Post TT blood results

[Dollydreamer12]

This is my first tests since TT 7 weeks ago.I'm on 150mg levothyroxine

Endo nurse will probably reduce my medication tomoz.

Am I right in thinking serum free triiodothyronine is T3 and means my body is adequately converting T4 to T3?

[greygoose]

FT4: 25.9 pmol/l (Range 12 - 22) 139.00%

FT3: 4.7 pmol/l (Range 3.1 - 6.8) 43.24%

Serum free triiodothyronine is T3, yes, but no, your body is not adequately converting T4 to T3. You are a very poor converter.

FT4 very much over-range, but FT3 only 43.24% through the range. If you converted well, the gap between the two percentages would be much smaller.

Your FT4 is much too high according to those results. BUT, how long was the gap between your last dose of levo and the blood draw? If you took it on the morning of the test then you have a false high FT4, there, and the results are useless. It should be a gap of 24 hours.

[Dollydreamer12 in reply to greygoose]

Thank you so much Greygoose.

The draw was at 9am and I took my dose of levothyroxine 24 hrs previously. (I had been reading Yr posts advising this)

Endo nurse is calling me tomoz and I expect she will reduce levothyroxine downwards.

Then I will have another set of tests done in a while.

I do feel OK but my blood sugar is running high since the operation, which they tell me is expected.

[greygoose in reply to Dollydreamer12]

Reducing your levo could actually improve your conversion, because at the moment it will be converting to a lot of rT3, and not much T3. But, time will tell.

[Dollydreamer12 in reply to greygoose]

Let's hope so. I thank u so much for Yr input to me and others. It's invaluable.I've also taken on board about vitamins/folate/ferritin in optimum range and also to stop any with biotin 7 days before a blood draw.

Fingers 🤞

[greygoose in reply to Dollydreamer12]

You're welcome.

[pennyannie]

Hello Dollydreamer and welcome to the forum :

It is very early days post thyroidectomy and it will take some weeks for your body to adjust to living without a thyroid.

Was your thyroidectomy because of GravesDisease ?

Do you happen to have any T3 and T4 readings prior to surgery, so have any idea where in the ranges your T3 and T4 sat - when well ?

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 mcg - with T3 said to be around 4 times more powerful than T4.

T4 - Levothyroxine is a pro-hormone and needs to be converted in the body into T3 which is the active hormone that runs the body -

with the thyroid be responsible for the full synchronisation of the body from your physical ability and stamina through to your mental, emotional, psychological and spiritual well being, your inner central heating system and your metabolism.

No thyroid hormone replacement works well until the core strength vitamins and minerals are up and maintained at optimal levels - so it might be useful to ask for your ferritin, folate, B12 and vitamin D to be run and we can advise where in the ranges ' optimal levels ' sit as just being in a range somewhere is not where you find your wellness and health restored.

We generally feel best when the T4 is in the top quadrant of its range at around 80% with the T3 tracking just behind at around 60/70% through its range at around a 1/4 ratio T3/T4 :

It is essential that you are dosed and monitored on your Free T3 and Free T4 readings and not a TSH reading -

You have had a medical inventions and your HPT axis - the Hypothalamus - Pituitary - Thyroid feedback loop on which the TSH relies on as working well - is now totally unreliable as your Thyroid has been removed and this circuit feedback loop now incomplete and open ended.

Some can get by on T4 monotherapy - Levothyroxine.

Others find that at some point in time 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 then with - they are able to restore T3/T4 hormonal balance and feel better.

Others can't tolerate T4 and need to take T3 only - Liothyronine - as you can live without T4 but you can't live without T3.

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

Currently your primary care doctor can only prescribe T4 and you will need to be referred back to a NHS endocrinologist if you find you need ' more ' than Levothyroxine to restore your health and well being.

Thyroid hormones do take time to settle and bed into the body so just go one step at a time -

We try and answer all questions / posts in around a 24 hour window from posting and any new information or question deserves a new post -

we can all read everything that is written -

If you get lost reading around on this open patient to patient forum just press the Profile icon which sits alongside MyHub -Chat-Post-Alert-Menu bar - top right on the laptop screen facing me - so maybe bottom left on a phone - and this will take you back to all you have ever written on the forum -

if you wish to read about any other forum member's thyroid journey simply press the icon alongside anything they have written :

If you go into Thyroid UK - the charity which supports this forum - you can read further around all things ' thyroid ' - thyroiduk.org

[Dollydreamer12]

Hello pennyannieMy pre op bloods on 31st may

Tsh 1.49 (0.3 - 5.5)

T4 15.4 (12-22)

T3 5.1 (3.1-6.8)

We r just working on levothyroxine to get dose right just now.

Thank u for information. I'll refer back to this as I go forward on my journey. It's alot to take in atm.

