TSH T3 and T4 NHS Test results via GP

[Rambling9]

I've just seen the test results online and note differences from the test via Medichecks on March 9th (see previous post) Test done just after 8am - fasting with only water - thyroxin over 24 hours before.

TSH is higher at 1.73 - on March 9th it was 0.69 - so quite a bit worse (same range for both 0.27-4.2)

Free T3 is below range - so I need to contact GP it's 2.8 now and was 3.34 before (same range for both 3.1-6.8)

Free T4 is in range (just below the max so still high) at 24.6 (range 10.8-25.5) on March 9 it was 32.1 (range 12-22)

I know that the TSH needs to be below 1 though - any thoughts?

I'm pleased that the lab did the T3 and T4 tests though!

Many thanks

[GlowCoach Administrator]

Are you now supplementing your low vitamin levels as per this post & replies? healthunlocked.com/thyroidu...

Have you treid a gluten free diet, I see you had positive antibodies? Some people also need to remove dairy to help symptoms.

You really do seem to be a terrible converter. Do email [e-mail] for a list of Endo's. Ask GP to refer you to one near you to hopefully get some T3 added to your Levo.

[Rambling9 in reply to GlowCoach]

Hi - yes now have VitD+K2 spray in addition to Vit D tablets and folate, also back on iron tablets and on leafy greens daily (plus back on citrus fruit with these meals - I'd avoided them because of gastritis issues) also switched PPIs for H2 Blockers so in theory absorption should be better in addition to more nutrients going in - but that may take time to even out?

Haven't tried GF diet yet - I was hoping that optimising vit and mineral intake plus sorting absorption would do the trick...

I've got the list of Endos and there's one at a close-ish hospital (although not the nearest one!)

[GlowCoach Administrator in reply to Rambling9]

H2 blockers aren't quite as bad as PPI's but they will still reduce your absorption of nutrients. Reflux symptoms in hypothyroidism are caused by LOW stomach acid so try a teaspoon of apple cider vinegar(needs to include part of the Mother) in a glass of water before main meal or Betain & Pepsin can be bought which might help.

Dietary changes for some hypo people are unavoidable regardless of thyroid & vitamin replacement level. Some issues can be caused by FODMAP's. See link. monashfodmap.com/ibs-centra...

[Rambling9 in reply to GlowCoach]

I'm taking the H2 blocker last thing at night - levo first thing in morning so fingers crossed it'll be as good as it can be.

I'd read somewhere else about hypo and low stomach acid - reflux and gastritis (plus last year a stomach ulcer) have been ongoing issues for me - are gastritis and ulcer due to low stomach acid too? It feels very counterintuitive!

Is it likely that my GP will suggest increasing Levo to increase T3 that way? I'm on 200mcg at moment. I'll talk to him about poor conversion and adding in T3 too

[GlowCoach Administrator]

Your low FT3 will be causing you lots of issues, I believe people with hypothyroidism are more likely to get stomach ulcers, so the low levels of hormone are more an issue than the low stomach acid.

Looking at your recent posts you have recently reduced Levo due to going over range on FT4. This is where you are likely to find out about your GPs understanding or lack of, of thyroid disease and treatment. They often disregard FT3 when TSH is within range as they believe that TSH is the only indicator of good replacement. As patients we know this is not the case and looking at free thyroid number FT4 & FT3 are a better indicator of how well we are and if our replacement is good or not.

You may need to push your GP for a referral to an Endocrinologist but do try to get to one on the list.

[Rambling9 in reply to GlowCoach]

Hi Jaydee - I didn't understand why reducing levo would help raise T3 - still struggling to get my head around all of this. So I reduced two days for a week by 25mcg but resumed 200mcg per day - If I decrease levo then won't that then decrease the amount converted to T3? or am I being very obtuse?!

[GlowCoach Administrator in reply to Rambling9]

Generally speaking reducing Levo will also reduce FT3. Doctors do not place any importance at all on FT3. This is where patient groups differ to the opinions of medics. They are obsessed with TSH being the best indicator of thyroid hormone replacement which is wrong.

The NHS frequently now only test TSH, sometimes also FT4. It isn't good to have an FT4 over range as yours was. None of that though is looking at the active hormone in your body FT3.

T4 is just a storage hormone.

[Hay2016 in reply to Rambling9]

I had the same thoughts as you but getting my t4 slightly reduced did increase my t3 as apparently high t4 slows t4/t3 conversion. In your case it may bring your t3 just into range but def won’t get it near levels where you’ll be relieved of your symptoms. Xx

[Rambling9 in reply to Hay2016]

Thank you

[pennyannie]

Hey there again ;

since you haven't a thyroid and TSH is a useless measure of anything.

you must be dosed and monitored on your Free T3 and Free T4 readings and ranges and these should both be in range and when of T4 monotherapy, at around a 1/4 ratio T3/T4 with T4 likely being in the top quadrant of the range to offer up a T3 in around the mid 5's.

Hopefully you will be referred to an endocrinologist and understand that can be someone of your own choice :

Obtaining T3 - Liothyronine on the NHS is something of a post code lottery -

If you go into openprescribing.net and then analyse you can by surgery and local CCG/ICB how supportive your surgery / area are - as I believe for new T3 prescriptions the Nice guidelines are not being followed properly throughout the country.

Just enter Liothyronine as the drug you are wanting details on ;

I see you have the Thyroid UK list - this is a patient to patient recommended list -

you can also ask, for current feedback on any endo/thyroid specialist you think you might like to so and your replies will have to be by Private Messages ( paper plane icon above ) as we can't be seen to openly discuss individuals.