please could I have help interpreting latest blood test results

[Oakwood4321]

My Medichecks results are:-

TSH 2.49 (0.27 - 4.2)

Free T3 4 (3.1 - 6.8)

Free Thyroxine 18.6 (12-22)

Thyroglobulin antibodies 93.5 (0-115)

Thyroid peroxidase a/bodies 5.6 (0-34)

I stopped B Complex a week before test.

Test taken 24 hrs after Levo. Nothing except water beforehand.

I can see my tsh is higher than the last test.

T3 is lower.

the only change since last test is that I was given Brillpharma liquid Levo instead of the Teva liquid I’d been on. The ingredients seem to be the same.

I’m going to start splitting my dose now. Currently still on 100/75mgs.

Still waiting for results of echo cardiogram and if ok nhs will continue giving T3.

I will get full bloods done on nhs as they want one for a cholesterol Clinic appointment they want me to go to as cholesterol still high. I’m hoping this will improve as thyroid profile improves.

Based on these results does my current Levo dose still seem ok? I’ve been in the same dose for years.

Thanks 😊

[Jaydee1507 Administrator]

Free T4 (fT4) 18.6 pmol/L (12 - 22) 66.0%

Free T3 (fT3) 4 pmol/L (3.1 - 6.8) 24.3%

Those percentages coupled with a TSH above 2 mean you should have a 25mcg dose increase. Use these references to take along to your GP and insist on a dose increase.

healthunlocked.com/thyroidu....

Your GP should be getting your thyroid treatment right before sending you to a cholesterol clinic.

You say you are on Levo but then mention T3. Were you taking T3 at one point, its not very clear?

[Oakwood4321 in reply to Jaydee1507]

hi Jaydee, thanks for your reply. I went on T3 (nhs trial) last year for a few weeks but stopped because I got a tight chest. The Endo, at a later date, said she thought it was more likely due to a too high Levo dose alongside the T3 rather than cardio, she sent me for cardio tests before tests before restarting T3 (I’m waiting for results) .

Thank you for working out those percentages, I can see now that’s so low T3 @ 24%.

Since posting this today, I’ve now just tested positive for Covid. I’m not feeling ill but did a routine test before visiting an elderly relative. I did the Medichecks on Monday morning so possibly had Covid without knowing. I’d like to increase my Levo but not sure if Covid might have made results worse. I would imagine these results are from poor conversion that’s already been going on.

Thanks for the tip on cholesterol, I’ve read the links on here about the thyroid/under medicated connection. I was going to postpone the appointment and concentrate on thyroid for a while.

[Jaydee1507 Administrator in reply to Oakwood4321]

When you did the T3 trial, how much did you start on?

Recommended by patiwnts to start on 5mcgs a day, then after 2 weeks increase to 10mcgs, split. Otherwise unpleasant symptoms can occur, something which Endo's seem oblivious to.

Perhaps retest in 6 weeks to be sure.

[Oakwood4321 in reply to Jaydee1507]

thanks Jaydee. I started on 5 mgs and reduced Levo to 75 mcgs a day .after 2 weeks I increased to make 10 mcg per day. I stayed on it for couple of months. Chest tight so private Endo agreed for me to stop t3 till I got heart checked but he didn’t think it was to do with that.

The nhs Endo thought possibly too high Levo dose with the t3 but arranged for cardio checks.

Looking back I think I could have reduced Levo to 50 not 75.

I’m just waiting for the echo result, ecg etc all ok .

Will keep self caring, vitamins etc and do full b/t bearing in mind to increase Levo or start nhs t3 again with lower dose of T4.

Thanks for your comforting words ! 😊

[DippyDame]

First important question...how do you feel?

Have you been advised to optimise vit D, vit B12, folate and ferritin...all essential to support thyroid function and T4 to T3 coversion.

That said, your T4 to T3 conversion could be better ...evidenced by your low FT3 compared to that of FT4

FT4 18.6(12 - 22) 66% through ref range

FT3 4(3.1 - 6.8) 24.32% ditto

Your daily dose of thyroid hormone is 175mcg levo?

Did I understand that correctly, or are you alternating 100mcg with 75mcg daily?

If the latter is the case then increasing to 100mcg daily would be a start.

