Underactive thyroid???

[Sperlonga7]

I was diagnosed recently with underactive thyroid and prescribed Levothyroxine. I wasn’t happy about taking any medication without further investigation so requested a T3 blood test.

My results were T4 = 10.9, TSH = 2.82, T3 = 3.1

From this I gather that the TSH and T3 are within the normal range but the T4 is slightly under.

I would like to know why I still need Levothyroxine if the only result which is a problem is the T4.

My GP has waffled on about my age and lack of oestrogen… I’m not so sure.

Anyone who has had a similar result might be able to enlighten me.

Thank you.

[helvella Administrator]

Few people are OK with a TSH over 2. Most in treatment expect close to 1 or a bit below.

Few people are good with an FT4 at or below bottom of the reference interval (Range).

And you don't say whether than was a Free T3 or Total T3?

For all, we really need the reference intervals - which can vary hugely between labs.

This is a link to a very good article in the British Medical Journal discussing what the 'normal range' really is. Very readable.

The normal range: it is not normal and it is not a range

helvella.blogspot.com/p/the...

[Sperlonga7 in reply to helvella]

thank you. I’ll read the article.

[greygoose]

I would like to know why I still need Levothyroxine if the only result which is a problem is the T4.

Because levothyroxine is T4. And, although it's impossible to say anything for sure without the ranges - which vary from lab to lab - it rather looks like your FT3 is a problem, too.

T3 is the active hormone needed by every single cell in your body to function correctly. So, it's T3 that causes symptoms when it's too low to saturate every cell. And it's not just about being in-range, it's about having results at the right spot within the range to make you well. You don't mention symptoms, but something must have sent you to consult your doctor, no?

[Sperlonga7 in reply to greygoose]

It was a NHS check up which the surgery asked me to go to. I was only experiencing tiredness.

[greygoose in reply to Sperlonga7]

OK, well then, you're one of the lucky ones that got caught early without a hassle.

[SlowDragon Administrator]

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)

Essential to test vitamin D, folate, ferritin and B12

Lower vitamin levels more common as we get older

How old are you

Pre or post menopause?

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

What vitamin supplements are you taking

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

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

statins not recommended if hypothyroid

nhs.uk/conditions/statins/c...

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

[Sperlonga7 in reply to SlowDragon]

Thank you so much for such a detailed reply. I’m 68 years old and i have had two bouts of cancer, the latest being ovarian. I took Olaparib for 2 years but this stopped in Feb this year. The only medication I take now is Sertraline and I haven’t yet looked into whether this might affect the thyroid.

I will also say that over the years my T4 level has nearly always been borderline.

I'll certainly look into getting a private test done.

[SlowDragon Administrator in reply to Sperlonga7]

Depression is common hypothyroid symptom

Come back with new post once you get thyroid and vitamin test results

Are you currently taking any vitamin supplements

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

[Sperlonga7]

I take Vitamin D3 + k2 combined 1000IU