Newbie needing a light shining on test results please.

[HappyBadger]

Hello, new here. Been lurking for a bit and wondered if there is anyone who could help me understand my recent bloods that just came back from Monitor my Health:

4.3 pmol/L

FT3 levels normal (normal range 3.1 - 6.8 pmol/L)

19.2 pmol/L

FT4 levels normal (normal range 12 - 22 pmol/L)

0.07 mu/L

TSH levels low (normal range 0.27 - 4.2 mU/L)

Bloods were taken 24hours after last dose of levo with no food or drink at 7:00am. Currently on 100mcg of Accord Levothyroxine .

Any help would be so appreciated

[fuchsia-pink]

Welcome to the forum.

Your results show:

TSH - suppressed - below the lower end of the lab range. This isn't anything to worry about once you are on thyroid meds - but might freak out your GP as they are trained to look only at TSH and tend to ignore everything else

Free T4 - 72% through range, which is respectable but there's room for a dose increase if you're not feeling great

Free T3 - 32% through range - so lagging quite a long way behind free T4. This means you don't convert free T4 to free T3 well (neither do I) - and this matters because T3 is the active thyroid hormone needed in every cell in your body.

So I would suggest:

first, testing key nutrients - ferritin, folate, vit D and B12 - as you need these to be good anyway to get the best from your levo and your profile suggests you're not feeling great. I've managed to get the GP to do these tests, on the basis that these are recommended by Thyroid UK - but if yours can't or won't, you will see plenty of posts here about private testing

then either an increase in levo, in the hope that more T4 means more T3; or trying to get some T3 meds (liothyronine or lio) to boost the level of T3 into your system.

It's possible but tricky to get lio on the NHS as it's endo-only; and some endos don't like it because it's expensive; its short half life makes it tricky to measure and some genuinely seem not to "believe" in it - and think that those - like me- who have found it transformative are all sharing in some giant delusion

You can get a list of T3-friendly endos from Dionne at Thyroid UK - [e-mail]

Good luck x

[HappyBadger in reply to fuchsia-pink]

Wow thank you fuchsia-pink. Should my TSH be below 0.2 do you think? I’ve heard it said on her a bit. And so am I right in thinking that both FT3 and FT4 should be way up at the high end of the scale? My new doctor seems to be pretty good ( I say that while touching every piece of wood around) 😂 He tests as often as I ask him too, which is very rare, from most of the posts I’ve read. And it was under my suggestion to up to 100mcg and he didn’t bat an eye. So I think I’m going to get my bloods done again and get him to check all the vitamins you said. Thank you again ☺️

[tattybogle in reply to HappyBadger]

It's not so much that the TSH should be below 0.2 ,or that the fT4 /fT3 should be at the top end of the range. Some people will feel best with a TSH that isn't quite that low , and some people will feel overmedicated with their fT4/fT3 right up near the top of the range. So those people should not aim to get T4/T3 right at the top , and should not try to lower TSH to below 0.2 if they feel good with TSH around 1

We are very individual in where we feel best. our individual setpoints for TSH /fT4 /fT3 were personal to us when we were producing our own thyroid hormones ,, and they remain personal to us once we are taking replacement hormone.

But some people only feel well when their fT4/3 are quite high, and their TSH very low ...and if that is the case they should be allowed to do it.

Some people seem fine with fT4 fairly low as long as their fT3 is good.. but others seem to need both fairly high.

[HappyBadger in reply to tattybogle]

Thanks tattybogle, I think I need to start doing my homework ☺️ There is so much to learn about this. X