Help with understanding results and ranges please

[Chell1]

Sorry, I know I’ve posted a similar question before, but these are my latest results and I can’t tell if they’ve improved or not. My ft4 is up, is this good? But my ft3 is less… not good? I find the optimal % confusing. For reference I’m not currently on any medication and I’m gluten and dairy free.

Latest labs: TSH 2.62 mIU/L (0.27 - 4.2) 59.8%

Free T4 (fT4) 19.1 pmol/L (12 - 22) 71.0%

Free T3 (fT3) 3.1 pmol/L (3.1 - 6.8) 0.0%

T4:T3 Ratio 6.161 

Thyroglobulin Antbodies (TgAb) 401 IU/mL (≤ 115)

Thyroid Peroxidase Antibodies (TPO) 102 IU/mL (≤ 34)

Last labs December 23

TSH 2.59 mIU/L (0.27 - 4.2) 59.0%

Free T4 (fT4) 14.2 pmol/L (12 - 22) 22.0%

Free T3 (fT3) 4.1 pmol/L (3.1 - 6.8) 27.0%

T4:T3 Ratio 3.463 

Thyroglobulin Antbodies (TgAb) 382 IU/mL (≤ 115)

Thyroid Peroxidase Antibodies (TPO) 131 IU/mL (≤ 34)

[greygoose]

Well, you're FT4 is up but your TSH hasn't changed. Still too high for someone on thyroid hormone replacement. Probably because your FT3 has gone down. You are a poor converter and your FT3 is too low for good health. Plus, your conversion rate has worsened with the higher FT4, which probably means that your FT4 is too high for you.

Really no point in retesting antibodies. They fluctuate all the time, and the actual level is of no significance. Once you know they are positive, there's nothing else you need to know.

I find the optimal % confusing.

Perhaps because there's no such thing. The reason we work out the percentages is so that we can compare the FT4 with the FT3, which have different ranges, to see how well you convert.

Optimal is how you feel, not a number.

[SovietSong]

The moderator's on here recommended that conversion be 4 or under and that TSH be 1 or below.How are you feeling? You must have symptoms with T3 level as low as that.Im not clued up on Hashimotos or antibodies so hopefully someone can offer better advise on that score.

[FallingInReverse]

Hi Chell1 and cc: greygoose

Reiterating that OP is NOT on any thyroid hormones.

Your bloods show you should be, but convincing the NHS is a whole different story.

Conclusive - you have autoimmune-caused Hashimotos. But your antibody level is now irrelevant - doesn’t matter if it’s high or low. The fact that you have them above range means you are auto immune hashis, and you don’t need to test them again.

Your high TSH shows your body is struggling to get even the basic levels of FT4 and FT3, and with that FT3 level I would guess that you have typical Hashis symptoms.

In past 3 months your conversion has suffered, but since you are not on any Levo, I do not know if the typical conversion expectations hold true. Someone else might know what conversion non-hormone-replaced people should expect.

[greygoose in reply to FallingInReverse]

Ah, OK. Well, it would be good to be reminded of that in the original post. One doesn't always have time to check past posts.

Someone else might know what conversion non-hormone-replaced people should expect.

Conversion is conversion, and whether on thyroid hormone replacement or not, if the FT4 reaches a certain point - something that's different for everyone - it's going to start converting to more rT3 than T3 so FT3 is likely to drop.

But, the high FT4 could just be due to having Hashi's and the usual fluctuations one gets with that. As the OP is not on thyroid hormone replacement, that high FT4 could very well be due to Hashi's fluctuations and not the 'normal' output of the thyroid. The December results would back that up.

[FallingInReverse in reply to greygoose]

Interesting to see FT4 behavior like that in a non-replaced person, yes, in one view I am imagining it's a moment in time window into early early flares. Thanks for the info!

Edit - I should have said fluctuation here, poor choice of word saying flare on my part.

[Chell1 in reply to FallingInReverse]

My current symptoms suggest I’m having a flare up at the moment, not sure what’s triggered it. I am seeing a thyroid specialist soon, someone recommended on this forum so hopefully she’ll help me know what meds I need. I’ve done all I can naturally/diet/supplements for 5 years and this is where I’m at. I appreciate all your replies I just wanted some clarification of my results before I speak to the specialist.

[greygoose in reply to Chell1]

What do you mean by a 'flare up'?

[FallingInReverse in reply to Chell1]

Your current symptoms indicate your Hashimotos is progressing, and that progression is all very familiar to all of us, as this is exactly as progresses.

You have a diagnosed autoimmune cause for what’s happening. That is the clear answer to “why.”

There is only one direction this goes - your thyroid function diminishing, resulting in you needing to replace the thyroid hormones your body is no longer able to produce for itself, exogenously (whether this is Levothyroxine pills, or liquid, or NDT for example.

That is what you’ve managed well for 5 years. And now it’s up to you to navigate the NHS in a way that gets you the hormone replacement you need. It might be semantics, but important to note, you do not need “medication.” You need to replace a natural hormone your body is no longer making enough of for you.

Keep in mind your TSH might but look like a problem to some doctors, but combined with your antibody-confirmed Hashis, and your diminishing FT3, no doubt this is causing your symptoms. The higher FT4 may throw some doctors off as well.

Let us know how it goes!