Test results.. Confused..

[MrsClanger]

Hi. Peeps...

Confused about recent blood tests....

My last thyroid test approx 5 months ago i forgot to take my t3 within 12 hrs of test, ( last dose was 4 pm day before am test) so theoretical it may have been lower than it should have been..

Since then i increased my T 3 slightly from 17.5 mcg daily to 20 mcg daily.

Mainly because it's easier than splitting tablets, and I now take all nhs t3, which I thought may be better than taking half an out of date tablet I would be buying online.

Im still on the same amount of levothyroxine ..at 75 mcg daily.

( actual tablets have changed tho.. Info below)

This test - I took a last dose of 5 mcg t3 at 9 pm the night before the blood test at 8.40 am .

I stopped taking all my suppliments inc all b vits a week before the test.

..

Can anyone please explain why my t4 has gone down so much now..3.9 decrease ..and my t3 almost the same as last test .??

If anything i feel like im under medicated even tho I increased my dose.. . Often tired gaining weight.. But stress eating so no surprise there.

But im not sure if i should increase meds more.. Gp and endo both say im over medicated because of the suppressed tsh.. But I am more concerned that the t3 and t 4 gap is getting bigger.. But they won't listen as it's within range. I feel something is not right.

.. I was feeling fine 5 months ago.. Had started taking estrogen pessaries ( last post has more info) but then just decided it was not worth taking as I'm just not interested in a sexual relationship, I'd only just started taking it for a month or two.. But after another attempt I just figured no point.. so I stopped. Gp said no need to worry about it and no side effects from stopping it..

Wonder could this have anything to do with my T4 level? But gp says no.. And it was such a brief amount of time.

Other possible cause..? my brand of tablets have changed slightly levothyroxine is now one 75 mcg( teva brand) tablet instead of 3x 25mcg. ( can't remember but it was some other brand)

For my T3.. I was taking half a 25mcg tyromel tablet that I bought online and one from nhs 5 mcg Morningside nhs supplied tablet 3 pm. ( 17.5mcg daily) Then i switched to ( 2x 5mcg Morningside twice daily = 20 mcg daily ) all nhs prescribed tablets.. I'm wondering if it could be to do with absorbing the tablets..

Im always worried about the other tests that are high.. doctors never seem to be able to explain that.

Recent Test results.

T4

14.5 pmol/L

Range:11.1 - 22 pmol/L

( 3.9 lower than last test )

T3

5.2 pmol/L

Range:3.1 - 6.8 pmol/L

(0.1 higher than last test )

Tsh..same .0.01 undetectable .

Tests too high = calcium & alkaline phosphatase these are always high out of range. And white blood cell count always low...

Serum adjusted calcium.

2.57 mmol/L

Range:2.15 - 2.5 mmol/L

Serum alkaline phosphatase

Higher than before..

130 iu/L

Range:35 - 104 iu/L

Serum calcium

2.54 mmol/L

Range:2.15 - 2.5 mmol/L

Wbc.( white blood cell count )

Lower than before.. Low out of range

3.4 10*9/L

Range:4 - 10 10*9/L

I asked gp to screen for all vitamins & minerals allowed but he only did these..

Ferritin.

45 ug/L

Range:30 - 150 ug/L

Note says Please note change to reference ranges as of

11th July 2023.

Ferritin concentration may be increased

post-menopause.

( i am post menopause .. So does that mean its even lower ?? )

Folate.

16.5 ug/L

Range:1.9 - 25 ug/L

B12

575 ng/L

Range:197 - 771 ng/L

[Lovecake]

Hi. I can’t give you a technical answer like some of the others, just what I think.

I have found that different brands make me feel worse. Teva makes me feel strange so I avoid it. I have noticed in the past that upping my T3 a little makes my FT4 drop 🤷‍♀️ (Someone knowledgeable may comment for you).

Your ferritin looks a bit low. That could affect your thyroid levels. I think our bodies need all the vits and minerals at good levels to help the thyroid in some way. So sorry I am not as eloquent as others (like SlowDragon, DippyDame et al).

And there’s the saying “if it ain’t broke, don’t fix it”. Bet you wish you hadn’t changed your doses now. But I can see why you did, because I take 12.5mcg T3 and it is a bit of a faff.

Hope others notice your post and have time to contribute.

[helvella Administrator Thyroid UK]

Are you doing anything about ferritin?

Many ranges for ferritin changed when NICE said that the cut-off at the bottom should be 30 (previously many were lower - typically 15).

I think you should consider some form of dietary shift and/or an iron supplement. Keeping an eye on it.

Your absorption of levothyroxine might be different. But we often see quite low FT4 in those taking any form of T3. Maybe you do need an increase in levothyroxine?

High calcium is an indicator something is wrong (even slightly high). Have you ever had a parathyroid test? Do you take vitamin D? Do you have a high calcium diet?

Low white cells could be transient. You need to keep getting tested to check they have recovered.

Estrogen does affect T4 - but primarily because of its impact on the proteins that bind T4. So we often see higher Total T4 when estrogen is higher.

