Help – just received blood results from this mornings test and confused

[Watamu]

Blood Test Results done on 5/7/23

TSH 0.15 mU/L 0.35 to 5.50 mU/L

Free T4 17.7 pmol/L 10.5 to 21.0 pmol/L

CRP <4 mg/L 0 to 9 mg/L

Ferritin 43.9 ug/L 10.0 to 291.0 ug/L

A normal ferritin may not exclude iron deficiency if levels are at the lower end of the normal range or in the presence of inflammation.

Free T3 5.5 pmol 3.5 to 6.5 pmol/L

Vitamin B12 798.0 211.0 to 911.0 ng/L

Blood Test Results done on 12/5/23

TSH 0.19mu/L 0.35 – 5.50

Free T4 20.4pmol/L 10.5 – 21.0

Free T3 5.6pmol/L 3.5 – 6.5

Ferritin 31.4ug/L (10.0 – 291.0) I’m taking 20mg Simply Heme by Three Arrows.

Folate 22.54 ug/L >4.12ug/L

Vitamin B12 874 211 – 911

Please can you interpret what is going on with my thyroid levels. Last time I posted in May my GP had reduced my Levo back to 75mcg from 100kmcg which he had increased only eight weeks previously, the reason being my TSH low level. I emailed him and he agreed to go 75/100 alternate days. (I cut the tabs in half and take the same amount each day) Now my TSH is even lower and I am worried he is again going to lower my dose. My T3 has dropped from my last blood test, I am worried that if my Levo is reduced my T3 will drop even more. Three Arrows seems to be working on my Feritin. My B12 has dropped also, should I start the B12 liquid again?

[radd]

Watamu,

Sorry you haven’t received a timely response but my answering will move your post back onto the 'daily feed' for members to re-view.

Alternatively you are welcome to repost your question 😊.

[pennyannie]

Hello Watamu ;

If your doctor is looking at just your TSH since the dose reduction in T4 your TSH has fallen even further and now under the range which is why the TSH is not a reliable measure of anything once taking any form of thyroid hormone replacement.

The TSH is also slow to respond to dose changes and may come back up and into the range.

You must be dosed and monitored on your Free T3 and Free T4 readings which are in range :

The previous reading gives a T4 at around 99% with a T3 at around 70% - so in some ways can understand the suggestion of a dose reduction:

Now your T4 is around 66% with your T3 at around 66% :

Your ferritin needs to be at least over 70 for any thyroid hormone replacement to work well and as this rises through the range you should feel more able to convert the T4 into T3 though your T3 has dropped a smidgeon it is still at a reasonable level.

Your inflammation reading looked high to me - but then the range used is up to 9 - and yes inflammation can falsely raise ferritin levels but since you are supplement iron I'm presuming this gradual increase from May due to your supplementation.

What symptoms are you dealing with - do you have Hashimoto's - a thyroid AI disease ?

OK - so just read your bio - and yes there are thyroid nodules and Hashimoto's as I read of high TPO antibodies.