Good morning,
These are my latest thyroid blood results with ranges:
Free T3- 7.2 (3.1 - 6.8 )
Free T4- 26.2 (12-22.0)
TSH- 0.05 (0.30-5.00)
I’m currently take 50mcg of Levothyroxine
Please help me interpret these as so confused! TSH low suggests Overactive now?!
Thank you
Your tsh is low and both the t3 and t4 are somewhat above range. This could suggest you are over medicated. How are you? Did you start on levo because you had symptoms of hypothyroidism and a blood test confirming this? Have your hypothyroidism symptoms gone and have you any new symptoms?
Cornwaller I’m feeling unwell with hypo symptoms. I started Levo because of the blood tests. I’m feeling probably the worse I’ve felt. I’m contacting the hospital tomorrow to discuss medication. I will ask GP to be referred somewhere else
i've put your 'previous' history to make it easier for people to see what is going on, otherwise you will have to keep explaining :
June 2021...You have an episode of 'hyper' but we saw no proof it was actually Graves, as you have no TRab antibody results(as far as we know )
TPOab >1000 .
fT3 11.3 ( 3.1-6.8)
TSH <0.02 (0.3-5.0)
fT4 24.4 (12.0-22.0)
"I was seeing a consultant regular for TED and there was no concerns so were discharged"
Carbimazole for 6 months .... then nothing for a few months .
June 2022 .... had become hypo.
TSH- 9.88
Free T3- 3.7
Free T4- 13.9
Prescribed 100mcg Levo.
31/8/22. (when taking 100mcg)
TSH- <0.02
Free T3- 6.6
Free T4- 26.4
Now taking 50mcg of Levothyroxine reduced from 100mcg" (after above results) .
"I had a blood test 2/11/22," are these the result from 2/11/22 ?
Free T3- 7.2 (3.1 - 6.8 )
Free T4- 26.2 (12-22.0)
TSH- 0.05 (0.30-5.00)
currently take 50mcg of Levothyroxine.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
These results on 50mcg Levo are basically very similar to the previous ones when you were taking 100mcg Levo .
the TSH has come up a little and is no longer completely supressed , and this does fit with the lowered dose of Levo.
However , the actual thyroid hormone levels T4 / T3 have not come down at all , in fact the fT3 appears to have gone a little bit higher .
I would expect your Levo dose to be lowered further to 25mcg , or possibly stopped altogether based on these latest results, as you clearly don't need any 'extra' T4 at the moment , you seem to have more than enough...., and the fT3 is bit high at 110% .
It would be really useful if the GP would get endo to test TRab (Graves) antibodies , or confirm if it has already been done . (It may have been done and found to be positive , but you haven't seen it , this may explain why they referred you to monitor for TED)
thank you for your response. I still have hypo symptoms. I believe originally I was tested positive for Graves’ disease. These results aren’t stable and I’m still incorrectly medicated. Stop medication all together? Isn’t this a lifelong condition? Which needs to be medicated? I will be asking to move to another endocrinology at another hospital.
"Isn’t this a lifelong condition?"
well you certainly have some sort of autoimmune thyroid disorder , the TPOab <1000 say so clearly. so yes it is safe to say it's 'a lifelong condition'.
But as for 'what variety of condition ,and what medication/ if any' ...that is currently harder to say. ie whether you have TRab or not ~we don't actually know for sure , so far it's just an assumption.
TRab can do funny things . There are 3 sorts;
'stimulating' .. stimulates thyroid produce more T4/T3 (hyper)
'blocking' ... blocks thyroid from getting the TSH 'message' to make more T4/T3 (causing low T4/T3 with often unusually high TSH ~hypo)
'neutral' .. don't seem to do much
The levels of each can vary , and when they do ,the effect you see on the thyroid hormones can vary accordingly
Most TRab tests unfortunately can't measure the different sorts independently, ( a 'TSI' can measure just the stimulating ones, but there is no easy way to measure blocking ones )....So if you have a positive TRab test you just know 'you have some', but not which sort are currently dominating .You can only tell that from looking at what the TSH / fT4 / fT3 are doing at the time.
Most people with very clear Graves (positive TRab and extremely high T4/T3 ~ much higher than yours) will also have some TPOab .... so having positive TPOab does not necessarily mean you have Hashimoto's. You may or you may not , although the very high level <1000 does perhaps suggest you do.
Without knowing for sure if TRab are involved , it is difficult to know whether you have Hashimoto's eg . your highish T4/T3 levels are just a result of the early destructive stages of that, and over time you will inevitably become more and more hypo... or whether your high T4/T3 levels are due to the action of some 'stimulating' TRab and the hypo phase (when TSH went to 9) was due to some 'blocking' ones.... in which case you may wander around between hypo / hyper / hypo/euthyroid/ hyper etc. at various points over your life and confuse the heck out of every endo you meet. This fluctuating pattern caused by varying levels of each sort of TRab is pretty rare, but it does happen.
So it is not yet certain that you are going to be hypo for life , or need levo for life .
(Also , if you have never had a thyroid scan you can't totally rule out a 'Hot' nodule. ,, but you hypo episode when TSH rose to 9 says this is unlikely , as hot nodules consistently 'over produce' T4/T3)
p.s i still have some hypo symptoms .. it is notoriously difficult to tell the difference between hypo and hyper untill it is at the extreme end of things,, being a bit overmedicated , (or a bit hyper) can very often feel very similar to being a bit undermedicated (or a bit hypo) .
Whatever your symptoms currently 'feel' like , you are not hypothyroid (low T4 / T3) at then moment (and you were not at your august test either which is why dose was reduced so drastically to 50) , your fT4 and fT3 levels clearly show now (and in august) that you have more than enough of both T4 and T3 therefore you are definitely a little bit 'hyper' (or a little bit overmedicated )at the moment.
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