Help to compare thyroid test results - Thyroid UK

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Help to compare thyroid test results

suzybear profile image
28 Replies

I had my thyroid blood test done around nearly 3 months ago and I wanted to post the results I had 3 months prior to that also if someone could help me understand the difference? Ive been taking 75 mg levothyroxine with both of these results . October 2023

Tsh 9.69%

Ft4 25.88%

Ft3 66.7%

January 2024

Tsh 50.83%

Ft4 41.07%

Ft3 60.00%

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suzybear profile image
suzybear
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28 Replies
greygoose profile image
greygoose

Can you give us the numbers, please - results and ranges - rather than just the percentages, Because an FT3 of over 60% with an FT4 of only 26% is rather suspect - especially on only 75 mcg levo.

Do you have Hashi's?

suzybear profile image
suzybear in reply togreygoose

Ok yes sorry I got confused I done it with the thyroid calculator on here and thought It was the percentage I needed to give. Ok so October's last year

Tsh 0.96 mu/l ref range. 0.55-4.78 mu/l

Ft4 14.4 pmo/l ref range 11.5-22.7 pmo/l

Ft3 5.5 pmo/l. Ref range. 3.5-6.5. Pmol

Jan this year

Tsh 2.7 ref range 0.55-4.78 mu/l

Ft4. 16.1. Ref range 11.5-22.7 pmol

Ft3. 5.3. Ref range 3.5-6.5 pmol

I'm sure I had what was called Tpo antibodies tested at the doctor's almost a year ago and that came back fine. I heard theres another test I should ask to have done is it thyroglobulin? They won't do that test for me . Are these the tests for hashis? I asked the doctor to refer me to endocrinologist a year ago so finally got that app soon in may . My tsh was over 127 when I was first diagnosed it was through the roof

greygoose profile image
greygoose in reply tosuzybear

OK, so we don't need a percentage for the TSH because whatever the range, a TSH is always a TSH and it should be around 1 or under. So, your October TSH was fine, but your January TSH is too high for someone on thyroid hormone replacement.

October's last year

Tsh 0.96 mu/l (0.55-4.78)

FT4 14.4 pmo/l (11.5-22.7) 25.89%

Ft3 5.5 pmo/l. (3.5-6.5) 66.67%

Jan this year

Tsh 2.7 (0.55-4.78)

Ft4. 16.1 (11.5-22.7) 41.07%

Ft3. 5.3 (3.5-6.5) 60.00%

So, those results are very strange. Your TSH has risen even though your FT4 has also risen, but your FT3 has dropped. But what's even stranger is that your FT3, percentage-whise, is so much higher than your FT4. To my mind that would suggest Hashi's.

Yes, there is another antibody test for Hashi's: Tg antibodies. TPO and Tg antibodies are the tests for Hashi's. But the NHS mistakenly believes that if your TPOab are negative, your TgAB will be too. Which just isn't true. Which is why both should be tested. And, also, we have to remember that not all Hashi's people even ever have over-range antibodies and are only diagnosed by ultra-sound. So, if you can't get the TgAB tested, you could try asking for an ultra-sound.

suzybear profile image
suzybear in reply togreygoose

Hi the brand of levo I'm on is accord. I just checked through my results from doctors and it was adrenal autoantibodies that was tested back last June so thats not the thyroid antibodies test ? I did specifically ask the GP to get my thyroid antibody tested. I didn't think my last few results seemed rite to me so that's why I thought I should ask on here. Thank you. So I should get my own tests done I guess for thyroid antibodies.

greygoose profile image
greygoose in reply tosuzybear

Your GP probably doesn't know what the thyroid antibodies are. Try asking for TPO antibodies and Tg antibodies. Might give him more of a clue! :)

suzybear profile image
suzybear in reply togreygoose

I did ask for tg when I went the other week to my gp but said they don't do it. I'll look into getting it done private

greygoose profile image
greygoose in reply tosuzybear

It's true, the NHS has this weird idea that the TgAB are always going to be negative if the TPOab is negative, which is not the case at all! So, they only test TgAB if TPOab is positive. And I really can't see the point of that. lol

suzybear profile image
suzybear in reply togreygoose

Thanks for the info. I could ask about getting the tpoab tested then and if positive see if they will test the tgab before doing a private test.

greygoose profile image
greygoose in reply tosuzybear

You could try that, yes. But don't know if it will work. They change the goalposts to suit themselves!

suzybear profile image
suzybear in reply togreygoose

Ok will do thanks. Just thought I would ask what your views are about taking T3 ? I've been reading stop the thyroid madness book and a lot of people say how they feel better with T3 included in treatment alongside t4. Was thinking this would be the thing to ask the endocrinologist and any idea if they prescribe this on the NHS? I have my endo appointment next month

greygoose profile image
greygoose in reply tosuzybear

Well, it all depends whether you need it. And with those results you don't look as if you do. It can be very difficult to get it prescribed in the UK, and you have to prove you're a poor converter to get it.

