Latest blood test results

[Dadof5]

Following an increase in my Levothyroxine dose to 175mg at the end of August. I have just retested my levels last Tuesday. I followed all the recommendations posted on here I stopped my b complex over a week before the tests. I took a monitor my health test just after 8 am and followed it up with a test at the hospital just after 9:15. Posted below is my monitor my health test from 14/08 followed by my monitor my health test 24/10 then my nhs test 24/10.

14/08

TSH 2.61 mIU/L (.27 - 4.2) 59.5%

Free T4 (fT4) 16.4 pmol/L (12 - 22) 44.0%

Free T3 (fT3) 5 pmol/L (3.1 - 6.8) 51.4%

T4:T3 Ratio 3.280 

24/10 (MMH)

TSH .67 mIU/L (.27 - 4.2) 10.2%

Free T4 (fT4) 17.1 pmol/L (12 - 22) 51.0%

Free T3 (fT3) 5.5 pmol/L (3.1 - 6.8) 64.9%

T4:T3 Ratio 3.109 

24/10 ( NHS)

TSH .6 mIU/L (.34 - 5.6) 4.9%

Free T4 (fT4) 13 pmol/L (7.7 - 15.1) 71.6%

Free T3 (fT3) 6.5 pmol/L (4.3 - 6.8) 88.0%

T4:T3 Ratio 2.000 

I can’t believe the nhs actually tested FT3

Anybody have any thoughts on my results as no doubt I will have to speak to the doctor soon. I’m a bit disappointed with the nhs results as they seem to show that I’m doing a lot better than the monitor my health results.

[SlowDragon Administrator]

How do you feel on increased dose?

Suggest you retest again in another 8 weeks including vitamin levels

[Dadof5 in reply to SlowDragon]

Lol three times now I have messed up the purple tube that comes with the full health screen from monitor my health. Either not enough blood to test or not mixing it with the anticoagulant coating. Although I do follow their instructions to the letter.

I did get my vitamin d this time. It was 82 down from 93 last time.

[pennyannie]

Hey there Dadof5 :

So do we presume you feel no better since the dose increase ?

The trouble is blood tests are just a snapshot in time and onluy one measure of wellness and sadly most doctors seem stuck on a computer screen rather than having a face to face conversation with the patient.

You are also comparing different ranges there MMH / NHS :

The accepted conversion ratio when on T4 monotherapy is said to be 1 / 3.50 - 4.50 - T3/T4 -with most people feeling at their best when the T4 is in the top quadrant and they come in this ratio at 4 or under.

So you appear to be running with a fast metabolism - BUT your T4 is not high enough in the range yet and your T3 / T4 ratio not an accurate measure of anything.

When T4 levels are too low the body protects T3 over T4 - and since there is not enough Free T4 circulating in the blood stream this ratio of 2 is not a true picture as your T4 is currently too low and you need a dose increase in T4.

What symptoms are you dealing with ?

[Dadof5 in reply to pennyannie]

To be honest it’s mainly a fuzzy memory and weight loss problems. I’m not really tired but then again I’m not working at all. Just at home caring for my partner and looking after the kids. If I was out working nine to five I may might feel differently. I was on this dosage during Covid and managed to get down to just over 17st from 19st but then my doctor freaked out at my TSH 0.02 and dropped me back to 150mg a day August 22 and I’ve put the weight back on. It’s the weight that is really bothering me to be honest.

[SlowDragon Administrator in reply to Dadof5]

Can’t remember……

Have you got high thyroid antibodies - autoimmune thyroid disease aka Hashimoto’s

Have you had coeliac blood test

Are you on gluten free and/or dairy free diet

Both could help with symptoms and possibly weight loss

Try gluten free first as it’s easier

If GP wants to reduce dose ….refuse

Remind GP Metformin lowers TSH

(they are highly likely unaware)

Metformin lowers TSH

cureus.com/articles/50564-e...

at next test it may show you have room for small increase in dose

[pennyannie in reply to Dadof5]

Hey there again - I've just reworded my reply from a day of two ago - you need to increase your dose in spite of the TSH :

[Dadof5 in reply to pennyannie]

I am curious as to what you mean by a fast metabolism?

[pennyannie in reply to Dadof5]

In normal circumstances a fast metabolism would mean your body running faster than usual - more energy, faster heart rate. more frequent bowel movements, eating more food but loosing weight, unable to swich off, nervous, jittery :

but I don't think this is your issue as I think you are just totally exhausted as you haven't enough T4 in your body to allow for easy conversion of T4 into T3 and why your conversion ratio of 2 is below the accepted ratio range -

Do you feel as though you're have to push everything uphill all the time and with no energy ?

Does thaat make sense ?

I could be totally wrong - ??

I notice you lost some 2 stone in weight duing Covid and then because of your TSH your doctor reduced your T4 dose and then everything went a bit pearshaped - you're now running on less T4 - and think you need the higher dose of T4 reinstated -

Apart from needing optimal core strength vitamins and minerals conversion can also be compromised by inflammation, antibodies, any physiological stress ( emotional or physical ) dieting - depression and ageing :

Dieting does not work when hypothyroid - and this may well have played into the equation - and adjusted your own set point of metabolising and the conversion of thyroid hormones.

[pennyannie in reply to Dadof5]

Running on ' empty ' ?

[pennyannie in reply to pennyannie]

The MMH result looks more realistic to me - MMH use an NHS laboratory - I'd show your doctor the MMH results - and ask for an rerun on the NHS.

[Bearo]

Re: results from MMH and NHS - I’ve had different FT4 results from the same blood draw sent to the two labs with the same ranges . My FT4 was 16 for mmh and 18 with nhs.

I think there is consistency between mmh tests, and between nhs tests but not between the two.

I think it shows that blood testing isn’t the reliable process we like to think it is!

[tattybogle in reply to Bearo]

" blood testing isn't the reliable process we like to think it is "

agreed , there are significant problems ~ especially when trying to compare different test methods/ labs / ref ranges .

Some are more comparable than others . but some do have significant differences .

Comparing fT4 / fT3 results from different methods/ labs is therefore not accurate. and evidence from the industry itself (and from occasional patients on here who have done comparison tests) , shows that converting results to '% through range' does not completely get round this issue.

The most reliable way to monitor changes in our fT4/fT3 levels (and to a lesser extent TSH ) has to be consistently using same lab/ test process / ref range ;

healthunlocked.com/thyroidu.... (difference-in-reference-ranges-reading-matter-for-a-rainy-day)

eg, if i'd like to know what my fT4 is at the moment to compare it to my GP result from several months ago ...... i could use a fingerpick kit , but none of them use the same [7.9-14] range/ test method that my NHS lab uses ... so i could not confidently compare the result to my previous NHS one .

I would fairly confidently compare a GP [7.9-14] result to another GP [7.9-14]result, or a MMH [12-22] result to another MMH [12-22]result , but not to each other .

My personal suspicion is that if i did 2 samples at exact same time , my GP's [7.9-14] results would appear as a noticeably higher '% through range' than a MMH [12-22] result would , but as yet i haven't put this theory to the test. (i rarely want to offer my GP an opportunity to fiddle with my prescription , unless really necessary)

Dadof5's fT4 results seem to support my suspicion that lower/narrower fT4 ranges (7/8ish -14/15 ish) are showing a significantly higher % through range , but as his samples were not taken at exact same time, it's not proven .