I 'd like some advice with these abnormally high test results. For the first time ever, my free T4 is out of range- too high-, and so is my Vit D. My TSH is also low, but I've had that before. I have Hashimotos and am on Levothyroxine 200mcg. My GP wants to reduce my Levo to alternating days of 175mcg and 200mcg. I take daily 3000iu of Vit D oral spray ( and went on holiday to a Med country in autumn), iron regularly (alternate days ), selenium daily and magnesium 3 times a week.
I took the test about 9am but had taken Levo about 8 hours previously. My levels have never been this high. Is this something to be worried about? I feel tired, a little jumpy, some hair loss- basically the same as ever.
(I finally managed to get a copy from my GP as the abnormal test results weren't available online).
FREE T3 5.1 3.10-6.80pmol/L NORMAL NO ACTION
!Vit D Serum 25-HO Vit D3 195 50.00-150,00nmol/L
Thyroid function
!Serum TSH level 0.05 0.27-4.20mIU/L
!Serum free T4 level 23.5 11.00-21.20 pmol/L
Thanks
Emski
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What did your last FT4 look like? And when was it done? Is this one a lot higher than the last?
Two possibilities:
a) the high level is due to taking your levo only 8 hours before the blood draw - it's better to leave 24 hours. Is that the way you normally do your tests?
b) the high level is due to a slight Hashi's 'hyper' swing. In which case, it will come down again by itself.
Or, could be a combination of the two.
What time of day was the blood draw for this test?
And, how do you feel? Do you feel over-medicated? Frankly, it's not that much over-range, so probably nothing to worry about. Especially as the FT3 is well within-range. Some people just need their FT4 over-range to get their FT3 high enough. But, the fact that the FT3 is ok leads me to think that it was probably taking the levo so close to the blood draw that caused the FT4 to be high.
I think your doctor is just looking at the TSH and having a knee-jerk reaction. They believe the TSH tells them 'all they need to know'. They are wrong. You are not over-medicated unless your FT3 is well over-range. Yours is only about 50% through the range. So, if it were me, I would refuse to reduce my dose - unless you do feel over-medicated, of course.
Thanks, greygoose, for your reply. I take Accord Levo and had the test at about 9.30am.
My last FT4 test was about 18, about 3 years ago. When I have had it tested (over the last 6 years), it's been in the 16-18. So I was very surprised to see it outside of range. I think it's likely the high range is due to a Hashi hyper swing. I'd like to get my FT3 higher, but it's never shifted- it's always around the middle.
I don't know if I feel overmedicated or if I'm feeling 'hyper' because of a hyper swing. I do know I feel jumpy, edgy and have a terrible memory, sometimes.
Well, I don't think it's a Hashi's swing, because the FT3 is still low. Usually, they both go over-range during a swing. I think it's more likely to be due to you taking the levo too close to the blood draw. It's best to leave a gap of 24 hours.
You are a poor converter, and often there's nothing you can do about that. But, are your nutrients optimal - vit D, vit B12, folate, ferritin? Have you tried taking selenium? If none of that works - and as you have Hashi's it probably won't, but worth trying anyway - the only solution is to obtain T3 and take that.
I do not have Hashi but my test results are always way out. T4 way above range,TSH incredibly low, but T3 highish but normal. I feel very well and I suppose my question would be: how do you feelafter a couple of weeks or so of having these results ?
Hi Fiftyone, thanks for your reply. I don't feel any different to how I've felt for years, which is not particularly well, but able to function. Mostly tired, incredibly hungry at times, mood swings, hair loss.
I take Accord and get the same brand at the pharmacy ( Teva and Northstar made me feel terrible).
I'm trying to understand how my Vit D can shoot up so dramatically, during winter. This is probably the most concerning of my results. I've been taking the same vit D brand for at least 4 years and never seen it this high. Any ideas would be welcome. Thanks
Thanks, Slow Dragon. Will look into folate.Yes, have lost weight so this probably affected my thyroid levels and Vit D. Will do another test, privately, to find out more. Thank you.
