why do I have such results?

[adin]

Today I received the results that surprised me, I don't understand.

On about the same dose(Tirosint 125mcg +15mcgT3) a big difference in ft4 and tsh. I looked at the box and noticed that the tirosint had expired in November last year, should that be the cause?

The tests were done when I came out of the night shift, I was tired...

[SeasideSusie Remembering]

adin

Did you leave 8-12 hours between last dose of Tirosint and test on both occasions?

Do you take any supplements that contain biotin (eg B Complex) and if so did you leave it off for 3-7 days before the tests?

What do you mean by "about the same dose"? That suggests a difference.

Why are there two results/ranges? Were these done at the same time or is one a current test and one a previous test?

TSH is the same.

Ranges are different so we use percentage through range to compare:

FT3: 40.42% (29/11/21)

FT3: 39.73% (other test)

FT4: -5.19% (29/11/21)

FT4: -2.85% (other test)

So allowing for natural fluctuation and testing on different platforms there is no real difference is FT3, and FT4 is minimally different so for all intents and purposes they can be classed as the same.

the tirosint had expired in November last year, should that be the cause?

I've not used Tirosint but do use T3 and am currently using a batch that expired in January 2019 (have been for a few months) and mine hasn't lost potency.

[adin in reply to SeasideSusie]

Hi SeasideSuise, yes each time I take the levo after the tests. Yes I take some supplements that contain B12 & folate but not in everyday. "about the same dose"is mean that i take some ndt, 1/4grain and the levo+t3.The two results are;one a current test and one a previous test 11/2021( right column). The ranges are the same. Ft4 was 15 and now is below, tsh was supressed and now is 1,6. Is wird.

[SeasideSusie Remembering in reply to adin]

So what were you taking for this new test and what were you taking when the 29/11/21 test?

[adin in reply to SeasideSusie]

The dose of levo(tirosint 125 mcg) +t3 is the same in both cases, but I'm adding a little ndt now.I think maybe I shouldn't take t3 and tirosint at the same time because the excipients in the t3 tablet prevent the absorption of gel caps of tirosint. Or the expiration date is the problem. Or the fatigue accumulated from night shifts, I don't know.

[Yeswithasmile]

Hi Adin

Having read your post and Replies I just thought I’d ask you or anyone reading if they thought the difference (I accept as SeasideSusie mentioned) is minimal but, I wondered if circadian rhythm might have something to do with it? I only ask as you mention you had done a night shift and assuming this was a waking night shift? Then you had a blood test early?

Just makes me wonder if the lack of sleep and being active used up some frees? As I imagine most people have their bloods taken after sleep.

Just a thought that made me pose the question to see if others have info on that. Obviously if my assumptions are incorrect it would be appreciated if you’d say - it’s been bugging me 😊.

[adin in reply to Yeswithasmile]

Hi Yeswithasmile

as you can see(left column) I did the recent tests after I left the night shift, at 9 a.m. in the morning. In the right column are the values that I did last year.

I don't understand why the difference is minimal (ft4 now and last year).

Otherwise, I found nothing else to influence the values, only the night shifts, and the expiration date.

I take T3 in the slow release form but not with levo, at the same time. I also take Vit.d3 , iron, omega3, and silymarin but all at least 4 hours apart.

After these tests, I realize why I am swollen, puffy face...

[Yeswithasmile in reply to adin]

The ranges are different between the two tests and the measurement. SeasideSusie worked out the percentages of your ‘free’s’ within their individual ranges and that’s what she is saying you need to look at. That’s where you can see that it’s minimal change.

I just thought I throw in the circadian bit but I suppose as long as your consistent with blood tests that’s all that matters. So if you are a regular night shift worker and you do your tests after then at least you have consistent values? If that makes sense?

[adin in reply to Yeswithasmile]

I work 12 to 24 and 12 to 48 shifts so I have about one night shift per week as border customs officer.The lab works with two values ​​for which it gives two ranges. I referred in my post to the values ​​given by the laboratory in pmol/L.

So, I don't understand why for the same dose of levo in November 2021 I had ft4 15, 19 pmol/L and yesterday after night shift (when I did the test) i had ft4 11,49(below range). There is a big difference between the two and I don't know why.

[Yeswithasmile in reply to adin]

Oh I see. The figure to the far right and it’s the same range….

Well yes there is a bit of difference isn’t there? I don’t take NDT but assume that 1/4 grain wouldn’t make this difference? That’s what you have added in isn’t it?

Hopefully someone will come on and help you as I am afraid I wouldn’t want to guess at it. That’s all I’d be doing. Guessing.

One guess is tho (lol) have you swapped brands of t3? From my own experience I know that my prescription t3 is much weaker for me than the t3 I self source. Cynomel dips my ft4 more than morningside. Maybe the your t4 meds are passed their date but there are plenty on these forums that continue to use expired t4 so I wouldn’t look at that in the first instance. May I ask why you added the small amount of NDT? Have you considered than maybe that has a stronger element of t3 in it so whilst it’s a small amount maybe that’s pushing your ff4 down?

I’m sorry I’m not much use. I sympathise though and can say with that level ft4 I’d feel awful so I’m not surprised you’re suffering.