33mmol T4 :( is it dangerous?

[Bonnybairns]

Hello all, I am on 150mg thyroxine daily, I did bloods yesterday, took meds 4 hours before the test, T4 came back 33mmol. I am super anxious if its dangerously high, do i need to go to hospital? How do i dose now? Thankful for any advice!

[SeasideSusie Remembering]

Bonnybairns

You haven't given us a reference range to go with the result, as ranges vary from lab to lab we have no idea how far outside the range your result lies.

The fact that you took your Levo 4 hours before the test means that your T4 was measured at it's peak, Levo peaks 2-4 hours after ingestion so it will be a false high, but we can't tell you how high compared to your normal amount of circulating hormone. Maybe retest with the correct time gap of 24 hours to get a meaningful result.

What was your last test result on 150mcg Levo, leaving the advised 24 hour gap.

[Bonnybairns in reply to SeasideSusie]

Hello, thanks for the reply, ref range is 11 to 22mmol is "normal". T3 is okay at 5.8, for that normal range is 3.1 to 6.8. I have never left 24 hour gap and could ask for another test but until then, by how much should i reduce thyroxine dosage? Shojld i take 100 instead of 150? I am panicking im over dosing.

[SeasideSusie Remembering in reply to Bonnybairns]

Is this an unusually high result?

When did you last test before this and what was the result?

I'm trying to understand how long you've had such an over range level.

Do you have Hashi's?

Dose changes should normally be in 25mcg steps.

[Bonnybairns in reply to SeasideSusie]

In october 22.9, yes hashis, if i took 100 tomorroz and would alternate would that be ok?

[SeasideSusie Remembering in reply to Bonnybairns]

OK, so in October it was a touch over range, but now it seems as though you may be having a Hashi's hyper swing (presumably you understand what happens with Hashi's?).

What is the range for FT3?

Yes you can alternate 100/150.

[Bonnybairns in reply to SeasideSusie]

are hyper swings common? can it be life threatening? ft3 range is 3.1 to 6.8,mine is at 5.8. im panicking cant fall asleep, heart rate is 70 if i sit down to 85, 90 when i stand up.

[SeasideSusie Remembering in reply to Bonnybairns]

Don't panic.

It's not life threatening.

Your FT3 is well within range. If it was as high over range as your FT4 is over it's range you'd probably have rapid heart beat over 100, pounding heart and other "hyper" symptoms.

Normal resting heart rate for an adult is 60-100bpm, 70 sitting is not a problem and it will rise if you move/rise.

How long have you had Hashi's and have you not done any reading yourself about it? General information about Hashi's.

Hashi's is where the immune system attacks the thyroid and gradually destroys it. When the attack happens, the dying cells release a lot of thyroid hormone into the blood and this can cause TSH to become suppressed and Free T4 and Free T3 to be very high or over range. These are called 'Hashi's swings'. You may get symptoms of being overmedicated (hyper type symptoms) to go along with these results that look as though you are overmedicated. The hyper swings are temporary, and eventually things go back to normal. Test results settle back down and hypo symptoms may return. Thyroid meds can be adjusted slightly at these times if necessary, but will need readjusting when hypo symptoms return.

Unless a GP knows about Hashi's and these hyper type swings, then they panic and reduce or stop your thyroid meds.

Hashi's isn't treated, it's the resulting hypothyroidism that's treated.

Fluctuations in symptoms and test results are common with Hashi's.

Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.

Some members have found that adopting a strict gluten free diet can help, although there is no guarantee.

Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.

You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.

Gluten/thyroid connection: chriskresser.com/the-gluten...

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

thyroiduk.org.uk/tuk/about_...

Supplementing with selenium l-selenomethionine 200mcg daily is said to help reduce the antibodies, as can keeping TSH suppressed.

Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies. It's essential to test Vit D, B12, Folate and Ferritin and address any problems. You are welcome to post these results, including reference ranges (plus units of measurement for Vit D and B12), for comment and suggestions for supplementing where necessary.

[Bonnybairns]

tomorrow*

[jimh111]

T4 levels peak about two or three hours after ingestion but since we store around 10 days’ worth of thyroxine this will make little difference. Assuming your levothyroxine is prescribed by a doctor you should discuss it with them. Going by this result I would reduce your dose, at a guess to 100 or 125 mcg. Beware that two much thyroid hormone causes anxiety, so you will feel anxious because of the results but also as a consequence of being on too much hormone.

[greygoose]

How did you feel before getting these results? I can understand you feel anxious about the high FT4, but were you anxious before the test? Did you feel over-medicated?

[Bonnybairns in reply to greygoose]

No i have gained weight but not changed my low carb/low gi/gluten free diet,i eat pretty much same meals every day. I actually thought i might need to raise it i have been having fatigue spells, but now when i think at other hand, i have had regular headaches over the last few months, loose stools and while i am diagnosed witg anxiety its been really intense lately. I have read being over treated can be dangerous i wonder is 33 very high, should i be as worried as i am? has anyone else been over treated by a quite a bit?

[greygoose in reply to Bonnybairns]

Well, it is quite high. But I don't think that temporary high levels are dangerous. If it continued for a long time, maybe, But, the thing is, as you took your T4 just four hours before the blood draw, you don't really know how high it is.

You say you've always taken your levo four hours before the blood draw? What was the highest FT4 you've had before this one? And, on what dose?

[SlowDragon Administrator]

When were vitamin D, folate, ferritin and B12 last tested

What vitamin supplements are you currently taking

Low vitamin levels tend to result in poor conversion of Ft4 to Ft3. This results in higher Ft4

Dieting and low carb diet also tend to reduce conversion

Suggest you either test full thyroid and vitamins now before reducing

Or reduce levothyroxine a little. Perhaps 125mcg and 150mcg alternate days and test in 6-8 weeks

Do you always get same brand levothyroxine at each prescription

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

For full Thyroid evaluation you need TSH, FT4 and FT3 tested.

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum especially as you have Hashimoto’s

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)

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...

[Batty1]

Maybe you can pay for your own thyroid test doing it the way it was recommended here and compare… stressing just going to make you feel worse.

[kiefer]

Going to hospital is unnecessary, so is lowering your dose. You're not in any danger.

Since you took your levothyroxine 4 hours before the blood draw, you're just seeing what is known as a peak serum level of Free T4. Most likely, your FT4 level will be lower if measured approximately 24 hours prior to your next blood test.

As you may be aware, it's the Free T3 level that determines therapeutic efficacy. If you haven't experienced any symptoms of overstimulation, then certainly, your level of FT3 (you mentioned was at 5.8) is of no concern. Keep in mind that the ranges for FT3 are based on the population, rather than your own individual requirements, so you must focus on your symptoms in order to calibrate a proper level.

Monitor symptoms first, then evaluate thyroid function test results. Otherwise, you'll have to obtain a physician's license to be allowed to interpret the results bass-akwards like they do.