Results please advice needed

[Pen1966]

Overall comment

13/02/2023

Your thryoid function results show an unusual pattern. There may be several reasons for this, such as taking thyroid medication or treatment or the sample was taken when you were unwell. If the result is unexpected, we recommend you discuss these results with your GP.

TRIODOTHYRONINE

13/02/2023

4.8 pmol/L

FT3 levels normal (normal range 3.1 - 6.8 pmol/L)

THYROXINE

13/02/2023

22.7 pmol/L

FT4 levels high (normal range 12 - 22 pmol/L)

THYROID STIMULATING HORMONE

13/02/2023

0.48 mu/L

TSH levels normal (normal range 0.27 - 4.2 mU/L)

Overall comment

29/12/2022

Your thyroid hormone levels are all normal (known as euthyroid). There is no indication of thyroid gland disorder. This interpretation is based on the assumption you do not have a pre-existing thyroid condition and/or receiving thyroid treatment.

TRIODOTHYRONINE

29/12/2022

3.9 pmol/L

FT3 levels normal (normal range 3.1 - 6.8 pmol/L)

THYROXINE

29/12/2022

21.5 pmol/L

FT4 levels normal (normal range 12 - 22 pmol/L)

THYROID STIMULATING HORMONE

29/12/2022

1.42 mu/L

TSH levels normal (normal range 0.27 - 4.2 mU/L)

Overall comment

17/11/2022

We are unable to provide interpretation of results for people diagnosed with a thyroid condition or on thyroid medication. This is because the monitoring of thyroid disorders needs to look at thyroid results together with how you are feeling such as ongoing symptoms. Your usual healthcare provider is best placed to assess your treatment and should be consulted before any changes to your medication.

TRIODOTHYRONINE

17/11/2022

4 pmol/L

FT3 levels normal (normal range 3.1 - 6.8 pmol/L)

THYROXINE

17/11/2022

21.8 pmol/L

FT4 levels normal (normal range 12 - 22 pmol/L)

THYROID STIMULATING HORMONE

17/11/2022

6.12 mu/L

TSH levels high (normal range 0.27 - 4.2 mU/L)

Overall comment

07/10/2022

We are unable to provide interpretation of results for people diagnosed with a thyroid condition or on thyroid medication. This is because the monitoring of thyroid disorders needs to look at thyroid results together with how you are feeling such as ongoing symptoms. Your usual healthcare provider is best placed to assess your treatment and should be consulted before any changes to your medication.

TRIODOTHYRONINE

07/10/2022

4 pmol/L

FT3 levels normal (normal range 3.1 - 6.8 pmol/L)

THYROXINE

07/10/2022

20.5 pmol/L

FT4 levels normal (normal range 12 - 22 pmol/L)

THYROID STIMULATING HORMONE

07/10/2022

3.03 mu/L

TSH levels normal (normal range 0.27 - 4.2 mU/L)

Overall comment

15/08/2022

Your thryoid function results show an unusual pattern. There may be several reasons for this, such as taking thyroid medication or treatment or the sample was taken when you were unwell. If the result is unexpected, we recommend you discuss these results with your GP.

TRIODOTHYRONINE

15/08/2022

4.3 pmol/L

FT3 levels normal (normal range 3.1 - 6.8 pmol/L)

THYROXINE

15/08/2022

22.5 pmol/L

FT4 levels high (normal range 12 - 22 pmol/L)

THYROID STIMULATING HORMONE

15/08/2022

1.81 mu/L

TSH levels normal (normal range 0.27 - 4.2 mU/L)

ABOUT THIS TEST

What are the thyroid tests and why are they important?

The thyroid tests are used to evaluate the function of the thyroid gland; to help diagnose thyroid gland disorders. The thyroid hormones regulate the body’s metabolism and how it grows, functions and uses energy

The thyroid gland is located at the front of the neck. It secretes two hormones known as thyroxine (T4) and tri-iodothyronine (T3) . The release of T4 and T3 into the blood is controlled by a third hormone called thyroid stimulating hormone (TSH), this hormone is responsible for keeping FT4 and FT3 at the right levels. Collectively, these three hormones are referred to as ‘thyroid function tests’ (TFTs).

