Advice on blood test results : Good morning This... - Thyroid UK

Thyroid UK

141,182 members166,423 posts

Advice on blood test results

Wednesdaystar22 profile image
16 Replies

Good morning

This is my first post. I’m hypothyroid, diagnosed 2003 with symptoms much worse since menopause and since thyroxine reduced from 100mcg to 75 mcg because results in ‘normal’ range. Only ever had TSH test. My GP was unhelpful. I’m seeing a private doctor later this week. My private blood test results are:

TSH 2.24 (0.27-4.2)

Free T3 3.78 (3.1-6.8)

Free thyroxine 18.5 (12-22)

Thyroglobulin antibodies 24 (<115)

Thyroid Peroxidase antibodies 264 (<34)

The accompanying doctor letter suggests this result just needs annual monitoring but my symptoms are pretty awful.

Any advice or feedback would be much appreciated.

Many thanks.

Written by
Wednesdaystar22 profile image
Wednesdaystar22
To view profiles and participate in discussions please or .
Read more about...
16 Replies
shaws profile image
shawsAdministrator

Welcome to our forum and I am sorry you have hypothyroidism. It is also pitiful that few GPs seem to know how best to treat patients who have ths condition.

I believe GPs must have had no training on anything to do with dysfunctional thyroid glands. (as I have had the most ridiculous comments from GPs and having to diagnose myself).

A GP failed to understand what a TSH of 100 meant (I can tell you I felt so very unwell) and like many on the forum who had never heard of 'thyroid hormones' but neither did the many private doctors I consulted.

Your FT3 is near the bottom of the range when it should be towards the upper part of the range.

TSH - the aim is a TSH of around 1 or lower. You need an increase in dose.

You can help reduce the antibodies (which means you have hashimoto's) by going gluten-free.

todaysdietitian.com/newarch...

niddk.nih.gov/health-inform...

Wednesdaystar22 profile image
Wednesdaystar22 in reply toshaws

Hi shaws, thanks so much for your reply, much appreciated. I will attend my private doctor appointment armed with more knowledge now. Looking forward to reading the links as well. Wish I’d found this forum sooner! Thanks again.

greygoose profile image
greygoose

Hi Wednesdaystar, welcome to the forum.

I take it you know that you have Autoimmune Thyroiditis - aka Hashi's - and how it works? And, your main problem is that, like a lot of Hashi's people, you do not convert T4 to T3 very well.

T4 is basically the thyroid storage hormone, which doesn't do much until it is converted into the active hormone, T3. It is low T3 that causes symptoms when it's too low. Yours if very low, so not surprising you have symptoms. So, what you need is some T3 addad to a reduced dose of levo (T4) to make you well.

Not all doctors - not even endos - understand that, because they have all been very poorly educated in thyroid problems. So, it is often a struggle to get our problems recognised and treated. I hope your private doctor is one of the more knowledgeable kind. Let us know how you get on. :)

Wednesdaystar22 profile image
Wednesdaystar22 in reply togreygoose

Thank you greygoose. No I didn’t know I have hashimotos. Thanks for spelling it out. And explaining about T3. I’m getting quite nervous about the doc appointment on Thursday. Yes will report back. Thanks for your reply :-)

greygoose profile image
greygoose in reply toWednesdaystar22

You're welcome. :) Good luck!

pennyannie profile image
pennyannie

Hello Wednesdaystar and welcome to the forum:

Once on any form of thyroid hormone replacement the TSH is the least reliable measure of anything as we should all be monitored and dosed by looking at a TSH, in conjunction with the T3 and T4 levels, and with the T3 being the most important reading of all these 3 results.

Once on any form of thyroid hormone replacement we generally feel at our best when our T3 and T4 are in, or towards the top quadrant of the ranges at around a 1/4 ratio T3/T4 and this in turn should reflect in a low TSH of at least under 2 and probably more likely under 1.

T4 is a storage hormone and needs to be converted by your body into T3 the active hormone that runs the body and it said to be around 4 times more powerful than T4 with most people needing to convert and find around 50 T3 daily, just to function.

Your own ability to convert T4 into T3 can be compromised by low levels of vitamins and minerals, especially those of ferritin, folate, B12 and vitamin D and other contributing factors can be inflammation ( CRP ) , any physiological stress ( emotional or physical ) , depression, dieting and ageing.

The accepted level of conversion when on T4 monotherapy is said to be 1 / 3.50 - 4.50 - T3/T4 - with most people feeling at their best when they come in at around 4 or under.

So to find your conversion ratio when on Levothyroxine you simply divide your T3 into your T4 and I'm getting yours coming in at around 4.90 showing your conversion struggling and wide of the centre.

Did you happen to run the ferritin, folate, B12 an vitamin D in the above test and do you have a result and range also for inflammation, probably shown as CRP ?

As you have over range TPO antibodies were you aware that you have Hashimoto's which is an auto immune thyroid disease ?

Wednesdaystar22 profile image
Wednesdaystar22 in reply topennyannie

Hi pennyannie No I didn’t run the extra tests. Will look into that. Thanks for explaining everything. No didn’t realise I am hashimotos :-0

pennyannie profile image
pennyannie in reply toWednesdaystar22

I'm sorry you weren't aware of this so if you want to read further Thyroid UK - the charity who support this forum has more details on all things thyroid and a very good first base to work out from as you learn how you can help yourself.

Thyroid UK - thyroiduk.org

pennyannie profile image
pennyannie in reply toWednesdaystar22

So briefly with Hashimoto's it expresses itself with erratic ' swings ' in thyroid hormone production and you can experience short term ' hyper ' type symptoms, quite similar to those of the menopause.

