help with interpreting results please

[minniemousetheelder]

Collected: 28 Sep 2022

Received: 28 Sep 2022

Provider Sample ID: 221907175

Pathology Investigations

Serum free triiodothyronine level 3.8 pmol/L [3.1 - 6.8]

Serum free T4 level 16.5 pmol/L [12.0 - 22.0]

Serum TSH level 4.07 mIU/L [0.3 - 5.0]

my levothyroxine has been increased to 125mcg from 100mcg

i have never had my antibodies done as my surgery keeps saying its unnecessary

i also have hyperparathyroidism with raised parathyroid hormone of 15.5

and raised calcium which gave this diagnosis.

i would like to understand free t3 and t4 levels and relevance to my tsh level

my protein and albumin levels have been low too.

[minniemousetheelder]

Collected: 22 Jun 2022

Received: 22 Jun 2022

Provider Sample ID: 221587287

Pathology Investigations

Serum vitamin B12 level 416 ng/l [200.0 - 960.0]

Serum ferritin level 57 ng/ml [20.0 - 350.0]

Serum folate level 13.5 ng/ml [3.0 - 18.0]

i have added my vitamin levels taken 4 months ago

[greygoose]

Hi minniemousetheelder, welcome to the forum.

Serum free triiodothyronine level 3.8 pmol/L [3.1 - 6.8]

Serum free T4 level 16.5 pmol/L [12.0 - 22.0]

Serum TSH level 4.07 mIU/L [0.3 - 5.0]

Difficult to interpret your results because we don't know anything about you. We don't know if you have already had a diagnosis of hypothyroidism, or if you are already on thyroid hormone replacement, and how much. And, these things would affect how we interpret your results.

All I can tell you is that your TSH is too high. A perfectly normal (euthyroid) TSH would be around 1, never over 2, and when it reaches 3 you are hypo.

So, if you have already been diagnosed as hypo, and are taking levo (T4) then you are under-medicated.

If you don't yet have a diagnosis, you're not likely to get one with these results, I'm afraid, because although your TSH is saying that technically you are hypo, the NHS likes it to go over 10 before it will diagnose hypo. (Unless, of course, you have high antibodies. Have you had your antibodies tested?)

i would like to understand free t3 and t4 levels and relevance to my tsh level

However, this I can explain:

TSH - Thyroid Stimulating Hormone - is a pituitary hormone. When the pituitary senses that there's not enough thyroid hormone in the blood, it releases TSH to stimulate the thyroid to make more. When it is satisfied that there's enough thyroid hormone in the blood, it reduces production of TSH.

T4 is basically a thyroid storage hormone. It doesn't do much until it is converted into the active hormone, T3. The thyroid produces mainly T4 - when it is working correctly - and just a little T3. The bulk of your T3 comes from conversion of T3 to T4.

[SlowDragon Administrator]

What’s happening about hyperparathyroid

You need vitamin D tested too

Have you had ultrasound scan and scheduled for surgery?

Very informative website on parathyroid

parathyroid.com/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

With high parathyroid levels do NOT supplement vitamin D

[SlowDragon Administrator]

which brand of levothyroxine are you currently taking for 100mcg brand

Get same brand levothyroxine for 25mcg

suggest you get FULL thyroid including thyroid antibodies tested in 6-8 weeks

medichecks.com/products/thy...

thyroid blood tests early morning, ideally just before 9am and 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...

Only do private testing early Monday or Tuesday morning. Watch out for postal strikes, probably want to pay for guaranteed 24 hours delivery