Help understanding recent blood test results.. next steps?

[PaleoGirl]

Hello, I am looking for some help interpreting my recent thyroid bloods.

TSH 3.04 (range 0.40-2.50 high

FT4 9.01 range 7.86-14.41

FT3 3.4 range 3.8-6.0 low

RT3 0.30 range 0.14-0.54

TT4 74.10 range 78.38-157.40 low

FT4:FT3 ratio 2.7

Anti TG <0.9

Anti TPO <1

How do I interpret these results, what's going on and what am I trending towards? Why low Ft3? Is it poor conversion of T4 to T3 (add selenium supplement). What about desiccated thyroid or T3?

I am 49 peri-meno very recently so about to explore HRT, now I have these bloods back. Fairly stressful year. Paleo diet.

Any thoughts in best way forward much appreciated.

[Jazzw]

You posted something similar 4 years ago and got some good replies that are as applicable to this latest post as they were then.

healthunlocked.com/thyroidu...

It very much looks like a central (secondary) hypothyroidism issue.

Have you seen a doctor with these results? What have they said?

[PaleoGirl in reply to Jazzw]

thanks for the comments. I have recently seen one of the specialist thyroid GPs from the thyroid UK list and they did not pick up on the central hypothyroidism, even when I asked about it. They thought that any antibodies (even from years earlier, which I had very marginally on the first tests shared here) is enough to point to hashimoto’s. Now feeling very confused as that’s a specialist thyroid GP giving advice but running counter to what has been posted here. GP gave a prescription for armour, which I have not done anything with yet.

[pennyannie in reply to PaleoGirl]

Hello PaleoGirl :

Irrespective of the cause - the treatment is the same - and you need to start some form of thyroid hormone replacement ;

5 years ago your TSH was 2.25 with a T4 in the range at 5% with a T3 just under the bottom of the range :

Your latest results show a TSH at 3.04 with a T4 at 17.50% but a T3 much further under the bottom of its range.

Armour is the leading, most expensive brand of Natural Desiccated Thyroid and the original treatment for hypothyroidism and successfully used for over 100 years by many thousands of people., and derived from pig thyroids, dried and ground down into tablets referred to as grains.

Each grain/tablet of Armour contains a fixed ratio of 1/4.22 - T3/T4 with each 1 grain containing a declared content of 9 mcg T3 + 38 mcg T4 :

A euthyroid reading would present with a TSH at around 1.20-1.50 with a T4 around midway say 50% through its range with the T3 tracking just below the T4 in percentage terms through its range.

No thyroid hormone replacement works well until your core strength vitamins and minerals - those of ferritin, folate, B12 and vitamin D - are up and maintained at optimal levels which can advise on if you have any current results, and looking back see you were given very detailed replies 5 years ago regarding these.

[SlowDragon Administrator]

what are most recent vitamin D, folate, ferritin and B12 results

[PaleoGirl]

My most recent bloods are:

TIBC: 53.6 range 45-81

Total Iron: 15.7 umol/L range 5.8-34.5

Ferritin: 75.8 ug/L 13-150

Transferrin Saturation: 29.3% 20-50

B-12: > 150 37.5-150 *

Vitamin D3: 128 nmol/L 50-200

Folate: 23.85 ug/L >3.89

Magnesium: 0.88 nmol/L 0.7-1. (FYI I cannot do any supplementation as BP crashes, even transdermal oil)

Cholesterol

Total: 6.87 mnol/L 0-5 *

LDL: 4.24 mnol/L <3 *

Non HDL: 4.61 <4 *

HDL: 2.26 >1.2

Total Cholesterol:HDL 3.04 <4

Triglycerides: 0.82 <1.7

FSH: 5.6 IU/L 3.5-12.5

Oestradiol: 364 pmol/L 114-332 *

out of range: *

[PaleoGirl]

I have read that treatment of central hypothyroidism that is caused by pituitary hormone deficiencies needs to be treated with thyroid hormone and glucocorticoids. Adrenal crisis may occur in patients who are given levothyroxine without glucocorticoids. Does anyone have experience of this?