There are two main conditions the effect the thyroid

Hypothyroidism (know as underactive thyroid) is when the thyroid glands fails to produce sufficient hormones for health. This can be treated by thyroid hormone replacement.

Hyperthyroidism (known as overactive thyroid) is when the thyroid gland produces too much thyroid hormone. This can be treated by hospital specialist depending on the cause.

Please note: these tests are available for people aged over 18 only. Please collect and post your sample to us Monday-Thursday, to avoid delays over the weekend. In a small number of cases, it may not always be possible to provide a result, please see our terms and conditions for details.

Who is this test for?

People who may benefit from having a thyroid function test include:

Individuals who are concerned that they may have a thyroid problem and those who wish to monitor a previously diagnosed condition.

Early signs and symptoms of thyroid dysfunction may often be very non-specific. The common symptoms hypothyroidism may in

[GlowCoach Administrator]

What is it that you are asking us to comment on? Doctors comments on Medichecks results really aren't worth having.

Are you taking thyroid hormone or looking for a diagnosis?

[Pen1966 in reply to GlowCoach]

Advice really others know from my old posts

[SeasideSusie Remembering]

Pen1966

Have all your tests been done under the exact same conditions to enable them to be compared, ie

* Tested at same time of day and no later than 9am

* Last dose of Levo 24 hours before test

* Last dose of T3 (if you are still using it) 8-12 hours before test, splitting the dose into 2 or 3 the day before the test

* Water only before the test

* No biotin, B Complex or any supplement containing biotin for 3-7 days before the test

* No infection or recent infection at time of test

[Pen1966 in reply to SeasideSusie]

Yes all done same time and no levo 24 hrs before

[SlowDragon Administrator]

Looking at your profile

You’re on levothyroxine

High Ft4 and low Ft3

Conversion is poor …..very common the longer we are on just levothyroxine, especially as get older and especially after menopause

Do you always get same brand levothyroxine at each prescription

Always test early morning and last dose levothyroxine 24 hours before test?

ESSENTIAL to test vitamin D, folate, ferritin and B12

What vitamin supplements are you currently taking

When were vitamins last tested

Once vitamin levels optimal…..if ft3 remains low you will need T3 prescribed as small doses alongside levothyroxine

Email Thyroid U.K. for list of thyroid specialist endocrinologists and doctors who will prescribe T3

[e-mail]

[tattybogle]

Hi Pen,

i just read your previous posts and see you had thyroidectomy many years ago due to being hyperthyroid .

and i see you were referred for Thyroid Eye Disease (TED) last year ... interestingly i think ?this was around the same time as your TSH inexplicably went up to 5/6.

i know you've got some T3, but can we assume you haven't ever taken any of it ? ( just asking because if you have experimented with taking it sometimes ,that might explain some of the TSH variations)

The TSH 6 and ?TED diagnosis plus you previous history of hyper thyroid and thyroidectomy are making me wonder if you have some of the antibodies that cause graves hyperthyroidism :

TRab (Thyroid Stimulating Hormone Receptor antibodies )

There are 2 kinds of these antibodies that have opposing effects ~both kinds can be present at the same time and levels of each kind can vary which casues the effects to vary :

~ 'stimulating' TRab (also called TSI) ~ these act like TSH and stimulate the TSH receptors on the thyroid causing it to make too much T4/T3.. these are what cause the high T4/T3 levels in Graves HypErthyroidism .......They are also what cause TED.. because for some reason . certain bits of the eyes have TSH receptors the same as the thyroid does.. so when 'stimulating' TRab are present in the body they can also cause the eye issues of TED

~ 'blocking' TRab ~ these block the TSH receptors ( they 'fit onto them' just like TSH does and this blocks them up so 'real' TSH can't get in) ~ these cause HypOthyroidism ( in someone who ISN'T taking replacement thyroid hormone ) ........ The thyroid is then not able to be stimulated by the 'real ' TSH (because it can't get in), and without this stimulation from TSH , the thyroid makes less and less T4/T3 , and as a result of the low T4/T3 levels, the 'real' TSH level goes up quite high .. (often 'unexpectedly' high ) .

