Hope this is ok to post on here on behalf of my neice. She also has hypothyroid like myself she's had it for the past 5 years and have never looked at her test results until now because I told her she should get her T3 and T4 tested also. Could I had some feedback with results please ?
Tsh 3.46 mu/L (0.55-4.78)
Free t4. 17.2 pmo/L. ( 11.5-22.7)
Free T3 5.3 pmo/L. ( 3.5-6.5)
Didn't take thyroid meds 24 hours before test.
Free T4 (fT4) 17.2 pmol/L (11.5 - 22.7) 50.9%
Free T3 (fT3) 5.3 pmol/L (3.5 - 6.5) 60.0%
Her FT4 is on the low side although she's converting well.
Her TSH indicates she needs an increase as it should be at or below 1.
Has she also tested key vitamin ferritin, folate, B12 & D3?
What is she supplementing with?
Yes that what I thought she need an increase in dose of levo . She's actually on 150 mg of accord . I told her her GP needs to check these things ferritin folate d3 and b12 because they haven't done so.
Check sh's taking her Levo on an empty stomach, alone, an hour before anything other than water.
Thousands of members here pay for their private tests to see the results they need. If GP won't then thats the other option. Optimal vitamins are essential for thyroid hormone to work well.
She takes her levo in the evening and says she don't eat anything maybe a few hours before this. I just found it odd as her free T3 is around the same as mine and don't understand how her tsh seems so high
Her TSH is likely as high as it is due to the way she is taking her Levo.
She could try taking it at bedtime which works well for many and avoids food and drink interactions.
Hi I checked with her again and she said she takes it 3 to 4 hours after food just before going to bed. Would it avoid food and drink interactions this way ?
Usually yes, unless she has a late night cuppa. It has to be taken alone too, no other tablets or drinks other than water.
Ok thanks I'll let her know. I've always taken mine in the morning I think it's a much better routine
Many people do well taking their Levo at bedtime, thats quite different to the evening.
Ok thanks
most importantly
How does she feel?
How much Levothyroxine does she take
Always same brand?
She feels awful and tired all the time. She takes 150mg levo and the brand is accord . GP hasn't tested vitamins b12 ferritin . Folate and d3 which I told her she needs these checked.
So that’s next step…..test vitamin levels
What vitamin supplements is she taking
Is she on gluten free diet or dairy free diet
Approximately how much does she weigh in kilo
TSH too high, Ft4 too low
suggest she requests trial increase to 162.5mcg daily
Cutting a 50mcg in 1/4’s
Retest in 6-8 weeks
TSH should be under 2 as an absolute maximum when on levothyroxine
gponline.com/endocrinology-...
Graph showing median TSH in healthy population is 1-1.5
web.archive.org/web/2004060...
Comprehensive list of references for needing LOW TSH on levothyroxine
healthunlocked.com/thyroidu....
onlinelibrary.wiley.com/doi...
If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).
Hi slow dragon sorry for late reply. She takes a multi vitamin gummies called chewy vites. Iron supplement spatone shots with vitamin c.
She weighs 64 kg. No she's not on gluten free or dairy free diet.
She takes her levo about 3 to 4 hours after food just before she goes to bed so not sure if this is interfering with anything or is it fine ?
Multivitamins never recommended on here - too little to improve deficiencies and cheap poorly absorbed ingredients
Stop any supplements that contain biotin 5-7 days before any blood test as biotin can falsely affect test results
Many many patients on levothyroxine need to take daily vitamin D and daily vitamin B complex
Test first and retest at least annually
SlowDragon Yes I agree multivitamins are only a very small amount and mostly not good quality. I've told her she needs to get her iron panel . Ferritin . Vitamin b12. Folate. All tested. I'm going to the GP with her Monday. I'll give my opinion she needs an increase in levo.
She had a few tests done and one was too high.. not sure if you are familiar with serum ALT ? Hers was 84 I/L
Range <41 so hers is high. Something to do with her liver which she said the GP hasn't explained anything about it to her.
I have had a high level of ALT in the past a few times. In my case I can reduce it again if I reduce my carb and sugar intake, and increase my protein and fat level to compensate for the lower calories.
For example...
My ALT went from 42 (127% thru range) down to 18 (53% thru range) between Sep 2017 and May 2018.
It went from 45 (136% thru range) down to 23 (66% thru range) between Dec 2021 and Jul 2022.
I do relapse from time to time on my lower carb, higher protein, higher fat eating which is why I continue to test my Liver function once or twice a year.
Edit : I don't eliminate carbs and sugar from my diet - I just try to keep my intake down to more reasonable levels - I'm a bit of a sugar addict when I really let myself go!
humanbean Hi thanks for your reply. I don't think my neice has much sugar she's not got much of a sweet tooth. Shes 32 and had fatty liver a few years years ago and then she was told it had gone so don't know if that's what it could be ? Or maybe from poor thyroid treatment if she hasn't quite been more optimal with her thyroid dose all this time ? She also has a slight heart murmur she was diagnosed with recently. Also shes lost about 3 stone in weight which she's not even tried to lose it
Blood test results borderline underactive thyroid 
Blood test results - help please!
Blood Test Results
At last my results 
Understanding Thyroid Test Results 
