weird results

[pinklemouse]

I have have been diagnosed with an under-active thyroid for about 20 years. As an ex-nurse it is my understanding that if it is broken it isn’t going to start working again! But my last blood results came back showing

FREE T4 @ 52.8 normal-7.9 -16

serum THS 1.8 ( 0.3 -5.0)

On 27/03/24 the results were all normal/low so I fail to see how while taking EXACTLY the same dose of 75 mgm of thyroxine each evening as I have done for some time now could suddenly result in this mad jump in my numbers. I got a panicked phone call from one of the GPs saying I was at risk of a thyrotoxic storm! Now as I say as far as I’m aware my thyroid gland CANNOT suddenly start to function after 20 odd years of non-function added to which my skin looks fine as does my hair, I’m not having palpitations nor is my voice horse nor is my throat enlarged in any way so I’m thinking there is a mistake somewhere plus I m still needing an afternoon nap which I surely would NOT if I was on the verge of thyrotoxic storm. I do know someone who has suffered this and before she was hospitalised she was like a woman possessed. This descriptor doesn’t fit me. Sadly because as I say I still tend to need my post lunch nap. Any advice/comments gladly appreciated and despite what the GP’s panic I have not reduced my dose to 25 for fear I shall turn into Rip Van Winkle sleeping for 100 years.

[Brightness14]

You need your FT3 result, which the NHS rarely does. Most people on here do a private blood test.

[Sparklingsunshine]

I wonder if its a mistake or the sample got contaminated, mixed up. Your TSH level certainly isnt reflecting the high FT4. Had you taken your Levo prior to the test?

I'd be tempted to either ask GP for a retest following forum guidelines ( last dose Levo 24 hours before hand, fasting, water only and before 9am) or get your own private home test done, before agreeing to decrease. It sounds decidedly iffy.

[helvella Administrator]

I'd consider directly contacting the lab - by phone or email.

Those results make no sense.

Seems to me that the first thing to do is re-run the tests. And, ideally, get a second sample from the same blood draw sent to another lab that uses a different assay. (Someone might see the sense of sending a second sample straight-away. Others might want the original lab's second assay to be done first.)

I assume that you are not doing something like taking high-dose biotin?

Some other factors are in my blog on this subject. But the blog is always going to be out-of-date and imperfect so there will be other possibilities.

helvella - Factors that interfere with thyroid tests

A summary of factors known to interfere with thyroid tests.

helvella.blogspot.com/p/hel...

[HealthStarDust in reply to helvella]

I'd consider directly contacting the lab - by phone or email.

If only! Labs are notorious for not communicating with patients especially by email.

But, the poster has a better chance by calling phoning them and hopefully speaking to someone who is willing.

[SlowDragon Administrator]

insist of retest

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

Do you always get same brand levothyroxine at each prescription

Exactly what vitamin should are you taking

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

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

[nightingale-56]

I had a result come back a few months ago, which was very much adrift from what it normally is. The only difference being was that this test was done as a finger prick test and not as normally done by venous sample. Was your test done any differently to usual? My recent test was done as usual and came back with my normal levels.

[Jazzw]

I would suspect a lab failing of some kind. If your FT4 was as high as that, your TSH would most likely be suppressed. And it wasn’t.

It’s not impossible for a thyroid to wake up again if you have Hashimoto’s but after so long I’d say it was a bit unlikely.

As others have said, insist on a retest, especially if you have no hyper symptoms.

[HealthStarDust]

The lab should have ran an FT3 test. The first thing you need to do is have another test to rule out any issues with the first.

[gabkad]

How about just redoing the test before changing anything? Maybe it's a typo.

[Fallman]

I wouldn't worry too much about thyroid storm if you have no other warning signs. Your risk is usually scored across a number of facotors and a high FT4 alone will not be enough to trip it.I've had amiodarone induced thyrotoxicosis for much of this year and at one point my FT4 was close to 100. My GP was similarly freaked, but the above is what I is was told by specialists.

Has anyone suggested Euthyroid hyperthyroxinemia?