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

When you were Hyperthyroid and had your thyroidectomy , did they ever confirm the cause of it ie. were you ever told you had Graves ?

Were TRab / TSI tested at that time ?

When you were referred for TED,, what was the outcome ?

Were TRab tested at that point ?

[Pen1966 in reply to tattybogle]

I have been told no sign of teds now not taken t3 yet although do have some now

[tattybogle in reply to Pen1966]

Ah ok .. no TRab results ever ?

has any attempt been made to explain why your TSH wandered off up to 5/6 while your fT4 levels remained fairly stable near top of range , and fT3 level were also fairly stable ?

[Pen1966 in reply to tattybogle]

No endocrinologist wouldn't see me gp dealt with no trab results ever not worth testing now I guess?

[tattybogle in reply to Pen1966]

well it would of course be interesting to know if you had them , as it may shed light on the 'TED/ not TED' and may ? explain the high TSH, (not sure about that bit though ) .....but realistically it's pretty expensive to do TRab privately , and it's not GP territory to test them , it's usually done by endo as part of investigation into cause of hyperthyroidism .. which they won't be interested in paying for now because you're not hyper anymore and they can't find TED

Have you ever tried lowering your Levo dose to aim to run your fT4 level a bit lower than where it usually is ? ........ just thinking out loud , because 'a bit too much' fT4 can be responsible for feeling just as crap as 'not quite enough' .. and doesn't always bring obvious/ typical symptoms of over medication.

egh . i've been slightly overmedicated with levo and it caused really nasty ?kidney area pain , and all sorts of other weirdness ,... but my heart rate didn't go up noticeably not sure if it even went up 'at all'

might be worth a try if nothing else seems to be getting you anywhere....., highish levels of T4 don't help with conversion of T4 to T3 , conversion often gets 'worse' once fT4 level is very high / over range .. so lowering fT4 level to more like 'mid range' may not necessarily lower your fT3 levels.

if you try that , do bear in mind that the first 5 ish weeks are likely to feel very undermedicated.. you do need to allow plenty of time for the body to adjust to the lower levels before improvements are gradually seen , hopefully by about 6-8 weeks ( if lower dose was the right move ) things would have stabilised and you may begin to see slight improvement again , which would continue to improve over time. That's been my experience of lowering Levo a couple of times anyway .. obviously everyone is different.

One time i lowered it and it wasn't the right move ~ then it was very apparent by week 6/7 that the undermedication feelings were still getting worse by the week not better.

I now realise that 20 yrs ago when a lower dose had been suggested by the GP , i only gave it 3 /4 weeks before going back up due to feeling horribly undermedicated.. but i do now wonder if i might have had less problems and better T3 levels from Levo if i had waited much longer to see what happened over time with a slightly lower dose.

[Pen1966 in reply to tattybogle]

I may lower t4 and add in a bit of t3 take it from there is it worth having tpo testing

[tattybogle in reply to Pen1966]

no, not worth you testing TPOab now , it won't change anything in practice whatever the result :

~ As well as being diagnostic for Hashimoto's , TPOab are also known to be present in the majority of cases of Graves , so you might have/ had some due to that ( if you did have graves).. A positive TPOab result from someone with graves just confirms they have/ had 'an autoimmune thyroid problem' , but not 'which one'

and you haven't got any / much thyroid left anymore ~so your need for thyroid replacement hormone is not ever going to be in doubt. therefore no need to 'prove it' with a raised TPOab result.

And even if you have got hashimoto's and TPOab COULD prove it .. so what ?? .... it's only known effect is to slowly destroy the thyroid , but that ship has already sailed.

and if you wanted to try any of the diets etc which aim to reduce effects of Thyroid autoimmunity on the rest of the body (like ? inflammation).. eg Auto Immune Protocol or Gluten Free etc etc .. to see it you felt better generally , you could just try them anyway.

[Pen1966 in reply to tattybogle]

Thank you 😊 x