I encourage you to keep notes of the makes of levothyroxine.

[MrsClanger in reply to helvella]

Thanks for replying helvella :)I'm taking an iron suppliment, but also now focusing on green veg ( broccoli and spinach daily) as my diet got a bit slack recently.

The tests that are high always seem to be like that, I don't take a calcium suppliment ( stopped at least 6 months ago)

I'm on a mostly vegan diet, and gluten free, I don't eat rice or other grains unless it's in gluten free bread only occasionally, so my diet isn't too high in calcium. But I think I get enough.

I take vit D and k2mk7 daily, so this will help me absorb the calcium from my food.

I did mention parathyroid to gp once before but he refused to do the test. I will ask the endo tomorrow though. I remember reading about that before and it all made sense with my symptoms.

The white blood cell count has always been low for years .. Every test is low.

I'll ask if they can prescribe the T4 in the tablets I was taking before too..

Good to know where to look into.. Thanks so much appreciated

[helvella Administrator Thyroid UK in reply to MrsClanger]

Iron is always slow and difficult.

helvella - Iron Document

This is a summary of what I have read up and found out about iron supplements over the past few years. I am not in any way medically trained. You are strongly encouraged to check every detail before making any decisions for yourself.

helvella.blogspot.com/p/hel...

Maybe have a look here:

Hyperparathyroid UK (HPT UK)

hyperparathyroiduk.com/

[MrsClanger in reply to helvella]

I normally take a iron suppliments from suppliments. Co. UK .. 14 mg iron bisglycinate. Other ingredients are microcrystaline cellulose diacalcium phosphate magnesium citrate... Do you think this is OK... Is a liquid one like floradix better ?

[MrsClanger]

Update... 14 Feb..After many calls to hospital I spoke to my Endo.. Who said he's concerned that my tsh is surpressed.. Doesn't think my muscle weakness weight gain swollen throat and general feeling crapp is to do with my thyroid...even tho my T4 has gone down so much.. He said its not relevant..

But he wants to test cortisol and other things including parathyroid..but said that's only to see the relationship between that and my calcium and vit D.... thinks that my vit D dose (2000 iu daily ) is too high.. So probably thinks that excess calcium is caused my too much vit D.. Which is wrong.. ( info I found on parathyroid. com... Who are the experts.. Very good info on there.. ) but at least he is testing my para thyroid.. Just need to wait for the form in the post Which will be a few weeks! 🙄

But he didn't reduce my thyroid prescription meds.... Phew..

Seems like one step forward two steps back... Better than just going backwards I guess..

[Jaydee1507 Administrator in reply to MrsClanger]

2000iu of vit D is a relatively low dose. I have vit D genetic SNPs and need 5-6000ius to stay optimal. Most people need 3,000iu.

Are you taking a B complex?

Your symptoms are likely due to low FT4, hes gaslighting you. Most people on a combined T4/T3 dose need 100-125mcgs levo.

[MrsClanger in reply to Jaydee1507]

Hi.. Thanks for replying.. I've been told to stop taking the vit d now because of high calcium in my blood, untill I have the parathyroid blood test.

I do take a high strength b vit but I am stopping all of my suppliments untill next week when I get all the blood tests again.. Couldn't get an am appointment till next Friday..

I was on 125 mcg levo before I started the t3.. Which I scorced myself first...i think I reduced to 100mcg levo and twas taking 12. 5 t3 ( I did increase slowly) I'm not exactly sure....but think that's about right..

But when I managed to get the nhs endo to prescribe the t3 they would only prescribe me 10 mcg if I reduced levo to 75 mcg. So I just added a bit more t3 with own scorced tablets.. Somehow i managed to get prescription twice from the nhs so I have enough nhs t3 at the mo to double the t3 dose.

At this stage I just feel like it's impossible to get to a point where I trust anything the endo or go says .... And I'm just relying on advice here and how I feel on the dose.

I'm concerned that I might actually have a para thyroid issue considering the recent high calcium levels, the fact I feel so fatigued since my calcium is over range even tho I'm on a vegan very very low calcium diet.. The GP and endo are both testing again so seem to be thinking the same, but the both of them could do with reading the info on the parathyroid website I think. So preparing for another confusing battle trying to diagnose abd treat myself...

Feeling depressed and fed up with it

[Jaydee1507 Administrator in reply to MrsClanger]

Sometimes there seems to be a price that people pay for getting NHS T3 in that there is no consideration for how someone feels and all the emphasis is on blood results - TSH.

As your TSH hasn't fallen you could aksk them to reinstate some Levo. Your last FT3 result will be a false low so you may not need more T3.

[MrsClanger in reply to Jaydee1507]

Ah OK.. That's a plan.... I'm looking into finding a different endo consultant.. Hopefully nhs.. They have the updated prescription now in the brand I was on before so I can get that tomorrow ( absorbsion may have been an issue with Teva?) so i will see what the blood tests say next week and raise the dosage with a new consultant..Thanks for the info