to keep the level of fT3 stable, despite the many changing demands the body has ..... so it seems to me that the body doesn't like change ... it's not just about getting to the right dose .. it's also about having a period of stability on the right dose before we slowly start to feel better. ... that's how i look at it .. and that's why i think dose changes should be as small as possible and allowed enough time to settle before we decide it's 'not better yet'

So my feeling is that, yes ,your levels have come up , but they only recently did that .. you have had several changes over the last few months resulting in your levels of T4 and T3 changing quite a lot.. possibly now gone from too low to a little too high for you ?

might settle down later as your body accommodates itself to all these changes.. bit like a pendulum swinging too far ... needs to settle down into the middle.

But anyway ... if my thinking about 'stability' is correct .. it's not surprising you don't feel right yet .. give it time... months not weeks .

And that is just the thyroid hormone factor .... add in any other poor nutitional/ /vitamin /mineral factors that if not optimal will mean the thyroid hormone can't work as well as they should .... then you'll still feel naff even it thyroid levels look good on paper.

(P.s re slowdragons 'good grief' comment .... i only suggested the "1'st day drop by 100mcg" because of the tremor and you sounded so uncomfortable, to get you to the 187.5mcg level in your blood a little quicker,, i wouldn't ever suggest changing the 'regular' daily dose from 200 to 100 .. which i think is what slowdragon thought you meant you'd done)

Kowbie profile image
Kowbie in reply to tattybogle

I actually did but have taken her advice and added the extra 75 . But think I will alternate and start taking 175 one day and 200 the next that saves me cutting a pill in half , do you think that will work thankyou for your help

tattybogle profile image
tattybogle in reply to Kowbie

yes , that works . levo has a long 'half life' so the dose just averages itself out . But despite the fact that it "shouldn't" feel any different due to the long half life , some people do feel the difference on the days when they take different doses .. so they prefer to split the tablet each day .

I split a tablet each day , not because i feel the difference , but because i find this easier than keeping track of 'which day it is' ..( i'm still too vain to get a pill box . lol )

Kowbie profile image
Kowbie in reply to tattybogle

Yea that sounds good advice I’ll do that thanks again

greygoose profile image
greygoose in reply to tattybogle

And if fT4 goes too high (for you ) it doesn't get turned into T3 anymore ... it gets turned into Reverse T3

High T4 doesn't stop getting converted to T3 altogether. Just less T3 and more rT3 than normal.

Normally, 30% is converted to T3, and 30% to rT3. Don't know what the exact proportions are when the FT4 is too high, but more rT3 than T3. :)

tattybogle profile image
tattybogle in reply to greygoose

i agree . i wasn't specific enough in my reply ... should have added a "Some of it " in there somewhere, .... ta for noticing .

greygoose profile image
greygoose in reply to tattybogle

You're welcome. :)

I don’t feel well when my t4 is even a little over range. I’d reduce it just a little - even 12.5 mcg if you can manage it or 100 less across the week and stick therefor six weeks.

Kowbie profile image
Kowbie in reply to JAmanda

Thankyou for your reply,that’s what I thought I would try I gave it a starter and only took 100 today I still can’t believe how much of a change there has been in results thanks again pauline

SlowDragon profile image
SlowDragonAdministrator

Looking at previous posts

You us to take levothyroxine with other medications

Now you taking it correctly, on it’s own on empty stomach and then nothing apart from water for at least an hour after

So you are probably absorbing dose much better

Try a very small dose reduction in levothyroxine ….perhaps reduce by 12.5mcg 2 or 3 times week

Which brand of levothyroxine are you currently taking

Do you always get same brand

As you have now had your endoscopy, you can now trial absolutely strictly gluten free diet. Minimum 3-6 months

Wheat or gluten often cause terrible joint pain if you develop gluten intolerance

About 86% of Hashimoto’s patients find strictly gluten free diet helps or is absolutely essential

Kowbie profile image
Kowbie in reply to SlowDragon

Thankyou slowdragon I only took 100 today I’ve normally been given teva thyroxine, so can I ask you why do you think I’m still feeling so tired and not a lot of energy still do you think it’s still got time to improve please , thanks again hope your feeling well .Pauline

SlowDragon profile image
SlowDragonAdministrator in reply to Kowbie

Good grief, recommend you take the 75mcg as well

only ever reduce dose by TINY amount….absolute maximum of 25mcg per day …..but that’s likely too much

If you normally take 200mcg per day…..just reduce to 175mcg twice week and 200mcg 5 days a week

or possibly alternate days …..So 200mcg one day, 175mcg the next day…..but that may be too big a reduction

