Hypo with Hyper results!

[Revolut]

Hi All and good to meet you.

Had a thyroidectomy in 2022. Just had a blood test with

TSH - 0.2 miU/l

FT4 24.5 pmol/L

On levothyroxine 125mg for 4 days and 100mg for 3 days.

Any idea why this looks like hyperthyroid?

Thanks for any advice.

[SlowDragon Administrator]

welcome to the forum

Was test 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)

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

Do you always get same brand levothyroxine at each prescription

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common on levothyroxine

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

Post all about what time of day to test

healthunlocked.com/thyroidu...

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...

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

[Revolut in reply to SlowDragon]

Thank you very much SlowDragon

I will will review and have more tests done as suggested. Thank very much.

[Starseed56 in reply to Revolut]

Not a lot to add after such a comprehensive response from slow dragon… but I will be interesting to see you new test results to see what your t3 is because maybe you are a poor convertor. 💜

[pennyannie]

Hello Revolut and welcome to the forum :

Having had a thyroidectomy - you can't be hyper but you could be over or wrongly medicated.

What was the reason for your thyroidectomy please ?

The thyroid is a major gland responsible for full body synchronisation from your physical ability and stamina through to your mental, emotional, psychological and spiritual well being, your inner central heating system and your metabolism.

A fully functioning working thyroid would be supporting you on a daily basis with trace elements of T1, T2 and calcitonin + a measure of T3 at around 10 mcg + a measure of T4 at around 100 mg - with T3 said to be around 4 times more powerful than T4.

T4 - Levothyroxine is a pro-hormone that needs to be converted in your body into T3 the active hormone that runs the body - much like petrol runs the car - and you likely need a full tank to get you through the day and back home again.

Conversion of T4 into T3 can be compromised by non optimal levels of your core strength vitamins and minerals so suggest you get ferritin, folate, B12 and vitamin D run and we can advise where these need to be maintained to support optimum T4 to T3 conversion.

It is essential that you are dosed and monitored on your Free T3 and Free T4 blood test results and not a TSH - as without a thyroid your HPT axis - the Hypothalamus-Pituitary-Thyroid feedback loop on which the TSH relies on as working well - now does not work well -as there is no thyroid in situ and this circuit loop broken with the TSH a very unreliable measure of anything - especially so if your thyroidectomy was because of Graves Disease.

We generally feel best when taking Levothyroxine only when the T4 is up in the top quadrant of its range with the T3 tracking just behind at around 60/70% through it's range.

Some people can get by on T4 - Levothyroxine only :

Others find that T4 seems to stop working as well as it once did and that by adding in a little T3 - likely at a similar dose to that their thyroid once supported them with - their metabolism kicks in again, T3/T4 hormonal balance is restored and health and well being restored.

Some can't tolerate T4 and need to take T3 only - Liothyronine - as you can live without T4 but you can't live or function without a decent level of T3.

Whilst others find their health restored better taking Natural Desiccated Thyroid which contains all the same known hormones as that of the human gland and derived from pig thyroids, dried and ground down into tablets referred to as grains.

Since around 2000 thyroid hormone replacements have been systematically withdrawn from the primary care sector and currently your doctor can only prescribe T4 - Levothyroxine - the cheapest option -

and you need a referral to an endocrinologist to be assessed as to your needs if T4 doesn't resolve your health and well being - and it does appear to be a bit of a postcode lottery with financial constraints rather than medical need taking precedence in some ICB/CCG areas of the country.

Thyroid Uk - the charity who supports this patient to patient forum hold a list of recommended thyroid specialists - NHS and Private - so this might make sense to have - just email admin @ thyroiduk.org -

and although you may think this is all going over your head - it isn't - stuff does start to sink in and make sense the more you read on this forum and we have all been there before you - in one way or another - and why we come back on here again to give back and help others get better thyroid health.

You can read anybody's Profile and all they have ever written on the forum by just pressing the icon alongside their name - and if you get lost - simply press the Profile icon top right on this page facing me on my laptop alongside the My Hub - Chat - Post and Alert symbols and that takes you back to your Profile page and all you have written and all your replies.

So anyway - first off we need a full thyroid blood panel to include your TSH, Free T3 + Free T4 antibodies, inflammation and ferritin, folate, B12 and vitamin D as these can all effect ho well you absorb and convert T4 into T3 - and just post all these results along with the ranges in new post and you will be talked through everything and advise of your next best steps back to better health.