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
I've lost about 12 kg due to exercise, and intermittent fasting (more time during lockdowns!) Will check out Vit B.Thanks for your advice and reminders.
has there been any improvement it how you feel since you increased to 200mcg 9 mths ago ?
if not , then there may be reasons to avoid having fT4 any higher than you need it to feel well , as it's possible there are some recent concerns that having high /over rage fT4 promotes cancer cell proliferation but the full facts are not clear yet , it's very recent research...
The TSH at 0.05 is about as low as you want it really , unless you really need it this low to feel well. ( as there is some evidence of increased risks at levels below 0.04 on levo :
So bearing all this in mind , and if you do not feel better on 200mcg , i would agree with GP that a slight reduction would be a sensible course of action at the moment and trying 175 / 200 alternate for a few months then retesting seems reasonable.
I would add that feeling (physically) jumpy was definitely a sign of overmedication for me , along with increased frequency of bowel movements , and a very fine tremor in fingers ,(this period of overmedication did not really relate to my fT4 levels (fT4 was a bit over range at 120% , but it had been much higher than that before and since without any symptoms of overmedication) .. bit my TSH at the time was a tad lower than my usual (usual was 0.05 ish or more ,and it had fallen slightly to 0.018) ....
however i note that you have mentioned feeling jumpy in several previous posts when you were on much lower doses that 200 , when fT4 /TSH were in range (i think) .. so it's not clear whether feeling jumpy is a sign of overmedication for you or not.
Your fT4 may well come down again all by itself in few months , mine did when it went through the roof a couple of yrs ago (for no apparent reason) , but for the time being, if i were you , i would reduce dose a LITTLE bit (unless you feel good a the moment.)
Tattybogle, thanks for your reply. Given me lots to consider and research
The different doses haven't made me feel any different: tired, brain fog, very forgetful sometimes, hair loss. In the last few years jumpiness is another symptom but its hard to differentiate that from having Hashis and having a hyper swing , and overmedication.
Others have suggested I don't convert Levo very well.
The high FT4 and Vit D results have confused me. Never happened to me before.So your FT3 was also high too for no apparent reason. Maybe this just happens?
Anyway, I 'll organise another blood test privately without taking Levo for 24 hours and assess again. In the meantime, I'll take 175mcg alternating with 200mcg., with a view to 175mcg every day.
sadly NHS never tested my fT3 when it would be have been most interesting to know it ..
the time i did have overmedication symptoms and felt truly unwell:
2016 .... (150mcg) TSH 0.018 / fT4 19.9 [8-18] 119% was clearly overmedicated, inc weight loss and all sorts, felt like i was dying TBH .
Reduced to 125mcg .. all symptoms resolved.
I think this episode of overmedication was due to me just needing a bit less thyroid hormone post menopause, as i had been stable on 150mcg for previous 15yrs .
6/2019 ...(125mcg) TSH 0.041 / fT4 20.6 [7.9-14] 206% ...felt ok. i was doing quite well actually .. but GP reduced to 112.5mcg.
9/2019..(112.5mcg) TSH 0.097 / fT4 22.7 [7.9-14] 242% ( had felt really naff for first 6 weeks on 112.5 and had only just started to feel half human again, but eventually i agreed to reduce further to 100mcg.
3/2020 .. (100mcg) TSH 0.511 / fT4 19 [7.9-14] 181% (by now ... a completely constipated zombie, unable to even cross the road safely.. i insisted on dose going back up regardless of what the fT4 result was)
10/2020 ..(112.5mcg) TSH 1.947 / fT4 16.6 [7.9-14] 142% i could function again and have stayed on 112.5mcg since .
Really interesting Tatty bogle. I'm going to track my results like this. Yes, trying to make sense of thyroid blood tests is like studying for a degree!Thanks.
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Thyroid levels are about the same with or without Levothyroxine
b12 levels high and serum ALT 
High cholesterol, high blood pressure & subclinical
High Testosterone Level 
