Test Results TSH 21 T4 17.9
Can you advise re Test results TSH 21 T4 17... - Thyroid UK
Can you advise re Test results TSH 21 T4 17.9 what does this mean? Do I need to up Levothyroxin or lower it
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Hi , we need more information to answer that :
what dose of thyroid hormone were you taking for the 6 weeks before this test ?
Were you taking it every day consistently ?
How many hours before the test did you take the last dose of thyroid hormone ?
Do you know the lab range for that fT4 result ? it should be after the result in brackets.
Are you taking anything else ?
currently taking 175 levothyroxin daily - before oct 22 was on 150 levo but was upped as Dr said I needed to in Oct 22. Test last week was a fasting blood test and I did not take any levo on that morning. I also take Nizatadine for chronis Gastitis (has Gastritis for years)
I also take Nizatadine for chronis Gastitis (has Gastritis for years)
So do you always take levothyroxine on it’s own on empty stomach and then nothing apart from water for at least an hour after
No other medication or vitamin supplements within 2 hours minimum
You need folate and B12 levels tested
Serum Total 25-OH Vit D Level 21nmol/L
Vitamin D is deficient
GP should prescribe LOADING Dose vitamin D
That’s total of 300,000iu vitamin D over 6-8 weeks
NHS Guidelines on dose vitamin D required
ouh.nhs.uk/osteoporosis/use...
GP will often only prescribe to bring vitamin D levels to 50nmol.
Some areas will prescribe to bring levels to 75nmol or even 80nmol
leedsformulary.nhs.uk/docs/...
GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)
mm.wirral.nhs.uk/document_u...
But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better
pubmed.ncbi.nlm.nih.gov/218...
vitamindsociety.org/pdf/Vit...
Once you Improve level, very likely you will need on going maintenance dose to keep it there.
Test twice yearly via NHS private testing service when supplementing
Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.
There’s a version made that also contains vitamin K2 Mk7.
One spray = 1000iu
amazon.co.uk/BetterYou-Dlux...
Another member recommended this one recently
Vitamin D with k2
amazon.co.uk/Strength-Subli...
It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average
Vitamin D and thyroid disease
grassrootshealth.net/blog/t...
Vitamin D may prevent Autoimmune disease
newscientist.com/article/23...
Web links about taking important cofactors - magnesium and Vit K2-MK7
Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine
betterbones.com/bone-nutrit...
medicalnewstoday.com/articl...
livescience.com/61866-magne...
sciencedaily.com/releases/2...
Interesting article by Dr Malcolm Kendrick on magnesium
drmalcolmkendrick.org/categ...
Vitamin K2 mk7
betterbones.com/bone-nutrit...
healthline.com/nutrition/vi...
Many Thanks for your reply. I have to wait until the 06.03.023 before I can get a Docs tel call appt to discuss. I will read the article links. I was a bit perplexe by the test result of TSH level on the 3.02.23 test. It is showing as 0.08 - what does this mean ?
GP will quite likely just look at very low TSH and want you to reduce dose
BUT your terrible vitamin levels will be lowering TSH
Suggest you say you’re not reducing dose as currently improving very low vitamin levels
Extremely common on levothyroxine to need to supplement vitamin D, magnesium and vitamin B complex continuously to maintain optimal vitamin levels
Levothyroxine is Ft4 - storage hormone
Active hormone is Ft3
To convert Ft4 to Ft3 we need GOOD vitamin levels
sorry - may have misled you - just checked and the T4 was 15.9 not 17.9 as stated - my typo error
Hi
I now have sight of my Test results for 03.02.2023 :
Serum free T4 15.9 (7.9-14.4) Abnormal
Serum Total 25-OH Vit D Level 21nmol/L
Serum TSH Level 0.08 mLU/L (0.38-5.33 ) Abnormal
Serum Lipids
Serum Cholesterol 5.1 mmol/L
Serum Triclg 1.5 mmol/L
Serum HDL Cholesterol 1.4 mmol/L
Serum Cholestrerol HDL Ratio 3.6
Serum LDL Cholesterol 3.0
Se non HDL Chol Level 3.7
The previous test in Aug 22 was as follows:
Serum TSH Level 4.5 (0.27-4.2) Abnormal
Serum Ferritin 130 ug/L (30-470)
Serum Sodium 142mmol/L (133-146)
Serum Potassium 4.1 mmol/L (3.5 - 5.3)
Serum Creatinine 72 umol/L ( 45-84)
EGFR (CKD-EPI) 1.72m*2 75ml/min
Haemoglobin estimation 152g/l (120-150 ) Abnormal
There are a few others but thought this would be enough for you to advise.
