My Endocrinologist is unavailable until next year. I need help in interpreting the recent TFT result below. 7 days off 10mg of carbimazole.

[Nmaezi]

CLINICAL CHEMISTRY

THYROID FUNCTION TEST [TFT] [181-

054]

Specimen: Blood

- - - Result Reference

TSH 3.17 UIU/ml children(0.2 - 6.0), Adult (0.4 - 4.0)

T3 FT3 = 3.33 pmol/l (3.1 - 6.8 )

T4 FT4 = 12.0 pmol/l (12.0 - 22.0 )

[kittyelen]

7 days isn't long, what was your TSH before?

[Nmaezi in reply to kittyelen]

CLINICAL CHEMISTRY

THYROID FUNCTION TEST [TFT] [181-

054]

Specimen: Blood

- - - Result Reference

TSH 1.08 UIU/ml children(0.2 - 6.0), Adult (0.4 - 4.0)

T3 FT3: 4.83pmol/l 3.1 - 6.8

T4 FT4: 16.45pmol/l 12.0 - 22.0

[kittyelen in reply to Nmaezi]

How long ago was that? 1.08 for TSH sounds pretty good, mine is in-between 1 and 2 atm which my endo nurse was happy with and I can come off Carbimazole v soon if it is still stable!! I really hope it hasn't changed much, my appointment is next week.

TSH 3.7 is more higher so this is more like the thyroid is going underactive? Is it unusual for it to jump that much? I thought coming off Carbimazole means a risk of it going overactive again but this would make the TSH lower not higher. Excuse me I am not massively educated on this I just know she tells me she likes it between 1 and 2. Next year isn't far away so I would say it's not too long to ask them but at least being around 3 it is still in range and things may just be settling down

[Nmaezi in reply to kittyelen]

Thank you, Kittyelen.I was still on carbimazole when the test was done. I will stay off it until I see the Endo.

Thank you very much

[kittyelen in reply to Nmaezi]

Did they not reduce you slowly? I went from 10 to 5 and now been on 2.5mg for some months.

[Nmaezi in reply to kittyelen]

No

[kittyelen in reply to Nmaezi]

Oh, how long were you on Carbimazole? I am coming up to just over 12M normally they say between 12-18M if you go into remission they try withdrawal but I have underlying Graves, do you have a different thyroid condition?

[SlowDragon Administrator]

Bloods should be retested 6-8 weeks after any change in medications

Always test as early as possible in morning before eating or drinking anything other than water to get highest TSH

Did you get vitamin D, folate, ferritin and B12 tested

Please add most recent results and ranges

What vitamin supplements are you currently taking, if any

Have you had coeliac blood test done

Are you on strictly gluten free diet

[Nmaezi in reply to SlowDragon]

The test I posted was done on the 16th of this December

[Nmaezi]

No, I didn't do those other tests. I take Reload multivitamin

[SlowDragon Administrator in reply to Nmaezi]

We never recommend multivitamins on here

Important to stop taking any supplements that contain biotin a week before all blood tests as biotin can falsely affect test results

Always test vitamin D, folate, ferritin and B12 at least annually

[Nmaezi in reply to SlowDragon]

Thank you very much. I will let my doctor know.

[humanbean]

How long were you on 10mg of carbimazole before you stopped it for 7 days and had these tests done?

TSH 3.17 UIU/ml children(0.2 - 6.0), Adult (0.4 - 4.0)

T3 FT3 = 3.33 pmol/l (3.1 - 6.8 ) 6.22% of the way through the reference range

T4 FT4 = 12.0 pmol/l (12.0 - 22.0 ) Bottom of range

With those results I would assume you feel absolutely terrible and also hypothyroid.

A healthy person with no thyroid disease would have a TSH on average of between 1 and 1.5. The higher the TSH the lower your thyroid hormone levels are likely to be. Yours are already very low.

Free T4 in healthy people would often be around mid-range. Free T3 might be similar.

Do you have a copy of your results from when you were first diagnosed with hyperthyroidism? Could you post them, if you have them.

I've taken a very quick look at the results you've posted in the past and can't find any that show signs of hyperthyroidism at all. I also note in one of your posts that you had a partial thyroid removal in 2003.

You can find your previous posts here : healthunlocked.com/user/Nmaezi

There is quite a lot of overlap between hypothyroid (underactive) and hyperthyroid (overactive) symptoms. I wonder if you are confusing the two, and so is your endocrinologist.

For future reference and as a very general rule :

People who are hyperthyroid will have a very low TSH - well below the reference range, perhaps a level of 0.001 or similar. They will also have extremely high levels of T3 - possibly about 50 - 70 or even more. They are also likely to have very high levels of T4 - usually (but not always) higher than the levels of T3.

People who are hypothyroid will have a high TSH - it could be very high in range (doctors tend to ignore TSH if it is in range and say everything is fine) - or TSH could be well over the range - levels of up to 100 or more have been reported although it is not common to go that high. Hypothyroid people also have very low or below range levels of T4 and T3.

T3 is the active thyroid hormone. Every cell in the human body needs it to function correctly. If your level is low (as yours is) you will have symptoms of hypothyroidism. If your levels are high you will have symptoms of hyperthyroidism.

People with thyroid disease usually have low levels of nutrients. It is common for people to confuse symptoms of thyroid disease with symptoms of nutrient deficiencies, and in any case, in order for people with thyroid disease to feel well they must optimise as many nutrient levels as they can, as well as treating their thyroid condition.

[Nmaezi in reply to humanbean]

Thank so very much for the detailed enlightening response. It is, indeed, very helpful

[pennyannie]

Hello Nimaezi :

Well you " look " to be heading towards hypothyroidism but this is likely too short a time span and there maybe still some residue AT drugs in your body and after another week these results may look different again.

More important is how are you feeling ?

I see you had a hemi thyroidectomy for Graves back in 2003 - and it's unfortunate that this didn't t resolve your health issues, though of course the thyroid gland can regenerate and Graves is an auto immune disease and as such for life.

Your thyroid is the victim in all this and not the cause :

The cause is within your immune system and read Graves is a stress and anxiety driven AI disease.

I found the Elaine Moore Graves Diseases Foundation website a very interesting read and it certainly helped me understand myself a bit better and where I was in all this Graves Hyper/Hypo saga, I certainly recognised myself in some the detailed research Elaine undertook and was able to take some strategies away with me for my stress and anxiety issues.

elaine-moore.com

I'm with Graves post RAI thyroid ablation in 2005 and became very unwell some years later and managing lingering Graves, thyroid eye disease, caused by the RAI, and hypothyroidism and now self medicating and taking Natural Desiccated Thyroid.

[Nmaezi]

I appreciate very much. I will go to the website