I’m totally confused by my test results. I’ve been hypothyroid for 3 decades but in the last 6 months I’ve put on 22lbs and I can’t stop crying. My endocrinologist says I’m now hyperthyroid but I have all the classic hypo symptoms. I really don’t understand. Can anyone help?
TSH 0.096 ( reference range 0.270-4.2)
T3 Free 2.84 (reference range 2.00-4.40)
T4 Free 0.986 (reference range 0.930-1.700)
TPO 23.9 (reference range 0.0-9.0)
Ferritin 23.1 (reference range 11.0-306.8)
Folate 9.8 (reference range 4.8-37.3)
B12 526 (reference range 180-914)
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Light202
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What you need is an endoectomy. This one doesn't know what he's talking about!
For a start, if you are hypo, you cannot suddenly become hyper. It doesn't work like that. A thyroid that has been under-producing for 30 years cannot suddenly start over-producing hormone.
You could be over-medicated, but hardly likely with results like yours:
T3 Free 2.84 (2.00-4.40) 35%
T4 Free 0.986 (0.930-1.700) 7.27%
You're only over-medicated if your FT3 is well over-range. And, whilst I think you've got your numbers muddled, neither of your Frees is anywhere near over-range.
(It would be unusual to see an FT3 range wider than an FT4 range, so maybe check that. I think the FT4 range must be 2-4.4 and FT3 0.930-1.7)
And your symptoms suggest under-medication, not over. I think your endo is only looking at the TSH, which is very much the wrong way to treat a hypo patient. Espceially as you have Hashi's, which is probably why your TSH does not concur with your Free results - it should be higher. But, with Hashi's, levels tend to fluctuate, and the TSH often takes a while to catch up.
Your ferritin is much too low, which will also be causing you symptoms. Your endo should be doing a full iron panel.
Whatever you do, do not allow him to reduce your dose of whatever it is you're taking. You are already grossly under-medicated. Reducing the dose will make you very ill.
Thank you for the information. I feel much better already. The doctor is making me feel like I’m losing my mind and making things up. I checked my test results and the ranges are correct for the FT3 and FT4. I’m living in America so perhaps that explains it 😂
Oh yes, they do that! And the reason they do it is because they are totally out of their depth and don't want you to see it. So, they cover up their inadequacy by blaming the patient.
No, living in the US doesn't explain those weird results/ranges. Unless you are taking T3 - and you haven't said what you are taking - it would be strange for the FT3 to be 35% and the FT4 to be only 7.27%. It's usually the other way round.
How did you get your results? Verbally or a print-out, or scribbled on a piece of paper?
You need your dose restored and this endocrinologist is wrong, you know s/he is wrong as you know your body better than anybody else.
The TSH was originally introduced as a diagnostic tool to help identify a person suffering with hypothyroidism and was never intended to be used as a measure of anything once the patient was on any form of thyroid hormone replacement as then you must be dose and monitored on the Free T3 and Free T4 blood test readings.
We generally feel at our best when both these vital hormones are balanced at around a 1/4 ratio T3/T4 and when the T4 is up in the top quadrant of the ranges as this should convert to a good level of T3.
No thyroid hormone replacement works well if your core strength vitamins and minerals are not maintained at optimal and it looks as though you need to restore a couple, if not more, of these -
Ferritin is well documented to need to be at least over 70 for T4 - Levothyroxine to work well and convert in the body and if it's of any help I know now that I feel at my best with a ferritin at around 100 : folate 20 : serum B12 500 ++ and vitamin D around 100.
Yes I was in a similar situation being dosed and monitored on a TSH - and became very unwell - read up, especially on here, as some days every other post is another person in a very similar position.
The TSH yearly thyroid function test in primary care is usually just a TSH so the issue of poor thyroid health is endemic throughout the whole medical profession and why we end up here looking for help and advice.
But you would have thought an endocrinologist knew better, though s/he was probably a diabetes specialist.
You might like to register on the Thyroid UK as they are the charity who support this forum and where you can read freely of all things thyroid and they also hold a patient to patient list of recommended endos and specialist who actually know how to read a thyroid blood test properly !!!
In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency
Look at increasing iron rich foods in diet
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Thyroid disease is as much about optimising vitamins as thyroid hormones
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron
Thanks pennyannie and SlowDragon for the advice.I live in Florida (born in Wales) and I think the whole medical system here is just a money making machine. Much worse than in Britain.
