Just picked up a print out of my last blood tests I'm not sure on what they mean can anyone advise? Tsh 0.13 T4 24.1

[Minnie43]

Hypothyroidism problems

[SeasideSusie Remembering]

Minnie43

Your previous post tells us that you take 125mcg Levo. When did you take your last dose before this test? It should be 24 hours before blood draw and we should only have water before an early morning test as certain foods and drink can affect TSH.

So if you took your last dose of Levo 24 hours before this test then your dose is giving you an over range FT4. This would normally suggest that you might be taking too much Levo but it's more important to see where FT3 lies. If FT3 is low then you are not converting T4 to T3 well enough.

If you took your Levo before the test then you have a false high FT4 result.

For good conversion of T4 to T3 we need optimal nutrient levels so you really need to get full thyroid and vitamin tested, as mentioned in reply to your previous post:

healthunlocked.com/thyroidu...

So to be able to offer any help or suggestions it would be a good idea to get all those tests done, and as your GP wont be able to do them all then maybe consider getting a private test with one of our recommended labs which were also mentioned in reply to your previous post.

[Minnie43 in reply to SeasideSusie]

I would of took my levothyroxine before the blood test He has put me back down to 100mg but only as I said I felt like I was going high again

I am going to get all the other things tested asap

[SlowDragon Administrator in reply to Minnie43]

Which brand of levothyroxine are you currently taking Do you always get same brand

As you took levothyroxine before test, the Ft4 result is false high result

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

Thyroid levels will need retesting 6-8 weeks after any dose change or brand change in levothyroxine

Essential to regularly retest vitamin D, folate, ferritin and B12

We need OPTIMAL vitamin levels for good conversion of Ft4 to Ft3

What vitamin supplements are you currently taking

As you have Graves’ disease are you on strictly gluten free diet

Cutting gluten out frequently improves symptoms, but get coeliac blood test done BEFORE stopping gluten

[jimh111 in reply to Minnie43]

Taking your levothyroxine before the test will have a small effect, see the lower flat line plots in these graphs thyroidresearchjournal.biom... .

Your fT4 is a bit high and TSH low so if you also feel a bit high it makes sense that you should try a reduction in your dose. You can see how you feel on the lower dose. When I do such a trial I skip my levo for a couple of days so the adjustment is quicker and it is easier to make a judgement, otherwise it takes weeks for your levels to come down and the transition is too gradual to judge.

You can run other blood tests such as TSH, fT3 and fT4 but if you feel well there is no need although I would run one such test when you feel well so you have a marker for the future.

[Minnie43 in reply to jimh111]

Ok thanks I'm seeing someone private on the 8th so will get further bloods done

[jimh111 in reply to Minnie43]

Describe how you feel and any symptoms to them so they give priority to your signs and symptoms. This will help avoid 'treating by numbers'.

[PurpleNails Administrator]

With these results the TSH low and FT4 high the doctor will want to reduce medication.

What you also need tested it the FT3. This may not be as equally high as the FT4. If you were a poor converter it may even be low.

If it is reduced it should be 25mcg daily (or alternate days) and you must be retested after 6 weeks.

Low nutrients can cause poor conversion and being hypothyroid can cause low nutrients.

Having a complete check is important.

Your previous post said you were hyperthyroid many years ago. Was is for a brief time? Were you on medication or have treatment to resolve it?

You may have had the start of autoimmune thyroiditis which often begins with transient hyper. As the immune system destroys thyroid and the tissues release their thyroid stores as more of the thyroid is destroyed you ultimately become hypothyroid and the process can be slow.

Have you had thyroid antibodies tested? TPOab TGAb. When you were hyper was TSIab or TRab ever tested?

[Minnie43 in reply to PurpleNails]

Hi I can't remember how long I had hyperthyroidism but it was at least 2 years and had carbimazole to treat itThere is only these 2 things on the sheet so presume not had anything else checked

[PurpleNails Administrator in reply to Minnie43]

You may have to look at private option to ensure everything gets tested. Often best way to make progress.

You can battle with doctor but it’s unlikely they will do a full test & sometimes the lab do not authorise the request. Which is very poor if you having a blood sample taken.

[Minnie43 in reply to PurpleNails]

Hi I'm hoping to see someone private on the 8th thanks for your help

[PurpleNails Administrator in reply to Minnie43]

Even more important to arrange a test and obtain full picture. Attending appointment without all information & paying for a private specialist which would likely need to arrange a test at higher cost.

Previous post gave examples of companies which provide fingerprick kits which can be done at home & posted. Results then available online usually within a few days. It’s possible to order kit and send back in time for appointment. Best to send early in week with postal delays some companies delay posting samples back until 4th Jan. I recently sent a sample and had results 2 days later.

[Minnie43 in reply to PurpleNails]

Ok thank you will look into that x

[Minnie43 in reply to PurpleNails]

Have just ordered

[PurpleNails Administrator in reply to Minnie43]

When you test, do 1st thing in morning & delay dose until after. Try and watch videos and read posts on tips how best to obtain sample. Read instruction at least 2x if not more. Be super prepared.

Drink lots of water in the two days before taking sample. Side of finger often works better than tip.

This post has good replies

healthunlocked.com/thyroidu...

[Minnie43 in reply to PurpleNails]

Ok thanks for that hopefully get it all done and results before my appointment

[DippyDame]

It's possible that your T4 to T3 conversion is poor....hence high FT4You really need to have FT3 tested too...if this is low then conversion is compromised.

Important that you have vit D, vit B12, folate, ferritin and antibodies TPO and TG.

Your high FT4 is causing low TSH...that's just how the body works.

TSH, a pituitary hormone, responds to the level of thyroid hormones in the blood

High hormones = low TSH

Low hormones = high TSH

The bottom line is, "how do you feel?"

If you have no symptoms you might just want to maintain the status quo

Otherwise, follow advice about optimising nutrients and consider a full thyroid test which will throw light on what needs attention.

Many of us have private tests in order to obtain the full range of results

thyroiduk.org/help-and-supp...

Listen to your body it will tell you if something is wrong.

[Minnie43 in reply to DippyDame]

I haven't felt right for a few months that's why I asked to have bloods done can't sleep anxiety and just not goodI have booked to go see a endo on 8th Jan as my gp just wants to put me on antidepressants and I think it's more to do with my thyroid he has said to reduce levothyroxine to 100mg but not much else

[Mountaineer67 in reply to Minnie43]

Hi It may also be worth a conversation about HRT, unless you are already using it, as the anxiety/ depression and general grotty feelings can also be due to menopause - anti depressants won't help

[Minnie43 in reply to Mountaineer67]

Hi pretty sure the menopause has finished for me but could be something to ask to check thank you 😊

[Mountaineer67 in reply to Minnie43]

Have a read of Dr Louise Newson on Insta or her Balance app - lots of discussion about symptoms & benefits after menopause has happened.

[Minnie43 in reply to Mountaineer67]

Thank you I will definitely look at that 😊