If you're a good converter, and your FT3 is a reasonable level - as yours is - taking it probably won't do you much good.

You also need to make sure that the endo you ask for T3 is T3-friendly, because not all of them are. Some of them are just too terrified of it to prescribe it. :(

suzybear profile image
suzybear in reply togreygoose

Ok how am I looking with conversation am I about midrange with T3 ? Do you mean it probably won't do much good if I take it as In it won't help me feel any better ? Yes I'll just have to find out and ask about it see what they say

greygoose profile image
greygoose in reply tosuzybear

Ft4. 16.1 (11.5-22.7) 41.07%

Ft3. 5.3 (3.5-6.5) 60.00%

OK, well, let me try and explain. Your FT4 is low, but your FT3 is a good level. However, to me, those results are not normal - the FT3 shouldn't be higher than the FT4. But, to an endo, who doesn't know much about thyroid, that FT3 would look good and he wouldn't enquire any further, he'd just say you convert well and you don't need T3. So, the odds are, you wouldn't get it. Although he might agree to increase your T4 as your TSH is a bit high.

You only feel benefit from taking things you need. Be that hormones or nutrients. T3 is not some magic elixia, and taking too much could make you feel worse.

And before you start thinking about anything else, you need to know why your FT3 is so high when your FT4 is low. My money is on Hashi's. But time will tell. If it is due to a Hashi's swing, the level will eventually go down, and might show you to be a poor converter, but at the moment, we cannot know.

We have to wait and see - that's all we can do right now. :)

SlowDragon profile image
SlowDragonAdministrator

How do you feel

Your results suggest you have room for next increase in Levo

Initially to 100mcg and 75mcg on alternate days

Which brand of levothyroxine are you currently taking

Yes you need to test BOTH thyroid antibodies private

What vitamin supplements are you taking

When were vitamin D, folate, ferritin and B12 last tested

Retest thyroid and vitamins 6-8 weeks after increasing dose Levo

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)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

suzybear profile image
suzybear in reply toSlowDragon

Hi I'm not feeling as good as I was before tbh.. for some reason I feel fatigued instead of feeling energised as most people would after exercise. Feeling tired more easily lately and hair gone so dry and my nails are so weak they just break. I sometimes get like a tingly shooting pain in the side of my neck for some reason. Don't know if it's a coincidence but think it happens when I'm more stressed about stuff. January this year

Serum ferritin - 34. Ugl Ref range 15-300ugl

Serum vitamin b12. 480 Ng/l ref 180-900. This is after taking b12 prior to my last test as it was low at 211 ngl.

Vitamin d total 25 hydroxy 64nmol/l

Ive also been low In iron. Last test not much improvement after using a sublingual iron better you supplement from Holland and Barrett. I've been taking what the doctor prescribed but makes me constipated ferrous sulphate 210mg .

Last results serum iron level 13 Umo/l

Ref range 10-30 umol .

Serum transferring 3.1 g/l ref 2.00-4.00 g/l.

Transferrin saturation index 16.7%. Ref 20.00-50.00%.

I always make sure I leave it 24 hours or just over when having my bloods done and it's when the doctor can fit me in usually around 9-9.30 am. I said to the doctor before about an increase in levo and she wouldn't do it. But lately since my last test I've felt worse. Thank you for the links.

I don't think I was tested for thyroid antibodies as the test wasn't tpo antibodies I got it wrong it was adrenal auto antibodies which was no action required

SlowDragon profile image
SlowDragonAdministrator in reply tosuzybear

Vitamin levels are low, as direct result of not being on high enough dose levothyroxine

Iron and ferritin

cks.nice.org.uk/topics/anae...

Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.

Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing.

It’s possible to have low ferritin but high iron

Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test

Stop iron supplements 5-7 days before testing

Medichecks iron panel test

medichecks.com/products/iro...

Look at increasing iron rich foods in diet

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

healthunlocked.com/thyroidu...

Posts discussing Three Arrows as very effective supplement

Great replies from @FallingInReverse

re ferritin and Three arrows

healthunlocked.com/thyroidu......

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Iron patches

healthunlocked.com/thyroidu...

Thyroid disease is as much about optimising vitamins as thyroid hormones

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin

healthunlocked.com/thyroidu...

Iron and thyroid link

healthunlocked.com/thyroidu...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

Good iron but low ferritin

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Chicken livers if iron is good, but ferritin low

healthunlocked.com/thyroidu...

Shellfish and Mussels are excellent source of iron

healthline.com/nutrition/he...

Iron deficiency without anaemia

healthunlocked.com/thyroidu...

Ferritin over 100 to alleviate symptoms

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Great research article discussing similar…..ferritin over 100 often necessary

ncbi.nlm.nih.gov/pmc/articl...

