I have hypothyroididm and have had it for years. I used to medicate myself, but can no longer afford to do so. I am now taking 100 ml of levothyroxine. I now seem to hae a problem with high blood pressure, hot flushes and what I call adrenalin punches in the stomach. I would not say I was ill, but I think my medication needs tweaking.
I have now had my annual blood test. My doctor only tested for two things: Serum FSH level and Serum T4 level. My TSH level is within the normal range, although on the high side, it is 3.4 mIU/L (above 4.2 is considered high), but my Serum T4 level is above normal. It is 22.6 pmol/L.
I have an appointment with the Endocrinology department in my local hospital. I know they are going to be more interested in my test results than how I feel, so can anyone give me any advice as to how I can use these minimal results, other than by saying I am not happy that the Free T4 is so high.?
Written by
pip173
To view profiles and participate in discussions please or .
I can't remember. I only had the test because my doctor said he wouldn't do anything without another test, I had already had three, and then he said something about algorithms. He was so up himself he was rather hard to listen to.
If your blood draw was within a few hours of taking your tablet, that could very well explain the combination of fairly high TSH and high Free T4.
We keep getting told that doctors are able to compensate for this when they interpret the results. Clearly this is not the case here. (I doubt they ever can.)
You haven’t mentioned FT3 leve. If that was tested and is quite low in range, that suggests that you could have a problem in converting T4 to FT3
I have an appointment with the Endocrinology department in my local hospital.
Strongly recommend you get FULL thyroid and vitamin testing done yourself private BEFORE consultation
You need Ft3 and vitamin results
Is your hypothyroidism autoimmune (hashimoto’s)
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
You say you used to treat yourself with whole thyroid -
I presume this option worked well for you and was this Natural Desiccated Thyroid ?
I doubt you will find a NHS endo prepared to sanction this medication but you might be able to get prescribed T3 alongside T4 -
but we haven't a T3 reading alongside the T4 reading so without enough information to offer considered opinion.
When optimally treated on T4 only your TSH should be kept under 2 and you likely feel best when it's lower at 1 or below - over 2 and hypothyroid symptoms starting creeping in - and years ago treatment was stated when the TSH was 3 -
so being medicated and having a TSH over 3 shows something not right -
what is the cause of your hypothyroidism,
what daily dose of T4 are you taking -
and had you already taken your daily dose a few hours before the blood draw as that would present as a ' false high ' T4 reading ?
We recommend that the blood draw should be by 9.00am and should be a fasting blood test just taking in water over night and that you do not take your T4 for that day until after the blood draw so having left around a 24 hour window from last dose - so we measure what your body is holding and not that just ingested.
No thyroid hormone replacement works well until the core strength vitamins and minerals - ferritin, folate, B12 and vitamin D are up and maintained at optimal levels :
Amazingly my NHS doctor did agree to the whole thyroid , although she was increasingly unhappy about it. Eventually I did agree to stop it and go onto thyroxine, but returned to it after a couple of months, because I felt so much better on it. I did tell my doctor, but I don''t think she realised as I was taking very low level thyroxine as well. I only stopped the NDT relatively recently when I ran out and couldn't afford to buy any Armour. I did get some stuff from Korea but it had way too much T3 in it and I came off it very quickly. I continued to take the very low level thyroxine, which I would occasionally alter as and when, but after I was on thyroxine alone my new doctor kept on increasing the dose until my TSH was at a level acceptable to him.
I do take all the vitamins you mentioned, and have for years.
I am not sure what I am hoping to get from the Endocrinology department. I think I would like to have a more comprehensive blood test and to be prescribed T3, as you suggested. I know I only have a slim chance of being listened to/offered what I want, but I thought it would be good to be better informed, rather than just saying "I don't feel right" when I look fit and healthy, so thanks for your advice. I now have an argument, based on my blood test results, about why I should have a new, proper test.
Well - yes - we should all be dosed and monitored on a TSH + Free T3 and Free T4 with the aim being to bring both these vital hormones into a balance that gives us back ourselves and our wellness.
If you go into openprescribing.net and go into analyse you can see by surgery and / or ICB area how supportive an area you live in as it has become something of a post code lottery as to getting prescribed T3 or NDT -
though you aren't able to ascertain -which doctor writes and supports T3/NDT - nor the number of ' new patient ' prescriptions - and can only follow the graph falling and rising over the months - so not ideal - but at least a heads up - or not !!
Just enter for T3 - Liothyronine as the drug and for NDT enter Armour as the drug - it is still meant to be available on a ' named patient only ' prescription - though the most expensive of all the treatment options and why over the years it has been discouraged, with patients switched back to synthetics, and not available to ' new patients ' .
I'm post RAI thyroid ablation for Graves Disease 2005 and refused any treatment option other than T4 in 2018 so I now self medicate NDT and much improved staying away and looking after myself.
That is why SlowDragon suggested you get your own private blood tests, full thyroid panel, before your appointment. Not wait & see if they will test all. To be armed with information and go in there better informed.
Yes, the difficulty is cash. Basically I haven't any spare. I had a bad fall four years ago and I am still paying out to get my chronic pain problems sorted out privately. I am hoping to be in a better position by the end of the Summer and will probably end up going down the private route, but I thought I would see if my local endo clinic was at all helpful.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
TSH & T4 levels
Latest Thyroid test results - not happy with GP
High Free T3 Level on recent blood test
Blood test results - v confused