Currently you are undermedicated....when medicated TSH should be close to 1... 2.9 is on the high dise.

Unfortunately doctors focus on TSH which science proves is not a reliable marker....it reflects the combined level of both hormones in the blood but crucially, not the level of them individually. This is causing many patients to be wrongly diagnosed and therefore wrongly medicated.

FT4 is the storage hormone which when the system is working well adequately converts to T3

However your FT3 level is miserably low and that will impact on your health

Every cell in the body needs to be flooded with an adequate and constant supply of T3...

Low cellulr T3 = poor health.

What to do?

First optimise nutrients as above

Next increase your levo dose... at 66% through range .you have plenty room to do this.

Hopefuly that will raise your FT3 ....

But, you may need to raise your levo to 125mcg or even 150mcg to achieve adequate T3.

Test after 6/8 weeks on a steady dose...no sooner.

Increase only after that time.

Those increases may be enough to raise your FT3

Both Frees should be approaching 75% through their respective ranges

Only after all that, and if T3 is not not rising and making you feeling well then you might consider a request to see and endo with a view to prescribing a little T3....somehow I feel with the above mitigations it won't come to that. I'm mentioning it so that you know there is a further option.

Improved FT3 should lower your cholesterol ( mine soon dropped to acceptable level) I would not be persuaded to take statins before raising T3!

Your antibodies are fine so no action required there

Ah! Sorry, just noticed you said

Still waiting for results of echo cardiogram and if ok nhs will continue giving T3.

That throws a different light on the situation

You don't mention that you are taking T3....

If so how much T3 are you currently taking

It's very difficult for members to comment if we don't have all the details

So, to answer your question....

Based on these results does my current Levo dose still seem ok? I’ve been in the same dose for years.

The answer is no...but still there is no mention of taking T3.

Those results show you are undermedicated.....

Clue....your TSH has risen and FT3 has fallen

Get all your ducks in a row then you / we will have a better idea about what is going on.

Good luck

[Oakwood4321 in reply to DippyDame]

thanks for your reply DippyDame and checking my percentages.

I’ve just also replied to Jaydee with more information.

I feel wiped out but that’s the same as I have for years so nothing new.

My dose of Levo is 75 one day and 100 mgs on alternate days. So sorry it wasn’t clear.

I did the advanced b/t 3 months ago, it was ok.

I remember reading on here that most people feel better with a tsh of 1 or under (I think I’ve got that right) so yes I see mine is high at 2.9. The way you explained it is really helpful!

I haven’t taken T 3 for a year. I had started a nhs trial and after a few weeks stopped due to tightness in chest. Again, sorry for the confusion! Since then I alternate with 75 one day and 100 the next of Levo.

g.p. been trying to put me on statins for a few years but I refused and explained to him about the thyroid link.

Since my post this morning I’ve just tested positive for Covid . I did a routine test before visiting my dad. Not feeling ill, just a bit ‘heady’. I was possibly positive when I did my Medichecks test on Monday morning. I wonder if that would affect these results. I m not sure now whether to increase Levo or wait till Covid out of my system then do a full blood test with vitamins myself. 🤔

[DippyDame in reply to Oakwood4321]

Poor you...yes, get covid out of your system before testing.

Please don't apologise....hypo can hit us very badly...been there with bells on

Hope you feel better soon

Your symptoms further suggest you need more levo but I'd wait until after you have your next full thyroid test before altering your dose.

When correctly medicated cardiac and cholesterol issues should resolve.

Well done for refusing statins!

My GP thought I was killing myself at one point ( I need high dose T3-only and self medicate)..... ultimately all she saw was improvement! My heart scan showed no problems.

It's a long boring haul to get there but rushing the process gives an inaccurate result and outcome and I'd stick my neck out and suggest you just need more levo and optimal nutrients

Rest meantime and just wait until covid clears up.

Better days ahead!

[Oakwood4321 in reply to DippyDame]

thanks for your understanding and encouragement DippyDame - needed to read that as starting to feel bit rough now with Covid.

Since being on this forum I reckon I’ve developed much more patience with the process because I gain more understanding of this thyroid journey. It’s a year now waiting to get the checks but worth it. In the meantime I can test, ask guidance on results and keep on good routine with the supplements to help this condition that I’ve learnt about on here . 😊