help/advice re blood results please : hi could I... - Thyroid UK

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help/advice re blood results please

Conor747 profile image
10 Replies

hi could I please get your feedback on the following blood test results it’s for my son who is on t4 replacement due to a pituitary cyst

free t3 range 3.1 -6.8

Result 3.4

Free t4 range 12.0-22

Result 16.8

tsh range 0.27-4.20

Result .51

iron range 5.8-34.5

Result 14.3

Thanking you in anticipation

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Conor747 profile image
Conor747
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SlowDragon profile image
SlowDragonAdministrator

presumably it’s your son who’s 21?

How does he feel?

On going symptoms?

How much levothyroxine is he currently taking

Does he always get same brand levothyroxine at each prescription

Was test done early morning, ideally around 9am and last dose levothyroxine 24 hours before test

When were vitamin D, folate, B12 and ferritin levels tested

What vitamin supplements is he currently taking

Has he had testosterone levels tested

Or cortisol and DHEA

PurpleNails profile image
PurpleNailsAdministrator

How much levo does he take? 

Does he feel well? 

FT3 very low.  Conversion poor. - likely causing higher cholesterol.  

Levo increase will likely lower TSH below range, so doctor will be reluctant - but push for a 25mcg daily increase as there is lots of room to increase before it goes over range.  

Can he have Folate, ferritin, B12 & vitamin D?  working of getting these optimal will help FT4:FT3. 

Conor747 profile image
Conor747 in reply to PurpleNails

hi thank you very much for responding Thank you for your comment re cholesterol as he had a reading of HDl 1.52 and LDL 3.28 in March 22 I’m am concerned about the LDL It’s good to know that there is room for a t 4 increase but endo won’t recognise or acknowledge link between thyroid and cholesterol which is worrying. His blood results on t 3 and t 4 have been slowly decreasing per the last 2 years. I don’t think he looks as well as he did two years ago but he is putting it down to busy schedule etc which he does have. He is not taking any iron or vitamins just now

PurpleNails profile image
PurpleNailsAdministrator in reply to Conor747

I omitted the word “tested” from the nutrient list. Best to test first and see what is needed & what level of supplementation.

There guidance that any treatment of high cholesterol should be delayed until thyroid issues are resolved. Doctor should really be aware of connection.

Conor747 profile image
Conor747 in reply to PurpleNails

hi sorry should add he is currently taking 100 mg levo reduced to 75 on sat and sun

SlowDragon profile image
SlowDragonAdministrator in reply to Conor747

Assuming test was done early morning and last dose levothyroxine 24 hours before test

FT4: 16.8 pmol/l (Range 12 - 22)

Ft4 is only 48.00% through range

FT3: 3.4 pmol/l (Range 3.1 - 6.8)

Ft3 is only 8.11% through range

The LAST thing he needs is dose reduction in levothyroxine

Most people when adequately treated will have Ft3 at least 50-60% through range

Approx how much does he weigh in kilo

Guidelines on dose levothyroxine by weight is approx 1.6mcg per kilo per day

Some people need higher dose.

ESSENTIAL To regularly retest vitamin D, folate, ferritin and B12

Many (most?) on levothyroxine need to supplement vitamin D and vitamin B complex continuously to maintain optimal vitamin levels

Test FIRST before starting any supplements

For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) we must have OPTIMAL vitamin levels

Low Ft3 results in low vitamin levels and higher cholesterol levels

Are you in NI or Republic for organising your own private testing

Conor747 profile image
Conor747 in reply to SlowDragon

thank you so much for your details reply and for working out the percentages I had already used the calculator thanks to this group but didn’t know how to interpret them I have the FT3 bloods results over the last 3/4 years which clearly shows to slow decline to his t3 range so hopefully endo will listen to us this time We are in the republic and have private health insurance but here it is very hard to find a good endo here. The last consultation I asked him about the thyroid /cholesterol connection and to my dismay he discounted it completely made me feel extremely inferior and asked me did I get info from dr Google so obviously not happy with endo. Maybe he will listen to us this time hopefully. My son weighs 68 kilograms I will certainly take your advice re vitamins etc and thank you so much for your advice again

SlowDragon profile image
SlowDragonAdministrator in reply to Conor747

68 kilo x 1.6mcg per kilo = approx 108.8mcg levothyroxine per day

approx 760mcg per week

So that might work out at 112.5mcg per day 5 days week and 100mcg 2 days per week

Obviously everyone is different

But a young active bloke likely to need at least guideline dose ….possibly higher

Next step is to get vitamins tested

Via GP or privately

Let’s get checked operate in RoI

Only do private testing Monday or Tuesday morning

Post back straight away

letsgetchecked.ie/home-esse...

SlowDragon profile image
SlowDragonAdministrator in reply to Conor747

vast majority of endocrinologists are diabetes specialists and useless for thyroid

Blue horizon also in RoI

Not currently taking orders until December

This is the one most members use in U.K. Blue horizon

Thyroid and all four vitamins

privatebloodtests.ie/produc...

Iron and ferritin test

privatebloodtests.ie/collec...

SlowDragon profile image
SlowDragonAdministrator

it’s the levels of Ft4 and Ft3 that are important

Not the TSH

nhs.uk/conditions/statins/c...

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

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