Low Iron implicated in hypothyroidism

healthunlocked.com/thyroidu...

Really interesting talk on YouTube, link in reply by Humanbean discussing both iron deficiency and towards end how inflammation can also be an issue

healthunlocked.com/thyroidu...

Inflammation affecting ferritin

healthunlocked.com/thyroidu...

Updated reference ranges for top of ferritin range depending upon age

healthunlocked.com/thyroidu...

Thank you for your incredible patience while you have been awaiting the outcome of our ferritin reference range review. We conducted this with Inuvi lab, which has now changed the reference ranges to the following:

Females 18 ≤ age < 40. 30 to 180

Females 40 ≤ age < 50. 30 to 207

Females 50 ≤ age < 60. 30 to 264l

Females Age ≥ 60. 30 to 332

Males 18 ≤ age < 40 30 to 442

Males Age ≥ 40 30 to 518

The lower limits of 30 are by the NICE threshold of <30 for iron deficiency. Our review of Medichecks data has determined the upper limits. This retrospective study used a large dataset of blood test results from 25,425 healthy participants aged 18 to 97 over seven years. This is the most extensive study on ferritin reference ranges, and we hope to achieve journal publication so that these ranges can be applied more widely.

suzybear profile image
suzybear in reply toSlowDragon

I forgot to say which supplement I'm taking. So I'm currently taking ferrous sulphate..

B12 and a b complex.

Magnesium byglycinate

CBD oil

SlowDragon profile image
SlowDragonAdministrator in reply tosuzybear

Exactly which B12 and B complex

Highly effective B12 drops

natureprovides.com/products...

Or

B12 sublingual lozenges

uk.iherb.com/pr/jarrow-form...

cytoplan.co.uk/shop-by-prod...

B vitamins best taken after breakfast

Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose

Post discussing different B complex

healthunlocked.com/thyroidu...

Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) Thorne can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

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

SlowDragon profile image
SlowDragonAdministrator in reply tosuzybear

Not taking any vitamin D ?

Vitamin d total 25 hydroxy 64nmol/l

This is too low

GP will often only prescribe to bring vitamin D levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly when supplementing

Can test via NHS private testing service

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7.

One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average

Vitamin D and thyroid disease

grassrootshealth.net/blog/t...

Vitamin D may prevent Autoimmune disease

newscientist.com/article/23...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Interesting article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

suzybear profile image
suzybear in reply toSlowDragon

Thank you for your reply. I will make my way through looking at the links. I take biocare nutrisorb methyl b complex. Viridian liquid b12.

I stopped b complex after Thursday just gone as I didn't realise I had to stop 7 days before having bloods taken until I seen this post. I'm having my bloods done in the morning but not sure if I should and if I'll feel like it as I'm coming down with a cold.

No I'm not taking vitamin d at the moment I didn't realise it was too low but I guess it will be even lower now as was last tested in January. I have got a vitamin d spray but think it might be going out of date so probably best get a new one.

Can I just ask what are your views on adding T3 to treatment ? I've been reading the stop the thyroid madness book and it's prompted me to ask. Any idea if an endocrinologist would prescribe T3 if needed on the NHS ?

SlowDragon profile image
SlowDragonAdministrator in reply tosuzybear

Ft4. 16.1 (11.5-22.7) 41.07%

Ft3. 5.3 (3.5-6.5) 60.00%

No point considering T3 at this point

A) your Ft3 currently higher than Ft4

B) Ft4 (levothyroxine ) is too low. Next step is increasing dose of levels

C) essential to get all vitamins up to optimal levels

suzybear profile image
suzybear in reply toSlowDragon

Ok I understand. I had a bloods done today so will see in the next few days if my levels have got worse compared to January's. Doctor wouldn't increase my dose last time so maybe worth seeing a different doctor if she won't increase it . Ok what about natural desiccated thyroid meds instead ?

SlowDragon profile image
SlowDragonAdministrator in reply tosuzybear

Come back with new post once you get results

suzybear profile image
suzybear in reply toSlowDragon

Ok thanks slow dragon

helvella profile image
helvellaAdministrator

This paper says a bit about why T3 levels can be higher than would otherwise be expected in some people.

Defending plasma T3 is a biological priority

Sherine M. Abdalla and Antonio C. Bianco

ncbi.nlm.nih.gov/pmc/articl...

suzybear profile image
suzybear in reply tohelvella

Hi sorry Im a bit confused. Is my T3 to high?

helvella profile image
helvellaAdministrator in reply tosuzybear

No.

But as you become hypothyroid, and are not getting enough T4 (whether from a tablet or your own thyroid), we can see T4 (as in the FT4 test) drop. But FT3 will be maintained as long as your body is able.

suzybear profile image
suzybear in reply tohelvella

Ok that makes sense thanks hellvela

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