blood test results

[Joant24]

Hoping you can shed some light on my husband’s medichecks test. He takes 125 mcg of thyroxine and had been feeling really well up until a month or so. He now had a very dry annoying cough (xray showed his chest was clear) and feeling very poorly, napping in the afternoon which is unusual. He had a gp blood test a while ago and as his TSH was low one of the Drs in our surgery got very annoyed because he didn’t want to reduce his medication.

I suggested a Medichecks test and these are the results. I don’t understand the high T4 alongside the lowish T3.

Hoping the collective superstars can help us please. 🥰

[TiggerMe]

He is a very poor converter hence the low fT3, really needs a referral to Endo and some T3

Also very low Vit D... grassrootshealth.net/projec...

Very high CRP suggests inflammation

[Joant24 in reply to TiggerMe]

Thanks much appreciated.

[Hashihouseman]

hi, those levels of fT4 have been associated (in very large scale observational studies) with increased risk (double the risk at 22 or more compared to 15fT4) of cardiac anomalies particularly atrial fibrillation and in my experience does cause that and other symptoms. The fT3:fT4 ratio from your posted results is the red flag (healthy normal is about 0.3) where poor conversion leads to excessive and potentially dangerous dosing of T4. This may be caused by a not that rare gene mutation which directly affects T4 conversion; it could also be caused or exacerbated by taking too much T4, particularly in one dose, because fT4 levels are part of the negative feedback loops for T3 production: high fT4 reduces rate and volume of T3 production in the various bodily tissues that need it and from the thyroid if its capable. I have been in that exact same scenario with those results and the only solution was to GRADUALLY reduce T4 and supplement with T3 to known physiological levels eg 80-90mcg T4 and 7-10 mcg T3 (which is helped by split dosing both 2or even 3 times per day/night) all of which should allow for around 15fT4 and 4.5 fT3 and 1.0-2.0 TSH. These are the healthy normal levels whatever endocrinologists and doctors who go by the ridiculously wide lab ranges will say to you. LAB RANGE IS NOT HEALTHY NORMAL (although a small proportion of individuals may well be somewhere else in the lab range but healthy normal is a good place to aim for initially).

[Joant24 in reply to Hashihouseman]

Thank you, will pass all this on.

[pennyannie]

Hello Joan -

Did he by chance take his T4 before the blood test rather than leave a 24 hour window from last dose ?

His body seems very stressed and inflamed ?

We generally feel best when on T4 monotherapy when the T4 is up in the top quadrant at around 80% with the T3 tracking just behind at around 70% - and at around a 1/4 ratio T3/T4.

So if I divide his T3 into his T4 I'm getting his conversion ratio very wide at 6.40 -

Do you have any previous blood test results from when he was presumed ' well ' that we can compare to ?

Both active B12 and vitamin D are too low and need to be over 100 -

I now aim for 125 for both - but think these just contributing factors and not the main reason ?

[Joant24 in reply to pennyannie]

This is the only previous full results we have from Aug 2021! (How time flies!) He was on either 50 or 75 mcg of thyroxine at the time of test we can’t quite remember. The GP started him on medication on the back of TSH only result of just over 5. It was done slowly due to other medical issues. Hubby is type 1 diabetic (50+years) and is well managed.

Can you become a poor converter over time?

Bloods done as per protocol and this morning will be dipping into my supply of Vit D etc!!!

Thanks for reply 🥰

Text of results

[pennyannie in reply to Joant24]

T4 to T3 conversion on this first blood test is much better -

So TSH is too high - and I'm presuming this the first test after starting taking T4 ?

a T4 @ 19.9 divided by a T3 @ 5 - gives us 3.98 - so if we round up to the nearest whole number we have him at 4 and pretty much on track :

So - yes, his conversion does appear to be on a downward trajectory -

Apart from the usual suspects of non optimal levels of ferritin, folate, B12 and vitamin D -

conversion can be down regulated by inflammation, antibodies, any long term chronic health condition, any physiological stress ( emotional or physical ) depression, dieting and ageing :

[Joant24 in reply to pennyannie]

That’s really helpful. He’s got a lot going on and is worried about his heart. He had a bypass 20 years ago and thinks maybe it should be checked. Dr said all okay because his bloods were okay!!!

[pennyannie in reply to Joant24]

I know it's not a done deal but maybe a little T3 alongside a slightly lower dose of T4 might be worth considering - to even up these 2 vital thyroid hormones ?

[weedee41]

Hello Joant24,

That is a very high CRP level, especially with his test not showing thyroid antibodies. That should absolutely be retested and investigated further by your GP. They would usually retest after two weeks to make sure it isn't temporarily raised due to an infection/cold if elevated. So definitely worth giving them a call about that.

[Joant24 in reply to weedee41]

Absolutely, he’s got a blood test tomorrow so we’ll see if they can add it. Thanks x