Need help with test results

[KristinCC]

I had some labs last week in preparation for a doctor's appointment tomorrow. I have PBC and have my liver enzymes tested regularly and asked my doctor to check my thyroid as well. I've had quite drastic hairloss and really feel it has to do with thyroid levels. I take T4 and T3 and my doctor is fixated on my very low TSH and can't really look past it for some reason to take the other two readings into account.

I had asked for a ferritin test as well, but it doesn't look like they did that one for some reason. I don't check B-12 as I also have PA and take B-12 shots. I'm still working on getting folate and vitamin D.

Test was performed in the morning before eating or drinking and I did not take my meds before the test.

FT3 2.740 (2.3-4.2)

FT4 1.180 (0.7-1.53)

TSH <0.015 (0.300-4.000)

These results are "normal" according to the ranges and my doctor will just agree with that. The TSH level stops him from looking at anything else. He thinks my hairloss is due to age and menopause.

My LDL was raised as well 124.2 (0.0-99.0)

Thank you for taking a look.

[SlowDragon Administrator]

how much levothyroxine are you taking

How much T3

Do you always get same brands at each prescription

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

On T3 - day before test split T3 as 2 or 3 smaller doses spread through the day with last dose 8-12 hours before test

is this how you did your test

Do you normally split your T3

FT4: 1.18 pmol/l (Range 0.7 - 1.53)

Ft4 is 57.83% through range

FT3: 2.74 pmol/l (Range 2.3 - 4.2)

Ft3 only 23.16% through range…..

but if last dose was 24 hours before test this is false low

[KristinCC in reply to SlowDragon]

I take 88 mcg levothyroxine (same brand each time)5 mcg liothyronine 2x daily, one in morning and the other dose around 2:00 pm (same brand)

I took T4 and only one dose of T3 the morning before my test, so I would have 24 hours without any meds before testing.

That is how I normally test and my T3 has never been that low before, but I see your point.

[SlowDragon Administrator in reply to KristinCC]

Suggest you retest correctly

Or as Ft4 is quite low increase levothyroxine to 100mcg and 87mcg on alternate days….wait 6-8 weeks then retest

[KristinCC]

Thank you for the advice!

[Decaston]

Hi Kristin,

Although l am resident in the U.K., l have lived in the USA for 3 years, our son was born there, l was not on a high wage and Blue Cross Blue Shield was not much help, so l learned the hard way re medical costs.

Here in the U.K., although costs are lower, and we have an nhs, you are not allocated a lot of time, they don’t read your notes properly and there is not a lot of joined up thinking 🤔.

We are both 70 years and it’s my wife that has hypothyroidism plus some other medical problems. Our doctors are brainwashed to think that the only thing they should prescribe is synthetic Levothyoxine, my wife has to get the natural thyroid on a private prescription.

It sounds like it’s time for you to become more knowledgeable and to diagnose your own symptoms, many U.K. doctors (sounds like USA same) just don’t know what they they are doing because they don’t factor in the different factors there are other medical issues that cause many of the same symptoms, so you could potentially have more than one medical problem e.g. low sodium, anaemia etc ( sorry 😞 not trying to stress you out further).

A sensible purchase for you would be ‘ stop the thyroid madness’ l think the author is American but it is written by someone with Hypothyroidism and someone that has had decades of being misdiagnosed ( an international best sellers) get it on Amazon.

So besides being on the alert for other medical problems, besides the thyroid, a low TSH is as you are probably aware is an indication that you either have an overactive thyroid or you are taking too much thyroid medication.

I am assuming you have an under active thyroid and are taking too much thyroid, if that’s the case take less, the usual dose is 30 mg, with a 15 mg increase every 2/3 weeks. There can be a massive difference in dosage. My wife was on the synthetic only and told she was normal on the scale, but felt dreadful. The charts are an indication but it is very much how you feel that is equally important.

If you buy the recommended book, the knowledge will empower you, it’s not rocket science, it’s common sense and logic. I hope this helps

Regards Stephen

[Bearo in reply to Decaston]

A useful sum up of the NHS approach to thyroid problems ! But I have to take issue with your assertion that a low TSH always means overmedication. As you can see, Kristin, like many of us, has mid range FT4 and rather low FT3 with a low TSH so how can she be over medicated? She needs to raise her FT3 and maybe also FT4 and she can’t do that on a lower dose.

Some of us find our TSH hits the floor and is unwilling to move even when the dose is lowered, but it’s where FT4 and FT3 are that really matters.