Test Results

[moleland]

Hi Everyone

I would be grateful for any comments about my recent test results. I’m confused.

Briefly I have been hypothyroid for 17 years, I was on Levo but for the last 10 years I have been taking NDT which has been great.

I’ve received a text saying I must see the doctor, they say I’m over medicated.

Results

TSH 0.01. (0.27-4.2) lab wants this in range.

FT4 17 (11.0-22.0)

F3 2.8 (3.1- 6.8)

A note with these results says FT3 is of no value in patients on thyroxine- below the reference limit. Avoid doses that causes TSH suppression in the elderly. I’m 70 years old.

Two months ago I was diagnosed with Indeterminate colitis and markers suggestive of Cohn’s disease. I’m currently on a weaning dose of steroids and had a COVID jab the day before my blood draw. Would those factors affect my results? I’m really not sure what to think and would be grateful for any input. Apart from that I feel very well if not a bit tired at times.

best

Mole land

[SlowDragon Administrator]

Steroids frequently lower TSH

Covid jab might affect test results

Suggest you retest again 6-8 weeks after stopping steroids

Day before test split NDT into 2 or 3 doses and last dose approximately 8-12 hours before test

Meanwhile get Dr to test vitamin D, folate, ferritin and B12 if not tested recently

What vitamin supplements do you currently take

[moleland in reply to SlowDragon]

Thank you, I normally take vi D3, selenium, B complex, magnesium and omega fish oil. I was wondering if I had a conversion problem? I will check bloods as I’ve had lots done since my recent diagnosis. Thank you.

[SlowDragon Administrator in reply to moleland]

you need to stop B complex 5-7 days before test as it contains biotin and biotin can falsely affect test results

Your Ft3 is currently low

Did you split NDT into smaller doses day before and last dose 8-12 hours before test

[moleland in reply to SlowDragon]

Hi I did stop the Bs. I didn’t slit the doses, my draw was at 8 30 am I took my NDT the previous early morning as I have had to juggle other medications around it.

[SlowDragon Administrator in reply to moleland]

so your Ft3 is falsely low

Next test …..day before test split NDT as 2 doses and last dose 8-12 hours before test

Many people on NDT split dose everyday

On NDT you would expect TSH to be very low or suppressed.

[Joant24]

hi, I’m no expert and am sure others will be of more help but your T3 is under range and if you reduce your NDT surely you’ll feel quite poorly. How do you feel now?

[moleland in reply to Joant24]

Hi yes I’m fine and I have always gone by the way I feel along with checking my results. My thoughts were the same as yours, surely my t3 needs to rise, and not reduce with a medication reduction. That’s why I’m confused by the lab information notes. It seems contrary to what is suggested on this site. Thank you. X

[pennyannie in reply to moleland]

Since you have left 24 hours between your last dose of NDT and the blood test your T3 level will look low as T3 does not stay in the blood as long as 24 hours so as already detailed - your blood test is showing a false low T3.

If this is the way you always run your blood tests - what levels has our T3 been previous times so you can compare because as you say, you feel ok, but for a bit of tiredness which you may well be explaining way, to other things, as I do.

On NDT we need around a 12 hour window from last dose of NDT to blood draw -

I take my NDT once a day ar around 3.00 am at a toilet break - and generally I leave around 10 hours and my T3 is high in range around 100% with my T4 at around 25% through the range -

I have no signs of hyper type symptoms, I've had RAI thyroid ablation for Graves and if anything I'm running myself slightly hypothyroid, in that not all my symptoms are fully resolved, but I'm much improved.

My TSH is suppressed at 0,01 irrespective of the time of day :

T3 suppresses TSH - it's just what it does and why you must track on a Free T3 reading.

[moleland in reply to pennyannie]

Thank you for your information

[pennyannie in reply to moleland]

The laboratory ' advice / suggestion report will be based on your TSH reading - that's just how it is :

Your doctor should know how NDT presents in blood tests and how to interpret these results in the round as TSH, Free T3 and Free T4 directly relate to each other.

Sadly I read, very many doctors do not even know of NDT - and look at just a TSH reading and follow the computer guidelines which are limited.

I'm not aware the computer knows of your health issues or why you are even taking this treatment as I'm not sure the computer does joined up thinking - yet !! ??

[moleland in reply to pennyannie]

Thank you for that information I did not know about the 12 hour bit. I will look back on previous tests and track t3.

[pennyannie in reply to moleland]

Well yes, if you previous results there and have always followed the same protocol you should be able to compare and pinpoint when, if, anything changed.

[moleland in reply to pennyannie]

I’m going on to split doses from today thank once again.

[pennyannie in reply to moleland]

I think you first need to know - if anything has actually changed regarding your thyroid function by looking at previous results as you followed the same protocol with dose and time of blood draw - so have a direct comparison -

If things have changed - following the same protocol - tap out your previous result so forum members can compare and give constructive advice.

As you say you feel well - why change your routine - your body is not complaining ?

I don't seem able to split my dose of NDT - as I find can't get off to sleep.

I'm only taking 1 + 1/2 grains which compared to others, is a relatively low dose, considering I've had RAI thyroid ablation and likely with a burnt up disabled thyroid.

Anyway - splitting your dose will not change the TSH and that is what has prompted this message.

So yes the T3 is a false low, as the suggestions are to run a blood test at 12 hours -

if I waited 24 hours my T3 would also be a false low -

but I'm fine in the 24 hour window before the blood draw - and I am not prepared to jeopardise my health any further and change my routine for the sake of blood test result which is not even understood by medics who look at a TSH reading in isolation.

It's just a number and a snapshot in time - you feel well - so be it :

[moleland in reply to pennyannie]

I agree unfortunately the dr is hell bent on fixating on the TSH and wants it at a particular number, (All my patients are well at this level ) I bet they are not. We all have individual responses to meds it’s not static, it would be easier if it was. Not everyone’s blood pressure is the same, it changes as you visit the gp but they allow differences of results within the normal ranges. Why he thinks a particular number is key is maddening.

[pennyannie in reply to moleland]

Yes, I understand and why I've not been near a doctor since 2018 when I was refused both NDT and T3 through the NHS where I live.

Sorry you have to go through this hoop - but the TSH does not respond immediately and it may never bounce, or crawl back into range :

Find your previous results - just for interests sake - if the TSH is stuck at 0,01 - why were they not bothered about you before now ?

[moleland in reply to pennyannie]

Quite thanks a bunch.

[Joant24 in reply to moleland]

Pennyannie is much more clued up than me, I shall say no more 😂😂