Hi there.
I finally heard from my Endo about my thyroid tests. He said to take 100 mg for 8weeks. Well I have felt awful during all this. Unable to sleep well feeling freezing cold even though it’s warm. Had IBS symptoms too. Here are results
Free T4. 24.6
TSH 0.7
Free T3 4.3
He suggests taking 100mg one day and 75mg the next.
sounds scary to me. My GP is calling later today to discuss.
Any thoughts will be appreciated
Metgirl
Please add reference ranges for your results, as these vary from lab to lab we need the ranges to be able to interpret your results and comment. At a guess I expect the FT4 is either close to the top of the range or over range and might be why a reduction in dose is suggested.
sounds scary to me.
What, exactly, sounds scary?
Hi there. Unfortunately these are the only results I was given No reference ranges just bare data.
Trying to work out what he means at mo. It feels scary to reduce my dose by so much. I previously took 125 a day.
Metgirl
Are you in the UK? If so then your surgery may offer online access to results, if so then register for it and all information will show there. If not then ask the receptionist (not the doctor) for a print out, never accept verbal or hand written results because mistakes can be made and information may be missing. The reference ranges will be alongside the results on the print out, eg
TSH: 2.5 (0.27-4.20)
Come back with the ranges so that we can help you.
Also, did you do the test as we advise:
* No later than 9am
* Nothing to eat or drink except water before the test
* Last dose of Levo 24 hours before test to avoid either a false high or false low FT4 result
* No biotin, B Complex or other supplement containing biotin for 3-7 days before the test
Hi everyone. I wasn’t told to fast or to get blood done early. Consequently it was afternoon. I took levo night before. And didn’t eat till after anyway.
I take Vitamin D3 and B12. Early morning.
I asked my GP for a printout she said she couldn’t do one. I speak t her again via phone call at 3 pm today.
I will try asking receptionist.
Thank you everyone.
I wasn’t told to fast or to get blood done early. Consequently it was afternoon. I took levo night before. And didn’t eat till after anyway.
So result is pretty useless
Free T4. 24.6
TSH 0.7
Free T3 4.3
TSH has pronounced diurnal rhythm and is highest in early morning. So testing in afternoon gives false low TSH
Last dose levothyroxine should be 24 hours before test
So you have falsely high Ft4 result
Ft3 looks likely extremely low
Results are meaningless without ranges
Suggest you refuse to reduce dose until tested correctly and got vitamin test results as well
I talked to GP yesterday and she is willing for a vitamin blood to be done Awaiting appointment now.
Thank you. I’ll try to get the results clarified. X
Hi just to add. My Endo is at Uk hospital and bloods done there. I assume the range used is whatever the UK ranges usually are if this helps. It’s first hospital tests I have had since my thyroidectomy in 2015.
I assume the range used is whatever the UK ranges usually are if this helps.
Unfortunately, no it doesn't help. There are no "UK ranges", ranges are specific to the equipment used by the lab and vary from lab to lab, hence it's essential to have the lab's ranges to be able to interpret the results.
You could contact the hospital lab and ask what the ranges are.
Was test done early morning ideally just before 9am and last dose levothyroxine 24 hours before test
Which brand of levothyroxine are you currently taking
Do you always get same brand levothyroxine at each prescription
Do you normally take levothyroxine waking or bedtime
ESSENTIAL to test vitamin D, folate, B12 and ferritin
What vitamin supplements are you currently taking
When were vitamin levels last tested
Ideally also full iron panel test if ferritin is low (below 60-70)
Looking at previous posts you had thyroidectomy ?
Approx how old are you
Pre or post menopause
You are legally entitled to printed copies of your blood test results and ranges.
The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results
UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.
Link re access
healthunlocked.com/thyroidu...
In reality many GP surgeries do not have blood test results online yet
Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.
Important to see exactly what has been tested and equally important what hasn’t been tested yet
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
For full Thyroid evaluation you need TSH, FT4 and FT3 tested.
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum…and especially after any dose reduction in levothyroxine
Recommended on here that all 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)
List of private testing options and money off codes
thyroiduk.org/getting-a-dia...
Medichecks Thyroid plus antibodies and vitamins
medichecks.com/products/adv...
Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins
bluehorizonbloodtests.co.uk...
If you can get GP to test vitamins then cheapest option for just TSH, FT4 and FT3
£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code
thyroiduk.org/getting-a-dia...
NHS easy postal kit vitamin D test £29 via
Only do private testing early Monday or Tuesday morning.
Watch out for postal strikes, probably want to pay for guaranteed 24 hours delivery
Link about thyroid blood tests
thyroiduk.org/getting-a-dia...
sorry my T3 meds were 20 mg not 100 mg. !!
Do NOT consider adding T3 at this stage
ESSENTIAL to test vitamin levels and get actual results and ranges on thyroid tests
Probably….Easiest to retest yourself privately
And always test thyroid levels early morning, ideally before 9am and last dose levothyroxine 24 hours before test
Next step is to get all four vitamins tested and at optimal levels by supplementing if necessary
Come back with new post once you get results
And with autoimmune thyroid disease it’s ALWAYS Worth trying strictly gluten free diet
Many people, when adequately treated on decent dose levothyroxine, with all vitamin levels optimal find conversion rate improves significantly
If (eventually) in several months time ……you need to add T3 ….you will need to cut T3 into 1/4’s to get 5mcg doses
Never ever start on too high a dose T3
Thank you so much . Going to ask for vitamin blood test. If I get refused I’ll get a private test. X
Hey there again :
OK - as detailed in my last reply to you we generally feel at our best when our T4 is in the top quadrant of the range as this should in theory convert to a good level of T3 at around a conversion ratio of 1/4 - T3/T4 .
So, we haven't the ranges - but we can still work out how well you are converting the T4 into the T3 - as the body runs on T3 and not T4 :
The accepted conversion ratio when taking T4 monotherapy is said to be 1 / 3.50 - 4.50 and we generally feel at our best when we come in this range at 4 or under.
So if I divide your T3 result into your T4 result I'm getting your conversion coming in at around 5.70 - so very wide of centre and showing you struggling on T4 monotherapy.
Even with optimal vitamins and minerals I very much doubt you can make up this differential.
You have had a thyroidectomy and literally ' lost ' your own natural production of T3 and whilst the NHS have guess estimated of your ' lost ' T4 natural production they haven't as yet restored your own natural T3 guess estimate and now need to consider introducing a little T3 - Liothyronine to restore vital thyroid hormonal balance.
Your T4 is likely over the range and the suggestion may well be to reduce your T4 dose - an obvious simplistic knee jerk reaction but this may well reduce your T3 level even further and is only part of the answer as a little T3 - Liothyronine needs to be added back into the mix with a lower dose of T4 and your Free T3 and Free T4 levels measured again after around 6-8 weeks of being on a T3/T4 comb.
hi there
I still have some T3 tablets 20 mg
but when I took only T3 I was unwell so my Gp said stop it. Trouble is they won’t prescribe it again. Tablets are too small to cut even in half or I would be tempted to try that. X
You need to drop your T4 dose by around 25 mcg and wait a few days and then introduce a maximum first dose of 5mcg T3 -
What dose of T3 did you start on and did you reduce your dose of T4 to ' accommodate ' this new medication?
How are your ferritin, folate, B12 and vitamin D ?
I replied in some length on your previous post as to ensure your core strength is strong as no thyroid hormone works well until the vitamins and minerals are maintained at optimal .
Hi
I have never had any vitamin tests done.
I took T3 20 mg on its own
Well I read that we need to find /convert around 50 T3 daily just to function - but I guess you still had T4 circulating in your body as that takes around 6-8 weeks to fully leave the body.
It's just a shame you weren't instructed on how to introduce, dose and monitor T3 alongside a slightly lower dose of T4.
First things first - no thyroid hormone replacement works well until your ferritin, folate, B12 and vitamin D are up and maintained at optimal levels.
I will ask my GP today if I can have vitamin tests.
Thank you. It’s a start …… x
Ok then - good luck - many of us get refused and need to arrange a full thyroid panel through one of the private blood test companies as listed on the Thyroid UK website who are the charity wo support this patient to patient forum.
ok I’m prepared for a negative reply to that but I’ll stay optimistic till then !
Thanks a lot very helpful x
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