Low T4

[Jglo]

Hi I have been taking 40mg liothyronine for 10 + years - this has never been changed. Recent trip to A & E ( very high BP) the Dr queried my low T4 levels but my GP is saying that this is normal with someone taking T3 meds.I would be very grateful for reassurance that my GP is correct .

[greygoose]

Hi Jglo, welcome to the forum.

So, are you on T3 mono-therapy? Not taking any T4 at all? If so, your doctor is perfectly correct: if you aren't taking any and your thyroid isn't making any, then your FT4 is going to be very low. I'm on T3 mono-therapy and my FT4 is zero. And that's fine by me. Whether or not it's fine for you is entirely another question, but your GP is right and I can't understand why any doctor would question that.

[Jglo in reply to greygoose]

Thank you greygoose for your prompt response. I spent 26 hrs in A & E with v high BP / breathlessness and the only thing they could find in my bloods was low T4 and sent me home to review this with my GP.I'm still having issues with fluctuating BP / headaches and fatigue and was hoping maybe an increase in my thyroid meds would resolve this.

[greygoose in reply to Jglo]

It might well do. High blood pressure, headaches and fatigue can all by hypo symptoms. Maybe you need more T3. Did they test for that?

If you've been fine on T3 only for over ten years, I very much doubt it's the low T4 causing the problem.

[Jglo in reply to greygoose]

I've a telephone call with the GP on Monday so will check T3 levels then.

[SlowDragon Ambassador]

suggest you get FULL thyroid and vitamin testing

Breathlessness often low iron/ferritin

what’s the reason for your hypothyroidism

Presumably you see an endocrinologist annually?

Do you always get same brand T3 at each prescription

Do you take as single dose or normally split as 2 or 3 doses per day

What vitamin supplements are you taking

When were vitamins last tested

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

Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune

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

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test

This gives highest TSH and most consistent results. (Patient to patient tip)

T3 ….day before test ALWAYS split T3 as 2 or 3 smaller doses spread through the day, with last dose approximately 8-12 hours before test

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...

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