Help with Latest blood test results

[LilyBloom]

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First time ever challenged with Hyperthyroid 6th of June with all the symptoms possible

TSH 0.01 (0.30-4.20)

T4 55.1 (12-22)

not tested T3

30mg carbimazole for 3 weeks

4th July test

TSH same 0.01

T4 42

T3 11.9 (3.1-6.8)

20mg carbimazole 3 weeks

27th July test

TSH same 0.01

T4 8.2

T3 2.8

Still no endo appointment to test if I have Graves or a nodule.

Endo on the phone communicates with GP

Advise "stop carbimazole for 5 days then start on 5 mg.

Latest test results on 17th August

TSH 0.31 (0.31-4.20) moving up which is good as I understand this one can be slow to get moving

T4 6.8 (12-22) still moving down. But is it because is getting converted to T3?

T3 3.3 (3.1-6.8) on a rise. Which is a good sign?

I am on 5 mg carbimazole. Calling now directly the endocrinologist department to actively move my appointment forward as they said this to my GP by seeing how quickly my T4 and T3 dropped in 3 weeks on 20mg carbimazole.

I am urging my GP and putting pressure on endo to test me for Graves so I know I am on the right diagnosis. They still assume I have Graves!

Anyone can shine their experienced light on this test results and movements.

I understand I have to watch that this might be Hashimoto, as sometimes the swing from hyper to hypo happens until it goes steady in to hypo.

TPO on 4th July was 130 (0-34)

Tgab normal

Thyroglobulin high 301 (0-01)

Not tested these again

Many thank yous

[PurpleNails Administrator]

The aim is for both FT4 & FT3 to be in range.

Your FT4 is -52% of range and FT3 is only 5.41% into range. You likely have many hypothyroid symptoms with current results?

So conversion isn’t your problem.

You can only really assess conversion until FT4 is good in range, for those tackling hyper FT3 is often disproportionately high.

There no predicting how FT4 & FT3 balance once they are allowed to rise.

5mg may still be too much, but again there is no certainty. When are you due a retest?

After 6 weeks on 5mg you’ll be able to gauge next step. If still low - look to stop or it might be right dose to keep you stable.

I suspect you will need to stop, and still monitor.

Push for TSI or TRab test.

[LilyBloom in reply to PurpleNails]

Thank you PurpleNails for your swift reply. Yes I have all the hypothyroid symptoms. Tired, sluggish, putting on weight steadily, which is good after loosing too much on hyper which is not good for me. But of course there is a limit to the extra weight I feel good with carrying. Had to push harder yesterday as symptoms are obvious.

No booked date for next blood test.

Should be due on end of September when my original endocrinologist appointment is.

My GP is on holiday but arranged a call with her on Monday so I can get the next blood tests done on time.

I feel that I should stop carbimazole as you suggest, especially as I feel so tired, sluggish and bloated really. Sleeping enough but not feeling rested vs hyper not being able to sleep. Even my resting BPM is often in the 50s now.

[PurpleNails Administrator in reply to LilyBloom]

Did you feel any improvement when you stopped for 1 week?

It’s difficult because todays dose will not correlate with today symptoms. It’s reduces production of new hormones and does not immediately alter hormone stores - that outcome is shown later.

[LilyBloom in reply to PurpleNails]

I felt better even before I stopped for a week as I already reduced to 5mg talking to my GP. Then Endo spoke to GP suggesting to stop 5 days and start again and that they will move my appointment for earlier. Shortly after that week of not taking carb I noticed lowering of mood and energy. It’s really difficult to except this pendulum swinging today. I stopped for 5 days on 5th of August till 10th. It’s 3 weeks back on 5mg