Which brand of levothyroxine do you normally have

Get weekly pill dispenser so you know what dose which day

Retest in 6-8 weeks

Kowbie profile image
Kowbie in reply to SlowDragon

Oh ok , can I also ask do I have hashimoto disease, had antibodies done, and could you tell me about the tiredness and energy question please , what your thoughts are thankyou

SlowDragon profile image
SlowDragonAdministrator in reply to Kowbie

Thyroglobulin antibodies 13000 iu/ml (Range (34)

Thyroid peroxidase antibodies 13.40 iu/ml (range 34)

Can you double check….

range on Thyroglobulin antibodies is normally 115

Obviously your Thyroglobulin antibodies are way over range

This can make you feel very unwell

pubmed.ncbi.nlm.nih.gov/303...

Kowbie profile image
Kowbie in reply to SlowDragon

I tried to send the photo but I don’t think it’s very clear but it is 115 I must have put the other one again sorry

SlowDragon profile image
SlowDragonAdministrator in reply to Kowbie

No problem

As you can see fro link I added …..high TG antibodies causes lots of symptoms

Always worth trying strictly gluten free diet….

Kowbie profile image
Kowbie in reply to SlowDragon

I know you’ve said about gluten free , but is there any other medication I could take for it ,because now my t3 is coming up I don’t suppose I will be able to get it now will I

SlowDragon profile image
SlowDragonAdministrator in reply to Kowbie

There’s no medical treatment for antibodies

Antibodies are the cleaners clearing up after autoimmune attacks

Lifestyle changes and optimal vitamin levels can help

Keeping TSH low, with good Ft4 and Ft3 levels too

Kowbie profile image
Kowbie in reply to SlowDragon

Your saying thyroglobulin antibodies are way over , what do I need to do about that please , sorry to keep bombarding you with all these questions

SlowDragon profile image
SlowDragonAdministrator in reply to Kowbie

Keeping TSH as low as possible seems to lower TG antibodies (slowly)

Another reason not to reduce levothyroxine any more than absolutely necessary

Going absolutely strictly gluten free frequently helps reduce inflammation

Antibodies are the “hoovers” cleaning up after autoimmune attack

Kowbie profile image
Kowbie in reply to SlowDragon

Ok so is that what I’ve had or having

Kowbie profile image
Kowbie in reply to SlowDragon

Yea it’s teva I’ll do that get pill box , thanks

SlowDragon profile image
SlowDragonAdministrator

Many people find different brands levothyroxine are not interchangeable

Which brand of levothyroxine are you currently taking on 200mcg

Which brand of levothyroxine would you be taking if took 175mcg levothyroxine

Kowbie profile image
Kowbie in reply to SlowDragon

Well I have some 25 s they are teva as well , forgot to add that thankyou

SlowDragon profile image
SlowDragonAdministrator in reply to Kowbie

So are all your tablets Teva

100mcg, 75mcg and 25mcg

Are you lactose intolerant

Have you always had Teva

Kowbie profile image
Kowbie in reply to SlowDragon

I don’t have any 75 tablets only the 25s but both are teva

SlowDragon profile image
SlowDragonAdministrator in reply to Kowbie

So how are you proposing to take 175mcg and 200mcg on alternate days

175mcg

As 100mcg plus 3 x 25mcg tablets

Do you have large number of 25mcg tablets…..if not you will soon run out

Kowbie profile image
Kowbie in reply to SlowDragon

Well I’m going to take my results to the dr and tell him what I propose doing , and ask for him to put 25s on my prescription, I have been thinking about it and thought I would keep it on a level by cutting a tablet in half and taking 185 1/2 a day, what do you think thankyou so much for your help

Are you sure of that Tg antibody range? It usually goes up to 115. But, if it is 34 the top of the range, pretty sure you do have Hashi's. And that could be why your FT3 has risen - although I don't know what your last results was. As tattybogle says, your FT4 has risen, too. So, it's more than likely due to the Hashi's. :)

Kowbie profile image
Kowbie in reply to greygoose

No I wrote it down wrong but going to send my results hope they are clear enough.

Latest results
greygoose profile image
greygoose in reply to Kowbie

Ah ok! So both antibody tests are negative. That does not prove that you don't have it, but it doesn't prove that you do, either!

But, your FT3 is not over-range, so you're not over-medicated. So, I wouldn't worry about it increasing, if I were you. :)

Kowbie profile image
Kowbie in reply to greygoose

What do you think I shouldn’t come down on my thyroxine then ,

greygoose profile image
greygoose in reply to Kowbie

Well, how do you feel? Your FT3 still isn't that high - could be higher, even. But, it depends how you feel.

