Hi
Thank so much for previous advice.
(Not on Levo)
My test was done before 9am
fasting.
GP tested the following:
TSH 3.82 mIU/L (0.35 - 4.94) 75.6%
Free T4 (fT4) 12.3 pmol/L (9.0 - 19.0) 33.0%
Free T3 (fT3) 4.04 pmol/L (2.43 - 6.01) 45.0%
T4:T3 Ratio 3.045
So everything looks ok?
They didn't check antibodies.
I have got the vitD and K mouth spray.
Maybe my symptoms are due to endometriosis or lupus then. 🤷🏽♀️
Anything else I should consider?
Thank you 💜
Firstly, absolutely amazing your GP tested FT3, nothing short of a miracle!
Well done for working out the %s. To feel well we need our FT3 up at around 60-70% and yours is half of that at the moment. Your TSH is above 2 also which indicates struggling thyroid output. You are likely to be experiencing symptoms of an underactive thyroid but the way diagnosis and treatment guidelines are set you won't get treatment until your TSH is above 5 on 2 consecutive tests.
Keep testing at 9am (very important to be as close to that as possible) every 3 or 4 months.
Edited to reflect undiagnosed.
note* Awwy is Not taking Levo / not diagnosed with thyroid problem
Apologies. In that case thyroid is struggling but unlikely to get a formal diagnosis and treatment until TSH is tested twice over 5. I hate that part.
Hi
Thank you for explaining this to me. The GP just keeps marking it as normal. Saying that it looks fine. All blood tests have been between 8.30 and 10.30 but not always fasting. So I now know that and will get GP to test again in 4 months. I have been told i have hypothyroidism by endocrinologist but to be monitored by GP and no medication.
P.s. conversation rate from calculator I was tagged into last time for my first query.
💜
Doctors really only deal with absolute deficiencies for vitamins and thyroid. They have zero comprehnsion that to reach that point you will be deteriorating the entire route along the way.
Hello Awwy :
We generally feel at our best when our T4 is in the top quadrant of it's range as this should in theory convert to a good level of T3 at around a 1/4 ratio T3/T4.
The ratio is not relevant and can't be used as a guide to conversion until your T4 is up in the top quadrant as when T4 is low, the body automatically preserves T3 over T4 and this result a false reading.
Generally speaking when optimally medicated your TSH should be down to under 2 possibly under 1 with some forum members finding their TSH low suppressed but this doesn't matter if T3 and T4 are in well and hopefully symptoms of hypothyroidism are, have diminished.
In some countries a TSH of 3 is when treatment for hypothyroidism is commenced .
P.S. Just read that you are not on any medication yet - so you have already been found to have Hashimoto's AI disease so it would be logical to start treatment with T4 - Levothyroxine to start to build up your T4 and hopefully relieve some of these symptoms.
GP said its all within range no action. 😔 didnt say anything about T4 being in upper quadrant. How do I have that conversation?
I wrote the first 4 paragraphs of my reply above thinking you were already taking T4 - Levothyroxine as explained in my P.S.
Since you have a blood test from last year showing over range and positive for Hashimoto's AI disease I would have thought that sufficient for a doctor to start treatment.
You received very detailed replies regarding low vitamins and minerals on a previous post and suggest if you haven't been able to have your doctor to acknowledge same suggest you consider looking for another doctor.
Sorry I have amended it now to clearly state not on any medication for thyroid. X
Think I will do a private test for my antibodies. Taking the vitamins as suggested in my previous post now.
Thank you
💜
Your blood test from last year will be sufficient - you shouldn't need a further blood test and antibodies wax and wane anyway - a score of 1000 - is good enough in anyone's language.
You could search the internet and buy your own but you need medical support and you'll need to build back these core strength vitamins and minerals and probably heal your gut before any medication becomes fully effective.
Your TSH is not (yet? ) high enough for an NHS diagnosis of hypothyroidism (or to get any Levo treatment) BUT it is clearly 'not well' and does need to continue being monitored by the NHS.
We know you had recent TPOab >1000 .... this confirms autoimmune thyroid damage has happened / is happening .
It is accepted by NHS that a raised TPOab means it is much more likely that people will eventually end up with persistently over range TSH (and eventually low fT4).... and therefore likely to need Levo at some point .
This applies especially if TPOab are significantly raised rather than just a bit ... anything over-range is 'positive' , anything over 500 is usually considered 'proof ' for research purposes which tend to have higher requirements for 'proof' .. so as you can see , your result of "more than "1000 means there is absolutely no question there is autoimmune damage going on and the NHS should continue to monitor this (probably once a year, probably with just TSH ~ or more often if symptoms of hypothyroidism are present) .