When this swing swings back you are left feeling more hypothyroid than you were before as the thyroid gland is further disabled and you will be more reliant on more thyroid hormone replacement than previously once your thyroid levels level off again.

I would imagine this was likely the cause of your dose reduction as your hormone levels would have been a reflection from a recent attack from your AI disease and your thyroid levels all over the place.

Hashimoto's was probably the cause of your starting Levothyroxine in 2003 though likely you were not told, as the treatment is the same anyway and likely the menopause has triggered this AI disease and caused your continuing symptoms.

Hope that helps a bit :

Wishing you good appointment and keep us in the loop if you wish - just start a new post with new information and any updates.

tattybogle profile image
tattybogle

"and since thyroxine reduced from 100mcg to 75 mcg because results in ‘normal’ range"

what were the results that led to the dose reduction ?

Dose should not be reduced due to TSH being 'in the normal range'

Dose should only be reduced due to symptoms that suggest overmedication or (arguably ) blood results that are outside the 'normal' range.

Wednesdaystar22 profile image
Wednesdaystar22 in reply totattybogle

Hi tattybogle, thanks for your reply. I can’t remember the previous results but I think they were just under the range and the word suppressed was used.

tattybogle profile image
tattybogle in reply toWednesdaystar22

'supressed' refers to TSH (Thyroid Stimulating Hormone) test. This is the signal from your pituitary to your thyroid asking for more or less T4/T3 to be made. High TSH means 'make more please'

Lowish TSH around 1 means 'that's the right amount to make'.

Fully Supressed TSH like ' 0 ' means 'stop making anymore, we got a bit too much'

However once we are taking Levo the same rules don't always apply, some of us only feel well when our TSH is lower than our GP is comfortable with. but they reduce dose as they are worried about out hearts and bones... often unnecessarily.. but that is what they were taught.

If you stay on just Levo. It's possible you could find a happy medium that makes you feel better than you do now ,but doesn't lower TSH so much that it freaks the GP out by having a dose of Levo half way between 75mcg and 100mcg. (GP's often prescribe 87.5mcg by giving 75mcg /100mcg on alternate days)

The term 'supressed' could be used (incorrectly) to mean your TSH was only just below range 0.25 [0.27-4.2] or it might mean it was really supressed ie. so low the machine couldn't measure it eg. <0.002

My brain has faded for the evening .. but my reply to this post: (3rd reply down)

healthunlocked.com/thyroidu... and the other links in it might be useful reading before your appointment .. on the subject of low TSH /risk /quality of life .

Wednesdaystar22 profile image
Wednesdaystar22 in reply totattybogle

I am waiting for access to my medical records and test results so I can find out previous levels. Thanks for the advice and links, much appreciated.

SlowDragon profile image
SlowDragonAdministrator

What were your results that prompted dose reduction

Your results show you are currently under medicated

Most people when adequately treated will have Ft3 at least 50-60% through range

ALWAYS test thyroid levels early morning, ideally before 9am and last dose levothyroxine 24 hours before test

Is this how you did your test

This gives highest TSH and lowest Ft4

Which brand of levothyroxine are you currently taking

Many people find different brands are not interchangeable

High thyroid antibodies confirms autoimmune thyroid disease

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 autoimmune thyroid disease and low vitamin levels are particularly common

Vitamin levels also frequently drop when dose levothyroxine is inappropriately reduced

Absolutely essential to regularly retest vitamin D, folate, ferritin and B12

What vitamin supplements are you currently taking

When were vitamin levels last tested

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

List of hypothyroid symptoms

thyroiduk.org/if-you-are-un...

SlowDragon profile image
SlowDragonAdministrator

FT4: 18.5 pmol/l (Range 12 - 22)

Ft4 65.00% through range

FT3: 3.78 pmol/l (Range 3.1 - 6.8)

Ft3 only 18.38% through range

Helpful calculator for working out percentage through range

thyroid.dopiaza.org

Assuming test done as advised……shows under medicated and poor conversion

Likely low vitamin levels

Have you had coeliac blood test done yet

If not GP or endocrinologist should do so

Likely to benefit from strictly gluten free diet

nice.org.uk/guidance/ng20/c...

1.1 Recognition of coeliac disease

1.1.1 Offer serological testing for coeliac disease to:

people with any of the following:

persistent unexplained abdominal or gastrointestinal symptoms

faltering growth

prolonged fatigue

unexpected weight loss

severe or persistent mouth ulcers

unexplained iron, vitamin B12 or folate deficiency

type 1 diabetes, at diagnosis

autoimmune thyroid disease, at diagnosis

irritable bowel syndrome (in adults)

first‑degree relatives of people with coeliac disease.

Wednesdaystar22 profile image
Wednesdaystar22

Thanks everyone for your replies. Very much appreciated, thank you so much 🙏 I will report back after my appointment on Thursday…. x

Not what you're looking for?

You may also like...

Test results on Levothyroxine

Hi everyone. I have been on 50mcg Levothyroxine since June 2016. I lost a lot of weight then, but...
Cepayne98 profile image

Advice on results

Hi, my blood test results are considered normal. Had one in April and one in November, with the...
QandA profile image

Blood Test Results

Hi I’m looking for advice on Medichecks blood test and recommendations, my symptoms are muscle and...
flfair profile image

Latest blood results advice please

Hi all I was diagnosed hypothyroid 8 years ago and I take thyroxine 100mcg and t3 6.5mcg, my TSH...
Bluelei profile image

Blood Test Results

Hello, I would be grateful for some advice regarding these results. The background is that my...
ValTay profile image

Moderation team

See all
Jaydee1507 profile image
Jaydee1507Administrator
PurpleNails profile image
PurpleNailsAdministrator
SlowDragon profile image
SlowDragonAdministrator

Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.

Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.