[pennyannie in reply to Dollydreamer12]

Hello - I've just found this message by accident !

In order to contact someone you either have to reply within their post using their reply button and you see their name automatically appear before you start writing -

or you have to type @ directly before you type their name - eg   Dollydreamer12 and a tab appears offering you forum members name options and the more you type the most obvious options appear which you then select and in print -their name turns blue - as above :

In someone euthyroid and without a thyroid health issue we would see a TSH at 1.20/1.50 - with a T4 at around 50% with a T3 tracking behind at around 40/45% through the ranges.

However your thyroid was already struggling as your T3/T4 were inverted - as your T3 was running at 54% with your T4 running lower at 34% - as the thyroid will always prioritise T3 over T4 when unwell.

If you felt well and with no symptoms prior to surgery - your metabolism was running at just over 3 - ( simply divide the T4 result by the T3 result ) - so trying to get back to around a 1/3 ratio T3/T4 may suit you best :

Once on thyroid hormone replacement and once the T4 -Levothyroxine is built up into around the top quadrant of its range -

the conversion ratio is said to be 1 / 3.50 - 4/50 T3/T4 with most people feeling at their best when their metabolism comes in this little ratio at 4 or under.

I know it's a ot to take in - just go 1 step at a time -

Your dose is likely to be reduced as your T4 is over range - but it is equally important that you are able to utilise the T4 better thereby converting T4 better into more T3 -

which is why it's equally important to have optimal levels of ferritin, folate, B12 and vitamin D - as with these corner stones of good health at optimal levels -

the original dose of T4 may well have converted to more T3 and less T4 - with your T4 then landing up ' in the range ' :

[Dollydreamer12 in reply to pennyannie]

Thank u pennyannie. I'll b sure to check where I'm clicking.

I'll b honest I didn't fully understand all of Yr post apart from optimum levels of ferritin, folate, b12 and vit d. Which I'm working on.

But I'm learning all the time. Endo nurse said there is no problem prescribing T3 if needed so not to worry about that going forward. Just said to keep recovering and taking 100mg levothyroxine then test results on 17th September

I'll keep referring back to Yr message to fully understand it.

Thank u. X

[pennyannie in reply to Dollydreamer12]

OK - no worries -

Yes you've been given a crash course and it's likely totally over whelming -

Don't worry - it will all be explained again if and when necessary.

If it were a book - guess you'ld be there with your pencil and ruler - as that's how I helped myself understand things a few years ago - as I'm not good with technology.

Always start a new post with new information - so we all can follow your progress -

and we try and answer as fully as possible every post as it arrives within around a 24 hour window - and then move on as the volume of new questions dictates.

You can always find everything you have ever written and all your replies by pressing your Profile icon which sits on my laptop facing me now - top right - alongside the Alert button etc.

Suggest you ask for your ferrtin, folate, B12 and vitamin D to be run and post the results and ranges in a new question and we can advise accordingly -

since just being in a NHS range somewhere / anywhere is not where your best health sits.

[Dollydreamer12 in reply to pennyannie]

Tbh pennyannie I do have lots of results on my nhs app but I don't understand them. It's all about red blood count, platelets, heamotin, nichphyls, all sorts of weird stuff. I've just had full tests done for my diabetes review, my bs is high at the moment, which they tell me is expected but I'm seeing the diabetes nurse next week so we will see. Endo nurse told me they get levothyroxine dose right then I see consultant for post op, then they treat diabetes (ie change medication dose).

I understand Yr post up to the percentages. I don't understand how to find the percentages for eg my t4 is 25.9 and it's 139 or 149%. How is that percentage calculated pls ?

[Dollydreamer12 in reply to Dollydreamer12]

I will ask for FFB22VITD test at next review next week or nurse mite b able to tell me what they are. I'll b there with pad n pencil.

[pennyannie in reply to Dollydreamer12]

Ok - so the range is 12. 00 - 22.00 and a range of 10 :

Your result was 25.9 which is 100% + + 3.9 which in a range of 10 = 39% ( 22 + 3.9 ) - so that is 139% through the range :

I'm sure there is a calculator manoeuvre for this - I'm not the best one to ask as I tend to just work things out in my head as taught 70 odd years ago !

Don't worry about any of the percentages or whatever - just focus on getting better and building up your vitamins and minerals if, where, necessary.

[Dollydreamer12 in reply to pennyannie]

Oh thank u so much pennyannie. U explained that perfectly well. Appreciated.

Yes I will and I'll try for values of ffb12vitd next week.

Thank u

I'm 63 btw n lord knows I wasn't taught about percentages lol.

Thank you. Take care xxx

[Dollydreamer12]

I've been reduced to 100mg levothyroxine Next blood test in 5 weeks. Results the week after.

Onwards....