Many Thanks
ah OK , so the title of this post was incorrect , your TSH was not 21 it is 0.08 , so you need to ignore any previous replies you received about needing a Levo dose increase
free T4 15.9 (7.9-14.4) Abnormal
TSH 0.08 (0.38-5.33 ) Abnormal
Because your TSH is actually low not high , and because your fT4 is a bit over range , your GP will probably suggest a slight reduction in your levo dose now based on these TSH /fT4 results .
You were previously taking 150mcg which looked like it was not enough ..and 175mcg appears to be a bit too much going but the fT4/TSH results ..so a small reduction to half way between would be the intelligent thing for GP to try next ... 137.5mcg ( 150mcg one day /175 the next/ alternate ........... but results are not everything.... it is equally important to consider how you feel on this current dose .
Also this is important to know ~ how long a gap did you leave between taking the last dose of Levo and taking this blood test ?
Many Thanks - yes the receptionist gave me incorrect dtls - I have now arranged to view my results on mu patient access a/c. TSH 0.08.
I have been feeling better on the new dose - no brain fog more alert = I had also change my diet in that I am not eating thing with fat - replaced with good fats nuts /olive spread etc as there had prev been an up on the Trigl choesterol. but just this week I am feeling a chest discomfort which is usually an indication I might be over medicated - I have been wrong in the past but the test result looks to indicate this might be the case. Doc did mention might be between doses but asked me to take the +25 taking to 175 daily as I was feeling breathless /no energy /bone pain etc and I have seen the diff and had felt much better until this week.
sorry - may have misled you - just checked and the T4 was 15.9 not 17.9 as stated - my typo error
Just checking is TSH 21 or 2.1?
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ALWAYS get printed copies of results (avoids mistakes)
Just testing TSH and Ft4 is completely inadequate
When were vitamin D, folate, ferritin and B12 last tested
What vitamin supplements are you currently taking
Request GP test vitamin levels
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
NHS no longer tests Ft3 routinely
Very likely You will need to test privately
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
plus test both TPO and TG thyroid antibodies tested at least once
About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s.
Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)
20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis
In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)
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)
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
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...
Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65
(Doesn’t include thyroid antibodies)
monitormyhealth.org.uk/full...
10% off code here
thyroiduk.org/getting-a-dia...
Only do private testing early Monday or Tuesday morning.
Watch out for postal strikes, probably want to pay for guaranteed 24 hours delivery
Thank you - that was very informative - will check for a printed result and research - not currently taking any vitamins
Hi
I now have sight of my Test results for 03.02.2023 :
Serum free T4 15.9 (7.9-14.4) Abnormal
Serum Total 25-OH Vit D Level 21nmol/L
Serum TSH Level 0.08 mLU/L (0.38-5.33 ) Abnormal
Serum Lipids
Serum Cholesterol 5.1 mmol/L
Serum Triclg 1.5 mmol/L
Serum HDL Cholesterol 1.4 mmol/L
Serum Cholesterol HDL Ratio 3.6
Serum LDL Cholesterol 3.0
Se non HDL Chol Level 3.7
The previous test in Aug 22 was as follows:
Serum TSH Level 4.5 (0.27-4.2) Abnormal
Serum Ferritin 130 ug/L (30-470)
Serum Sodium 142mmol/L (133-146)
Serum Potassium 4.1 mmol/L (3.5 - 5.3)
Serum Creatinine 72 umol/L ( 45-84)
EGFR (CKD-EPI) 1.72m*2 75ml/min
Haemoglobin estimation 152g/l (120-150 ) Abnormal
There are a few others but thought this would be enough for you to advise.
Many Thanks
Your Endo should give you YOUR target TSH level. Increasing or decreasing your dose then follows from that. Everyone is different and MY TSH target would most likely not be yours.
We can not tell you what you might want to try without knowing from your doctor what your target TSH number is. Everyone is different. Your doctor knows what your target numbers should be and how to get you there. This forum is GREAT for many things but not for giving you your traget numbers.