T4 21 pmol/L

[Slosh]

Hi all,

Wonder if anyone could shed some light.

Had Covid about 7 weeks ago. Since then my Mast Cell Activation has gone nuts! Reacting to everything. And down to about 10 or so foods.

When I react to a food/s or chemicals some of the symptoms are anxiety, irregular and racing heart plus low blood pressure.

My hair is falling out and I have lost about 9kg in the 7 weeks. So I was also wondering if I i am slightly over medicated. My TSH is 278 mIU/L and T4 21 pmol/L.

Whilst I had Covid I also had a heart emergency - severe arythymia with heart racing at 236 bpm and very low blood pressure. They had to reset my heart inA&E. Very traumatic.

I’ve had this happen before about a year ago (resolved before I got to A&E) - they kept me overnight. And that time they lowered my thyroid dose from 100mcg to 75mcg.

I am currently still on 75mcg. Am 65 year old female and also on Prednisolone - currently 7mg. Have been on Pred since January 2017.

Thanks xxx

[SeasideSusie Remembering]

Slosh

My TSH is 278 mIU/L and T4 21 pmol/L.

Are you sure your TSH is 278? Have you missed out a decimal point? 278 would be very hypOthyroid.

And what is the range for the FT4 result, these vary from lab to lab. With that result and the range my surgery uses of 7-17 it would be over, with the usual private lab range of 12-22 it would be almost top of range. So without the range that came with your result we can't say if you are overmedicated. But it's the FT3 result which tells us if we are overmedicated and you don't appear to have had that tested.

[Slosh in reply to SeasideSusie]

So sorry - it’s 2.78

[Slosh in reply to SeasideSusie]

I apologise -

The range for T4 is 11-22

And the TSH Range is 0.27 - 4.20

[SeasideSusie Remembering in reply to Slosh]

Slosh

So your TSH is actually out of sync with your FT4. Generally with a top of range FT4 we'd expect to see TSH low in range. However, certain things can affect TSH level and as it varies throughout the day - highest early morning and lowering during the day then beginning to rise again mid-afternoon - we need to always test at the same time to be able to get an accurate picture and compare results.

Your FT4 doesn't suggest overmedication but as mentioned you'd need FT3 tested at the same time as TSH and FT4 to know if you are overmedicated.

Also, if you took your Levo before your test this will show a false high FT4.

I imagine that Covid might be playing a part in what's going on and it may take time for things to settle. Plus being on prednisolone can affect conversion of T4 to T3 and may also affect adrenals.

When you next do a thyroid test, follow the advice we always give:

* Test no later than 9am

* Water only before the test, certain foods and drink may affect TSH level

* Last dose of Levo 24 hours before the test

* No biotin or any supplement containing biotin (eg B Complex or hair/nail supplement) for 3-7 days before the test

[Slosh in reply to SeasideSusie]

Thanks so much.

Yes filled all of that except the B Vitamin advice.

My doc has lowered my dose to 50mcg / 75mcg alternating because I have lost nearly 10% of body weight.

How would the adrenals affect all of this?

My Endo does think I have Adrenal suppression due to being on Prednisolone so long.

[SeasideSusie Remembering in reply to Slosh]

Slosh

Yes filled all of that except the B Vitamin advice.

So if you continued to take your B Complex, because it contains biotin it may well have caused a false result. See

thyroid.org/patient-thyroid...

biotin use can result in falsely high levels of T4 and T3 and falsely low levels of TSH

I think it would be best to retest leaving off your B Complex. Explain to your GP that you took your supplement containing biotin and you understand this should be left off for a few days before your test due to it possibly giving false results. I wouldn't adjust dose without having an accurate test and also ask if FT3 can be tested as well.

My Endo does think I have Adrenal suppression due to being on Prednisolone so long.

Then Endo should be testing. If adrenals are out of whack they need to be addressed so that thyroid hormone can work properly. Adrenals and thyroid work in tandem.

everydayhealth.com/thyroid-...

[Slosh in reply to SeasideSusie]

Hi Seaside Suzy - thanks for your response. Maybe I should just do a medichecks test. Doubt whether the NHS will do another test so soon.

Will lay off the B vitamin supplement.

But have lost so much weight and feel so malnourished feeling and down to about 10 foods because the Mast Cell Activation is so nuts.

I did not take my thyroid supplement yesterday and must say I felt a bit calmer - not so anxious.

[SlowDragon Administrator]

Just testing TSH and Ft4 is inadequate

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Presumably you have Hashimoto’s? Autoimmune thyroid disease

Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis. Both are autoimmune and generally called Hashimoto’s.

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended on here that all thyroid blood tests early morning, ideally before 9am last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Is this how you do your tests?

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

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

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

[Slosh in reply to SlowDragon]

Thank you so much.

Will do a medichecks test.

Just started a new diss of 50mcg / 75mcg alternating days.

How long shall Zim wait before testing?

Thanks again

[SlowDragon Administrator in reply to Slosh]

Minimum 6-8 weeks

Do private test early Monday or Tuesday morning, ideally before 9am and last dose levothyroxine 24 hours before test

Meanwhile suggest you get vitamin D, folate, ferritin and B12 tested by GP if possible

Alternatively test vitamin D now here

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

[Slosh in reply to SlowDragon]

Had Vitamin D done two weeks ago it looked fine - but was after a mega dose two weeks before.

My B12 is always super high.

Ferritin was very very high 456!

Folate in range

[SlowDragon Administrator in reply to Slosh]

High ferritin doesn’t necessarily mean high iron

High ferritin can be due to inflammation

GP should be doing full iron panel test for anaemia/hemochromatosis

[Slosh in reply to SlowDragon]

Thank you - yes full iron panel was done and it seems to be inflammation.

[SlowDragon Administrator]

Did you take levothyroxine before test

This would (falsely) give high Ft4 result

[Slosh in reply to SlowDragon]

No - 26 hours later.Saw GP today - she suspects that because of my weight loss that I am overnefivated and going

[Slosh in reply to SlowDragon]

No 26 hours after - fasting blood test at 9am. Took last dose of Levi the day before at 7am

[Momma66]

I’m in USA… but joined this group. Any advise for USA Testing kits? My provider and insurance won’t test T3 regularly and I too had Covid in December and my thyroid has been out of whack ever since. Now TSH 0.1 with elevated T4. List voice 3 1/2 weeks ago and had ultra sound 2 months ago showing “dead” thyroid gland.

[Slosh in reply to Momma66]

Oh goodness sorry to hear that. Maybe some of the more knowledgeable ones will come on and give some advice to you

[SlowDragon Administrator in reply to Momma66]

Info here

stopthethyroidmadness.com/r...