Also the fluctuating pattern of your TSH level is far from looking 'happy' ..
TSH does have a natural daily variation ,so if previous tests were done at different times of day you will get a bit of variation in level , but you would not expect a 'healthy' graph to be as 'spiky' as yours is ...... (make sure all future tests are early morning to rule out any natural variation) ,,,
?? don't suppose you have any idea what might have happened to it in 2020 ?
Hi tattybogle
In 2020 I was very ill. It was the time where my endometriosis was at its peak and I was bedbound. I had not been diagnosed yet with endometriosis, Hashimoto's or mixed connective tissue disease.
So I had loads of tests and scans at the time. Its a bit of a blur those months as I was on strong pain killers and in and out of hospital.
I was diagnosed with stage 4 endometriosis via an MRI. Was then put into medical menopause. I was also referred to endrocologist because of my TSH results. Subsequent testing showed improvement in my TSH panels so it was a case of monitoring them since.
I finally got my mixed connective tissue disease diagnosis in July 2022 being treated for the Lupus part of it from September 2022.
Its been hard trying to get GP's to listen to me and trying to get them to do something about it.
Thank you for your response 💜
I always feel like I have to take in loads of evidence for them to take action.
ah right , we have to ignore any TSH / fT4 / fT3 results from times when you were very ill / in hosp / taking serious painkillers etc .because the thyroid control system does a lot of 'compensating' during acute illness ,
But it still needs keeping any eye on at least once a year due to your very high TPOab ,, and even if we ignore 2020, the most recent part's of your graph still look a bit more 'spikey' that i would expect . (looks like it's bounced around from approx 3.2 to 1.6 to 3.8 which is a bit more than you would expect from 'normal daily variation' , and if all 3 were done same time of day it's another clue 'something is not happy'
to give you a rough idea of why we must ignore thyroid results during 'other '(non thyroidal) acute illness/ severe trauma etc ~see this graph of what happens to them during serious illness/ recovery ~ levels go all over the place for a while.
Previous post discussing your really terrible vitamin levels
healthunlocked.com/thyroidu...
Low vitamin levels tend to lower TSH
GP won’t treat your hypothyroidism until TSH is over 5
They don’t look at the whole picture
Work on improving low vitamin levels over next 2 months then retest thyroid levels
Come back with new post once you get retested in 2 months
Hi
Thank you. Yes I am taking them as suggested. Got all vitamins introducing one at a time and then will be tested in 3 months. Thank you. 💜
Your GP / we can talk you all round the houses but the bottom line us that you have thyroid autoimmune disease and that is a common cause of hypothyroidism in about 90% of cases
thyroiduk.org/if-you-are-hy...
You are struggling to lose weight...a common symptom of hypothyroidism
Your Frees are far too low...suggesting hypothyroidism
Your cholesterol is high....again hypo symptom
You suffer fatigue.... ditto
Your essential nutrients need optimising to support thyroid function/ conversion
The problem is that frequently medics fail to,join up the dots....and to ask you how you feel!!
Sadly medics focuss on TSH as a diagnostic tool....it is unreliable but at 3.82 you will be told all is well....despite your symptoms. Rubbish!!
thyroidpatients.ca/2021/07/...
We are human beings, not machines! With machines it is easy to calibrate an accurate result to correlate the readings with those of a standard in order to check the instrument's accuracy....
This principle cannot be used for human beings, but it is ....and medics seem to forget this. We are all different and need different ( not standard) diagnoses and treatments.
Your GP tested FT3 which is excellent ....maybe he/she is open minded and enlightened enough to listen to your point of view. They are supposed to consider not only lab numbers but also clinical evaluation/ signs and symptoms.
In an ideal world if you feel under par you need to be correctly diagnosed and given the correct treatment to make you feel better!!
"Ideal" and reality however, can be very different concepts.
Good luck!
”The problem is that frequently medics fail to join up the dots …. and to ask you how you feel.” This is just so massive. It’s difficult to comprehend/believe, when it’s their job; that they are so ineffective at it. Dangerous in fact. Unfortunately I have spent an undesirable amount of time just thinking about my health history. Even in the days before ‘firefighting’ in the NHS became the norm, I was misdiagnosed/not helped. It’s very sobering. This disease, whilst extremely common, often goes undiagnosed. Then we find that even when it has been diagnosed - this allegedly simple to treat disease - medics can’t get their heads around it. In the end it’s the cold blooded lack of care I find difficult - that inexplicable lack of true engagement with the patient. We hypothyroids seem to bring out the worst in our alleged medical helpers. If our medical helpers were criminals or mentally ill, they would be described as sociopaths.
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