sudden drop in thyroid results!!

[Pinky3]

I recently had some health concerns which are still being investigated, in the meantime a new symptom of swollen face has occurred and I seem to of gained all the weight I just lost. I got some thyroid results today and was shocked to see how they have decreased when I usually have a steady result.

Today:

13.2 free t4

4.4 free t3

TSH 0.01

previous to these my results were:

07 Aug 2023

Serum free T4 17.2 pmol/L

Normal range 11 - 22.6

Serum free T3 5.2 pmol/L

Range 3.5 - 6.5

Serum TSH level 0.02 mu/L

Normal range0.2 - 4.0

I take HRT 2 pumps oestrogen and 2 tablets progesterone 14days a month.

I am prescribed testogel also 1/7 per day of gel.

Can anyone advised why my levels have dropped significantly? I know I will have trouble asking the doctor to increase my dose as these numbers are in range but I know I feel better when the results are higher. Can they decline? I also take my tablets on an empty stomach. Current dose 150mg t4, 10mg lio.

Any suggestions ?

[SlowDragon Administrator]

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)

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

Is this how you do your tests

Which brand Levo

Which brand T3

Do you always get same brand at each prescription

No vitamin results

What supplements do you take

[Pinky3 in reply to SlowDragon]

Thank you for replying, yes that’s how I take all my blood tests.

I recently had a b12 injection but the last result for that was 329.

Vitamin D I supplement with a spray better4U due to the last result being 54.

Serum folate in Jan.

Result

11.4 ug/L

Normal range 3.0 - 14.4

FERRITIN in December.

30 - 150 R

126ug

The brands are always the same.

I’m just confused by the drop in my thyroid levels? My face is definitely puffy and I’m having digestive issues and feel pretty flat in mood. Do you think I could do with an increase?

[Pinky3 in reply to Pinky3]

Does anyone have advice on whether I’m under medicated and the amount I need to increase, I’d really appreciate an opinion.

Being on liothyronine my tsh is always 0.01. For my t4 and T3 to drop after being in the upper ranges for a long time is strange? I can only think the HRT might be having an effect? Although the oestrogen is not orally taken it’s a spray and I have read it should not have an impact.

I am going to try and contact the endocrinologist today, does anyone have any words of wisdom?

[TiggerMe Ambassador in reply to Pinky3]

Yes, you certainly need to discuss an increase with your Endo, I tend to feel awful if either of my frees drop below 50% (I had to tweak my dosing up a little when I added HRT) but only wanting to change one thing at a time I'd be inclined to ask for another 5mcg T3 🤗

Did you feel well in August?

[Pinky3 in reply to TiggerMe]

Thank you so much for your reply🙂

I will ask for the 5mcg T3 though I know it’ll be a challenge 🙄 do you think that will be enough to raise both T4/T3?

I felt well in August apart from the apparent perimenopause symptoms as my testosterone was low.

It was 4 weeks ago that my face started to puff out and I felt down, my skin is definitely drier and I look haggard, no motivation and started to get the usual digestive complaints. The only thing I did change was 3 pumps to 2 as apparently my oestrogen too high.

It’s so frustrating to have to battle through these conditions and worry about asking for the right amount of medication. I really hope I get somewhere?

[TiggerMe Ambassador in reply to Pinky3]

Probably best to be guided by your Endo thankfully he obviously isn't one that works by TSH so he'll have to agree your frees are low... he might offer you 10mcg! They bang on about the dangers and then often give quite large increases 😵 and then you have a bit of flexibility with how much you choose to add... have you tried splitting your T4 dose as sometimes that improves uptake?

[Pinky3 in reply to TiggerMe]

I’ve never tried splitting, I will give that a go, I did panic and pop 25mcg T4 in the afternoon after I saw those results lol! Well he normally asks me to raise my TSH up but he gave up after I challenged him with the information I learnt on here.

[TiggerMe Ambassador in reply to Pinky3]

They do tend to back down when TSH dosing is challenged thankfully 😏

It's good that you have results to show when you felt well and you have a change in circumstance (HRT) which have possibly upset things a little (not uncommon even with transdermal) so it seems understandable that a tweak is in order... you have all the evidence to join the dots 🤗