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
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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.
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.
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.
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
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 ?
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.
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.
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.
'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 .
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