Had an 'accident' with my Email App and deleted every, single email! Perhaps it's for the best except, the new email package also lost my email address! But all is well I hope.
I've had nothing but failure with blood tests but I had to go to A&E yesterday (I'm okay, well, we'll see) but I had a really nice doctor checking me out and after the CT scan etc, we started talking about thyroid treatment and I mentioned the problems I was having getting the right tests via my GP and she said, 'What do you need?' So I said, 'Well T3, T4, TSH and perhaps could you throw in Reverse T3 while you're at it please?'
As I'd already had blood taken, the hospital stll had it, so she made a phone to haematology? and later last night she phoned me up with the results!
Now, they're not complete because I couldn't get (or forgot to ask) reference ranges but hey, beggars can't be choosers.' and in any case, as I take my Levo at night (around 9:30pm), and the blood was taken around Noon the following day, these numbers should be okay?
So here are the magic numbers:
TSH: 0.84
T4: 12.00
T3: 3.8
I couldn't get Reverse T3 or Thyroid antibodies as that requires a separate test.
Now, I did some reading of 'Thyroid Patients Manual' and my numbers seem okay, except; I still, as ever, have ALL the symptoms of Hypothyridism regardless of what the numbers say: sensitive to the cold, brittle hair and nails, dry skin, digestion problems, 'brain fog'.
Here's the TPM numbers from the book:
TSH: 0.27 - 4.2
FT4: 12.0 - 22.0
FT3: 3.1 - 6.8
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Mlinde
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But those ranges may not match your recent test results as different labs use different ranges.
Now presuming these are FT’s and not 'totals' your recent numbers look like FT4 is very low and FT3 is just low, but without ranges its impossible to be sure. Can you not view your results on line or ring the hospital lab to find out the ranges?
Re difference between September & now’s results, TSH has reduced inline with Levo increase along with FT3 but FT4 has mysteriously reduced. This can happen when we remain under medicated.
Thyroid hormones are effected by trauma. You appear under medicated, possibly further compounded by trauma caused by your A & E admission.
I'm afraid that results without ranges are absolutely meaningless. Ranges vary from lab to lab, so we need those that belong to your lab/results.
Having said that, if the ranges were
FT4: 12.0 - 22.0
FT3: 3.1 - 6.8
(where did you get those numbers?) then you would be horribly under-medicated.
Not only that, but your FT4 would be a false 'high' because you between 9.30 pm and noon, there's only 14.5 hours, and it should be a 24 hour gap.
The exception to that is the TSH. A TSH is always a TSH no matter what the range - and they don't vary that much - but if your blood was taken at noon, it would have been at it's lowest - we always recommend having the blood draw before 9 am for that reason. So, all in all, I'm afraid those labs are virtually worthless. And, you can't compare them to the results from September 21 because I don't suppose they were done under the same conditions. And, we don't have ranges for those, either. Sorry.
There's no point in testing rT3, it doesn't give you any information that you can get from the FT4/3.
If TPO or TG thyroid antibodies are high this is usually due to Hashimoto’s (commonly known in UK as autoimmune thyroid disease). Ord’s is autoimmune without goitre.
About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s.
If you ring the hospital main switchboard and ask to be put through to blood test labs you can ask them for the ranges. They were very helpful when I did this........but I did let them asume I was a doctor! 😂
I tried a 25mcg increase of Levothyroxine for 2 days, BAD NEWS! Left me feeling very unwell and messed my stomach up! There is no way I'm increasing it! Perhaps if I cut a 25mcg in half?
You say I definately need an increase, when they're all inside the range?
Its not being in range that counts but where in the range and how you feel. Most people need their thyroid hormones to be in the top third of the ranges ft4 & ft3 and the atsh to be under 1, some need near the top if the ft4 & ft3 range. But if you feel well on your current dose then that is brilliant.
Wavy, physically, I don't feel bad but I have the same symptoms, still sensitive to the cold but not as much, but brittle, dry hair and skin and brittle nails. The problem is I don't convert T4 to T3 very well. The only thing that's not 'standard' for hypo is my weight, I still weigh the same as I did when I was a teenager (I'm now nearly 77), 62-63 kilos. I have a healthy diet, don't smoke or drink and I've given up trying to get a different treatment, life is too short!
T4: 12.0 pmol/L Range - 10 - 23 15% (reduction from previous 32%)
T3: 3.8 pmoI/L Range - 3.1 - 6.8 19% (significant increase from previous minus13%)
Previous
21 September 2021 on 100mcg
TSH: 21.30 mIU/L Range - 0.27 - 4.2
T4: 15.2 pmoI/L Range - 12 - 22 32%
T3: 2.6 pmoI/L Range - 3.1 - 6.8 minus 13% (below range)
So the increase to 125mcg has increased your fT3 significantly .. (and given your lowish fT4 level that's a 'relatively' good fT3 level, if you see what i mean... so its possible your conversion isn't as rubbish as you think ?)
the fT4 test is always influenced by how long before the test you took your last dose Levo :
latest test was Midday /levo @9.30pm .. so 14/15 hours after last dose.
What was time gap gap for previous test ?
(if the time gap isn't similar then you can't really compare the fT4 results properly.)
I only took 150mg of Levo for 2 days and reverted to 125mg and the last test was 2 days ago. The increase to 125mg was in January, I did it off my own back, I was feeling really awful, shivering, sweating. My GP concurred.
yes i realised you only tried 150 for a couple of days.. I meant "how many hours before the September blood test did you take the Last dose levo ? "perhaps you can't remember now , but if you can it helps with comparing the results.
Some people do find changing doses up / or down by 25mcgs at a time is too much .. some of us only need VERY small changes to make the difference between feeling better and feeling dreadful.
So even if you would have felt better with an increase, '25mcg every day' might have been too much. and made you feel worse ...
Having said that ....'2 days' is a very quick time to feel that much of a response ...for many people it would take more like a week to to feel the difference from an increase... but it is possible.. some of us are much more sensitive to small Levothyroxine changes than GP's think is possible.
So , if an increase is suggested in future it might be wise to do it in much smaller increments ie cut 25mcg tablet in half so you can add just an extra 12.5mcg on alternate days , and then wait several weeks on that to see how the effects settle.
The September 21 test was done according to 'the book'. At least 24 hours after last dose, first thing in the morning, no food or drink, just water, blah,blah... I can't get my GP to do a damn thing! Total, benign neglect! And yes, I am sensitive to Levo, the last time I tried upping from 100mg to 125mg I got awful heart palpations, so I reverted immediately but after a more than a 1 year of at least stability, I felt so awful I just upped it to 125mg on my own and improved immediately! I've learnt since that as you get older, the Levo loses its effectiveness.
One interesting observation following the increase to 125, I had 2 weeks of completely clear thinking! no 'brain fog' but it didn't last. So I'm at the point where I prefer to let 'sleeping dogs keep on sleeping', to paraphrase.
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