Thyroid results

[Starmen]

I have just seen my results from the blood test I did this morning on the NHS app.

Serum T4 16.6pmol/L. Range 11.5- 22.7

TSH 0.26miu/L. Range 0.34- 5.44

I have had a message from surgery asking me to phone to discuss I also have an endo appointment next week.

I have been feeling much better on my increase of medication from 75mcg to 100mcg but not as well as I have been in the past. I followed guidance from here before the tests this morning nothing to eat or drink and last thyroxine 24 hours before . Also stopped the Thorne Basic B complex 7 days ago which I will take again from today.

I have noticed in the last few days feeling more tired and some palpatations which had stopped previously. Could this be down to stoping the the Basic B?

The readings have not changed much since my last posted readings in November . The GP thought I was over medicated however i told her I had felt better she agreed not to change anything until after this blood test. Any advice about the results would be appreciated.

Thank you.

[SeasideSusie Remembering]

Starmen

TSH 0.26miu/L. Range 0.34- 5.44

I think your GP will want to discuss this, will tell you as it's below range you are overmedicated, which is probably what happened previously when your GP thought you were overmedicated.

Your FT4 is 45.54% through range so not even half way through range. Even though your FT3 hasn't been tested (and it's over range FT3 that tells us that we're overmedicated) with FT4 that low your FT3 is going to be low as well. You'll have to convince your GP that you're not overmedicated and that may not be easy because all they seem to do is look at the TSH and nothing else.

If this is what happens you can try using the following information to show that you're not overmedicated, if anything you need an increase in your dose of Levo to bring your FT4 up the range more:

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the professional magazine for doctors):

"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).*"

*He confirmed, during a talk he gave to The Thyroid Trust, that this applies to Free T3 as well as Total T3 and this is when on Levo only. You can hear this at 1 hour 19 mins to 1 hour 21 minutes in this video of that talk youtu.be/HYhYAVyKzhw(Not working as expected?)

You can obtain a copy of the article by emailing ThyroidUK:

[e-mail]

print it and highlight question 6 to show your doctor.

[Starmen in reply to SeasideSusie]

Thank you so much for this. I will e mail for the article. Last month she did agree not to decrease medication because I said I felt better and am seeing the endo soon.Any idea if leaving off the Basic B complex could have increase the fatigue palpatations and hissing in ears? That had also improved until a week ago.

[SeasideSusie Remembering in reply to Starmen]

Sorry, no idea if leaving off the B Complex has affected you in any way, I've been off mine for a week due to testing and not experienced any changes but we're all different. Palpitations and fatigue are hypothyroid symptoms, I'm guessing they might be caused by undermedication as your FT4 is low and your FT3 is very likely to be to.

[Starmen in reply to SeasideSusie]

Ok thank you .

[Starmen in reply to SeasideSusie]

I had consultation with GP yesterday afternoon and to my surprise agreed to leave my medication as it is until I see the endcronologist next week. She also said that I might need something added but she said the endocrinologist will make that decision. At least she seemed to think something is not right !