Help with results

[Kajcho]

Hi

I had a thyroidectomy in 2014 and have been on levo since then. Over the past few years I have gained over 20kg despite being a healthy eater and doing physical activity.

My blood test results in March were

T4 - 17.5pmoul / range 9-25

TSH 7.9miu/l / range 0.3-5

My doctor increased my dose to 175mcg

New results

T4 26.3pmoul / range 11.5-22.7

TSH <0.05

Can anyone help me interpret these results please?

[Jaydee1507 Administrator]

Are you consistently taking Levo on an empty stomach, with nothing other than water for an hour afterwards?

Its possible for results to swing if you have Hashismoto's but otherwise can be due to absorption issues.

How you take your blood result also makes a big difference. Time of day and when you last took your levo.

Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process).

Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo/T3 just prior to blood draw can show a falsely elevated result and your GP/Endo might change your dose incorrectly as a result.

[pennyannie]

Hello Kajcho :

Looking back some years I see you were being dosed and monitored on just a TSH and a T4 reading - which really doesn't tell you a whole lot of information and as detailed back then -

we need to see a TSH - Free T3 and Free T4 - to offer considered opinion.

What the above limited blood tests tell us is that in March your TSH was much too high for someone taking thyroid hormone replacement as it should be kept under 2 - and probably the patient would likely feel better if kept under 1 and towards the bottom of the range -

so with a dose increase in T4 it has taken you over the range and the NHS knee jerk reaction will be to drop you back down again -

if the increase in T4 was 25mcg - maybe suggest dropping just 12.50 mcg. in the short term -

BUT ask that your thyroid blood test be rerun to include a TSH + Free T3 + Free T4 :

T4 - Levothyroxine - is a pro-hormone and needs to be converted in the body into T3 which is the active hormone that runs and supports all your bodily functions from your physical, mental, emotional, psychological and spiritually well being, through to your inner central heating system and your metabolism.

Your conversion of T4 into T3 can be compromised by non optimal levels of the core strength vitamins and minerals - ferritin, folate, B12 and vitamin D - so ask that these are also run -

and conversion of T4 into T3 -the active hormone - can also be down regulated by inflammation, antibodies, any physiological stress ( emotional or physical ) depression, dieting and ageing.

So do you have Graves Disease and why you had a thyroidectomy ?

and yes, you likely need your dose of T4 reduced and a prescription for a dose T3 introduced - to replace that little bit of T3 lost which your thyroid once supported you with to make a T3/T4 combo of thyroid hormone replacement which will kick start 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 mcg - with T3 said to be around 4 times more powerful than T4.

Some people can get by one T4 only :

Others find that at some point in time T4 seems not to work as well as it once did and that by adding in a little T3 - Liothyronine - they feel better and their health restored:

Some 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 thyroids, dried and ground down into tablets referred to as grains.

Currently your primary care doctor can only prescribe T4 - the cheapest option with anti depressants the second line treatment which does not work if you need full thyroid hormone replacement which is likely as you do not have a thyroid.

If your doctor can't run the full thyroid panel to include the vitamins and minerals, antibodies and inflammation you can get this done privately, as very many forum members have been forced to do, and then post the results and ranges back up on the forum in a new post and you will be talked through your next best steps back to better health.

Thyroid UK - thyroiduk.org - have a page of private blood test companies who can run the test of 10/11 biomarkers - sometimes called an advanced thyroid function blood test -

If taking any supplements stop these about a week before the blood test - fast overnight and do not take your T4 until after the blood draw - which should be an early morning appointment on a Monday/Tuesday as if posted same day will have been analysed and results sent back to you by the weekend.

If with Graves Disease - elaine-moore.com

-

[SlowDragon Administrator]

just testing TSH and Ft4 is inadequate

Which brand of Levo are you taking

What was reason for thyroidectomy

You were very under medicated in March

On Levo the aim is to be on high enough dose for TSH to always be below 2

What dose were you on BEFORE increasing to 175mcg daily

Your more recent results…..was test early morning and last dose levothyroxine 24 hours before test ?

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

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

Essential to test vitamin D, folate, ferritin and B12

Lower vitamin levels more common as we get older

For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) we must maintain GOOD vitamin levels

What vitamin supplements are you taking

Also VERY important to test TSH, Ft4 and Ft3 together

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

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

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65

(Doesn’t include thyroid antibodies)

monitormyhealth.org.uk/full...

10% off code here

thyroiduk.org/testing/priva...