I am 55 and I multi dose. 65mg of T3 in the morning and afternoon and 25mg T4 before bed.
I have already booked a full iron panel for tomorrow. My endocrinologist knows nothing of this. She’s on holiday for the next 3 weeks. I’m trying to get as much information together before I see her in August.
I was also thinking about the whole leaky gut issue too, which would fit in with the malabsorption of nutrients. I don’t know if you have any thoughts about this.
2 doses of T31 25mcg dose of levothyroxine before bed
I followed all the rules posted by members before the blood tests. So that was vital information. I didn’t know about not taking the levothyroxine 24 hours before or the T3 8 hours before blood tests. Plus taking tests before 9am. I’m just grateful that I came upon this forum and I’m now getting information and support.
the term 'Hyperthyroid' really means 'your own thyroid is producing too much thyroid hormone (T4/T3) continuously'
'Hyperthyroid' is when someone who is not taking any thyroid hormone has a high T4 and /or T3 .... and as a result of the high levels of T4/T3, their TSH goes low .
'overmedicated' means a hypothyroid patient who is taking a bit too much thyroid hormone.
Some doctors/ endo's use the term 'hyperthyroid' for both situations ,which confuses people.
It would be have been less confusing if your endo said "i think you are overmedicated because your TSH is below range"
As to whether or not you are actually overmedicated ?, well... if you were overmedicated , you would expect to see high ish T4 and/ or T3 levels ...but yours are not even remotely high.
And also you would expect to have some symptoms of overmedication ,( which are pretty much the same as hyperthyroid symptoms)
But because Endo's are taught 'that TSH tells them everything', they often look only at the TSH and believe you are overmedicated if your TSH goes below range , (even if your T4/ T3 are in range, and you don't have any symptoms of too much T4/T3)
But on here , we see that very often when people take T3 , it lowers their TSH disproportionately, so they can have below range TSH even though they are not overmedicated ....... leading to differences of opinion with those Endo's /Gp's who only look at TSH and don't look at T4/T3 levels .
So your Endo thinks you are overmedicated due to your low TSH, but your T4/T3 levels ,and your symptoms say you are not .
Ask you Endo to think about how you could possibly be overmedicated with these lowish T4/T3 levels :
Thanks great information. I’ll have to really think about what I want to say and ask the doctor. If I don’t get it right then she’ll go defensive and will not be open to having a conversation.
Ferritin 23.1 (reference range 11.0-306.8)4% through range
Folate 9.8 (reference range 4.8-37.3) 15% through range
B12 526 (reference range 180-914) 46% through range
...
Your ferritin (iron stores) is diabolical. Any one who is hypothyroid needs really good levels of ferritin - usually around mid-range or a little bit over. With the range you've given, you should be aiming for roughly 160 - 220. We always suggest that people should get an iron panel before taking iron supplements and should also repeat the iron panel every so often while taking iron supplements because taking excessive amounts is poisonous and the body can't get rid of it easily.
Your folate is too low as well. Optimal for folate is upper half of the reference range i.e. approximately 21 - 37.
The best supplement for raising folate is methylfolate. I've just checked and it is available on US Amazon.
...
Your B12 could be better. Optimal varies according to what you read :
1) Above 500
2) Upper half of the range
3) Top of range
4) Around 1000
The best supplement for raising B12 is methylcobalamin, which is also available from US Amazon.
...
The best way of improving B Vitamins is to take ALL the following, at least for a while.
B Complex
Methylcobalamin
Methylfolate
Once B12 is optimal drop the methylcobalamin.
Once folate is optimal drop the methylfolate.
Continue taking the B Complex permanently.
One of the best B Complex supplements is Thorne Research Basic B. It doesn't contain excessive amounts of anything, and the ingredients are in the best form for people to absorb.
I was also thinking about the whole leaky gut issue too, which would fit in with the malabsorption of nutrients. I don’t know if you have any thoughts about this.
One of the effects of hypothyroidism is to reduce the production of stomach acid. This leads to all sorts of problems with gut health, but also low stomach acid reduces extraction of nutrients from food and also reduces absorption of nutrients. This is why so many of us end up with such low levels of vitamins and minerals and why so many of us are on loads of supplements.
Thanks for all the information. I’ve put in a order on Amazon.I think that apple cider vinegar is good for low stomach acid. I haven’t taken it for years but I’ll try that too!
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