Kowbie profile image
Kowbie in reply to greygoose

So sorry I thought I got back to you but looking I don’t think I did ,anyway I can’t say I’ve noticed any difference to be honest went into town this morning and I could really feel that I was getting slower and slower walking along , and since I got home have dropped of to sleep for a while , I suppose with results going up there’s still time to improve I hope else what do I do then thankyou for listening to me , hope your well ,

greygoose profile image
greygoose in reply to Kowbie

Well, you could wait a while, and see if things improve. If not, the only other solution is trying to procure some T3 - either by getting it prescribed (very hard!) or by buying it yourself.

Kowbie profile image
Kowbie in reply to greygoose

Thankyou for your help I hope you have a lovely Christmas bye for now

greygoose profile image
greygoose in reply to Kowbie

Thank you, you too. :)

tattybogle profile image
tattybogle in reply to Kowbie

oh, i see TGab is 13 not 13000.. so both antibodies are negative. I thought 13000 was extremely high...... i should have twigged it's too high to be sensible . sorry. A tremor is still a classic sign of overmedication though (regardless of the cause of hypothyroidism)... the normal antibodies result doesn't change that part.

Kowbie profile image
Kowbie in reply to tattybogle

Sorry for that forgot the dot , but why do I sleep so much and feel very tired no energy,do you think trying some t3 and dropping some thyroxine would make any difference, or even changing brand of thyroxine would help thankyou for help

tattybogle profile image
tattybogle in reply to Kowbie

I don't know . Lowering Levo and adding T3 may ultimately help .....but you may not need to ..... look how much improved your fT3/4 are already .... either from your recent dietary changes or whatever else has caused the raise, (it could still be that you have Hashimoto's autoimmune even without high antibodies, a few people with it don't get high antibodies ).... but if it was me, and i had developed tremor at the same time as a high fT4 level , i would FIRST see if lowering the Levo dose slightly for a few weeks reduced the tremor. This is the first and most obvious thing to rule out .. and is quite simple to check . Also, doing this experiment now may come in handy for later, when talking to endocrinologists.

~ They will undoubtedly suggest the cure for all your ill's is to lower your levo dose ... (not because it's right , but because it's their first/only suggestion to nearly everybody, about everything, once they see a low TSH /high fT4 often without even discussing fT3 level at that time) ~

So ... if you've already tried a reduced dose , and got fT4 a little lower.. then if it didn't improve things you can tell them " i've already tried a lower dose of 'x' and my blood results were 'x' and i had 'x' symptoms ".... so then you can move the conversation on quicker to "what about me trying some added T3 ?"

Seeing an endocrinologist for an opinion , with very high / over range fT4 results and a very low TSH , and symptoms of tremor, is a bit of a foregone conclusion ... they will first expect you to reduce the Levo dose before considering anything else ....so you may as well eliminate this possible cause of tremor by yourself before your endo appointment happens .

Kowbie profile image
Kowbie in reply to tattybogle

Thanks very much you do make sense, I have cut down this will be my 3 rd day today, I haven’t got tremors all the time some days I don’t have it and the another day I do bit weird really but thanks a lot for helping

Kowbie profile image
Kowbie in reply to tattybogle

Sorry forgot to say how would you get to know then please

tattybogle profile image
tattybogle in reply to Kowbie

get to know what ? :)

Kowbie profile image
Kowbie in reply to tattybogle

Oh sorry if your hashimoto thankyou

tattybogle profile image
tattybogle in reply to Kowbie

Not 100% sure ..

I know they can see by looking at the structure of the thyroid .... after a long enough period of autoimmune damage has occurred, there is a recognisable pattern , specific to autoimmune damage .. something to do with seeing a pattern like giraffe skin ! But whether this can be seen on an ultrasound scan, or it needs to be some other sort of a scan/biopsy i'm not totally sure.

Sorry i can't be clearer.... i never really read up on it, cos i had loads of TPOab .

I just know that there are case reports/studies showing physical evidence of autoimmune thyroid damage in some people without raised thyroid antibodies .... and they don't know why this is ..

( but then they don't know much about autoimmune disease at all, cos they are not very interested ... so that's not very surprising ! )

Kowbie profile image
Kowbie in reply to tattybogle

Thankyou for your reply, it’s all a bit too much for me I think, I suppose it doesn’t really matter, I guess I have it what ever , but thankyou your an angel for all your replies to me , do appreciate it very much nice meeting you as well , x

tattybogle profile image
tattybogle in reply to Kowbie

x :)

Well to be honest i don’t feel as if anything has changed at al really I still keep wondering about trying to get some t3 to see if I felt better with a bit of that and then cutting some thyroxine down as I’ve been on thyroxine about 30 years and have never felt right all the way through thankyou for your advice

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