Thyroid Test Results - Help!

[Hypogirl50]

As recommended I have had a private blood test with Medichecks. All tests have come back as ok except for the Thyroid which read:

TSH 19.25 mlU/L (normal 0.27 -4.2)

FreeT3 2.8 pmol/L (normal 3.1-6.8)

Free Thyroxine 12.6 pmol/L (normal 12 - 22)

The doctor's report:

Your thyroid stimulating hormone is high and you have a low t3 which suggests that your levothyroxine dose is too low.

If you feel you have some thyroid symptoms, however, then you should discuss this further with your doctor who can advise you as to whether you need an increase in your levothyroxine dose.

Your thyroid antibodies are reassuringly normal.

Elsewhere in your test your vitamin and mineral levels are excellent.

I took the test as I have felt for some time that my dosage was not correct. I take 100 mg a day, as I have for years now with results by NHS saying I am 'normal.' However if I take these results to the doctor how will he know what dosage to give me as he is particularly ignorant of thyroid problems. Any advice to help me forward would be very much appreciated.

[SeasideSusie Remembering]

Hypogirl50

You are obviously very undermedicated.

Have you had thyroid antibodies tested before because I would be suspicious of Hashimoto's.

Can you post the whole of your results with their reference ranges as their idea of normal and excellent doesn't necessarily mean optimal.

However if I take these results to the doctor how will he know what dosage to give me as he is particularly ignorant of thyroid problems

Your GP wont know and you can only increase dose of Levo by 25mcg at a time, retesting 6-8 weeks later and another increase, repeating until symptoms abate and you feel well.

[Hypogirl50 in reply to SeasideSusie]

I had Graves disease and had radiation iodine treatment 20 years ago. I have no idea if I have had thyroid antibodies tested. The rest of the results are:

CRP HS 0.96 mg/L

Ferritin 124 ug/L

Folate-Serum 17 nmol/L

Vit B12 - Active 150 pmo/L

Vit D 109 nmol/L

Thryoglobulin 15.8 klu/L

Thyroid Peroxidase antibodies 9.5 klU/L

Thanks.

[pennyannie]

Hey there again :

If you had a full thyroid panel undertaken privately suggest you photo shoot or type in all the results and ranges so we have the fullest of all pictures - what was your inflammation reading ( CRP ) ?

Your doctor is not obliged to accept any private blood test results but I hope this TH reading alone forces his hand to arrange a full thyroid panel through the NHS.

As they stand your results show you very hypothyroid.

The TSH seen in isolation, especially when Graves after RAI thyroid ablation and then on thyroid hormone replacement is not a reliable measure of anything but this is the most used measure in primary care and this result alone should force your doctor's hand to action further NHS blood tests and/or an urgent referral to an endocrinologist.

Your T4 is barely in the range and your T3 under the range and it looks as though you are very under medicated.

As detailed previously you have lost both your T3 and T4 own thyroid hormone production through having had RAI thyroid ablation.

RAI is a slow burn, and mainstream medical have guess estimated and replaced your own T4 with Levothyroxine and hope is you will be able to convert sufficient T3 to keep well.

Conversion of T4 into T3 can be compromised by non optimal levels of ferritin, folate, B12 and vitamin D, inflammation, antibodies, and any physiological stress - emotional or physical can compound and down regulate T4 to T3 conversion as can depression, dieting and ageing.

I too experienced a TSH up in the mid teens at some point in time after RAI thyroid ablation and a T4 was run and it was in the top quadrant and a further blood test a month later showed my TSH right down the bottom of the range where it normally sat.

TSH rises and generally speaking taking T4 lowers the TSH back into range :

With a T4 at just 6% through the range and a T3 under the range your TSH is shouting out for more thyroid hormone replacement :

P.S. Have you started any other medications or have other health issues which may be affecting the absorption of the Levothyroxine ?

Have you any other T4 readings from previous thyroid blood tests through the surgery ?

Thyroid UK - thyroiduk.org have a list of NHS/private specialists and endocrinologists - it's a patient to patient recommended list - contact admin at Thyroid Uk for a copy.

If you are thinking of seeing anybody privately - you can ask for feedback - start a new message but as we are not allowed to talk openly about any person - you ask for replies by private messages - a PM - and your ' Chat ' button above lights up with any replies and when you press this icon you get taken to a different screen.

[Hypogirl50 in reply to pennyannie]

The results are returned in such a way as to make a photo shot impractical. Here are the other results which were reported as normal - I haven't repeated the three results I first posted.

CRP HS 0.96 mg/L

Ferritin 124 ug/L

Folate-Serum 17 nmol/L

Vit B12 - Active 150 pmo/L

Vit D 109 nmol/L

Thryoglobulin 15.8 klu/L

Thyroid Peroxidase antibodies 9.5 klU/L

Thanks.

[pennyannie in reply to pennyannie]

Looking back - 3 years ago you shared a blood test result on here and your TSH was 0.08 and your T4 was to 24.40 in a range of 11.00 - 25.00 : ??

[Hypogirl50 in reply to pennyannie]

If I did that was from the NHS blood results. I can't remember that I ever got a reply but confused as to why that has relevance to today's result, am I missing something? Sorry

[pennyannie in reply to Hypogirl50]

I was just trying to establish if T4 ever worked for you - and whilst waiting for you to reply just looked back and saw this result which tells me T4 seemed to be much better absorbed 3 years ago as your result then look like what one would expect when on a decent dose of Levothyroxine.

[pennyannie in reply to Hypogirl50]

If you press on the icon alongside the word ' more ' top right corner of this screen you can then trace back all your posts on HU by going into - your profile - and then post.replies etc.

[Hypogirl50 in reply to pennyannie]

thanks - I can't remember if I was on 125 mg then

[pennyannie in reply to Hypogirl50]

25mcg on way or the other would not make such as massive difference in readings.

It looks as though there is an absorption problem ?

[Hypogirl50 in reply to pennyannie]

what causes that?

[pennyannie in reply to Hypogirl50]

Could be any numbers of things :

T4 is a very fussy hormone and needs to be taken well away from anything else and it's recommended to be taken with a full glass of water on an empty stomach, and you wait around an hour before you eat or drink anything.,

Low stomach acid ?

Other medications interfering with absorption ?

SIBO ?

[Hypogirl50 in reply to pennyannie]

Thanks for this. I am making an appointment to see my doctor but have to have a phonecall from him first. No, no new medication but been feeling that things aren't right for some time - it was my reflexologist who began to tell me some time ago that something was very wrong with my thyroid hence the private blood test. During two years of Covid I wasn't tested at all as there was a shortage of vials so just carried on. One test since which was done about 12-18 months ago and I was told all was ok. I phoned the surgery to ask for print out but was told I couldn't have them. I will press for this now. Lesson for everyone, if you feel things are wrong do something about it immediately.