Blood results

[SamB22]

hi

So I received a call from the consultant earlier with my results. I explained that I hadn’t received appointments on 3 occasions and he told me to call the secretary and an appointment should be made.

Anyway here are my results from 6 July (which I clarified the date due to the previous mix up with another patients results on my record - that’s all sorted now 👍

So up until the 1 July I was on 10 mg carb for 8 weeks. Then from then on 5mg of carb - bloods took on 6 July and been on 5 mg for 6 days at that point.

Tsh 0.56 (0.35 - 5.5) Last bloods 0.05

T4 10. (9-23)

T3 3.7 ( 3.5 - 6.5)

Antibodies normal - that was from May he said they don’t do them all the time.

The consultant was happy and said the carb was controlling the thyroid. (Next bloods in 8 weeks). Stay on 5 mg. However close to being low so if I feel very weak, tired to go for a blood test sooner.

I forgot to ask what optimal would be - but he seemed happy and not too bothered about how I’m actually feeling as he said my thyroid is fine.

I’m hoping that the change in dose to 5mg will have prevented it going under.

Thanks as usual for all for your thoughts

Sam x

[PurpleNails Administrator]

Sorry you are having to battle to get answers & appointments. I don’t think they realise how much it add to stress. Try to remain calm & persistent with it.

I had a read of your previous post trying to understand a little about your treatment so far.

When you were first diagnosed you said your TRab was tested and it was:

1.9u/l - the range should be 1.0 -1.8.

Usually Antibodies have a 0–X range but there can sometimes be a unequivocally range. It does appear you do have antibodies positive for Graves.

Once you have had a positive result that confirms diagnosis. Levels fluctuate and do not always reflect the severity of the disease. Levels falling considered a reversal of the disease but it can indicate treatment is going in right direction.

Your TSH was supressed and FT4 31 & 40 (9-23) which was clearly high. (No FT3 tested)

You original started on 20mg carbimazole? & you were prescribed Bisoprolol then propranolol which you later stopped

After six weeks your results were:

Tsh - 0.05 m/Ul - range 0.35 - 5.5 ( unchanged)

Ft4 - 22 pmol - range 9-23 (down from 54)

Ft3 - 7.2 pmol range - 3.5-6.5 (no previous)

Was dose changed at this stage to 10mg.

You are currently on 5mg and your latest results show

Tsh 0.56 (0.35 - 5.5) Last bloods 0.05

T4 10. (9-23)

T3 3.7 ( 3.5 - 6.5)

Your FT3 & FT4 are low in range now. (TSH will have a delayed response & not reliable).

So within a few months of carbimazole 20, 10, a few days on 5mg your FT4 has gone from 54 to 10 or 321.43% of range to 7.14%. So that a huge drop in a short space of time & not on a very high dose of carbimazole.

You’re already had a recent dose reduction. So it think you need to stay steady for now and see if the reduction allow those levels to rise a little. Was the dose changed by doctors after seeing results?

Doctors think of 5mg being the lowest dose possible but It may even be necessary later on to take it every other day or split a 5mg

Making alterations to doses and testing too soon will make it more difficult to exactly predict what’s going on because it takes 8 weeks to discover how a new dose fully impacts levels. Leaving it to go too low isn’t wise either.

You can fall into a trap of associating present symptoms to recent changes when in reality the symptoms you feel now stem from adjustments from many weeks before.

Was TPO & TG antibodies tested as any stage? Antibodies can have a huge cross over. These may be very high you Trab was fractionally high.

Might be quicker and more hassle free to test privately. Do a full test before your next appointment so you have a full picture,

Working on getting nutrients optimal will also help.

Your doctor will be happy your thyroid levels & TSH is in range and to prevent it from being high them are often keen to keep it a low in range as possible this can help the TSH rise too - which make them even more happy. What they don’t recognise is low levels can make people feel unwell - like you said - he said thyroid is fine, he wasn’t bothered about how you feel.

So that is something you will have to monitor and make sure he’s not leaving you with very low levels & unwell so he has pleasing lab test results.

[SamB22 in reply to PurpleNails]

Thank you for explaining things in your reply - I didn’t know why it was 8 weeks between appointments. Yes the dosage was changed after results by doctor. TPOand TG as far as I’m concerned we’re not tested unless he just didn’t give me results for these. Thanks again x