reviewing latest bloods ..?

[Starseed56]

Hello thyroid buddies

I’ve just done a blood test (through Randox this time) as I’ve been on NDT for just over a year now.

My previous bloods in March were (Medichecks)

TSH 0.005 (0.27-4.2)

T3 6.1 (3.1-6.8)

T4 19.1 (12-22)

October 24 results… Randox

TSH 0.013 (0.35-5.5)

T3 5.14 (3.1-6.8)

T4 14.10 (11.9-21.6)

Anti TPO 42.9 (less than 34)

Thyroglobulin 64.3 (less than 115)

My last antibodies test was August 23 same ranges

Anti TPO 43

Thyroglobulin 28.5

TPO almost the same, (indicating Hashis) thyroglobulin gone up a lot (more than doubled 🤔) but still within normal range. Ranges same from both labs.

I can’t find the link to the percentage through ranges tool if anyone can help with that? I lost the bookmark.

I tested Monday morning 9am, and last dose was Saturday evening.

My thinking is this… in March my levels were top end so I reduced my NDT just dropping two doses a week. I’m inclined since my levels have dropped a little and my almost non existent TSH has upped a tiny tad, that I will reinstate the two doses I dropped. And test again in a few months.

I take Roseways own NDT now (since March), prior to that i was taking ERFA. Two grains a day, one morning, one evening away from food etc. I think Roseways NDT has a little less T3 and little more T4 than ERFA I may have that the wrong way round. I was surprised at the T4 drop. Will adding those two doses back in be enough?

Thoughts please?! 💜

Oh and I have a phone consultation (😲 really?) with an endo in a couple of weeks. My main reason is to try and get T3 on prescription so I will discuss with them and hope they have an open mind! They’ll probably keel over at my TSH 😂

TIA 🙏🙏

[pennyannie]

Hello Starseed:

Did you follow the same timings for both blood tests - namely waiting around 36 hours from last dose to blood draw - if so both results show false low results.

Ideally we need a fasting blood test some 10-12 hours after last dose to have an idea of your peak T3 reading.

To be optimally medicated on any form of thyroid hormone replacement likely puts the TSH low in the range - and if taking and form of T3 this will suppress your TSH :

The TSH was originally introduced to be used as a diagnostic tool to help identify someone dealing with hypothyroidism and was never intended to be used once on any form of thyroid hormone replacement as then we should all be dosed and monitored on our Free T3 and Free T4 readings.

[FancyPants54]

You are looking for thyroid.dopiaza.org for the calculator.

You have left far too long from last dose to blood test. Why so long? Your T3 will be very much lower than during a normal day. I think you really should repeat the test I'm afraid, before you speak to the endo. Monitor my Health just do the TSH, FT3 and FT4 and is a very good price if you use the discount code found on ThyroidUK web site.

I am on Armour + a bit of T4. You say you dropped a couple of days of NDT? So you had 2 days a week when you took nothing? If that is the case then this is not a good idea with any T3 containing medicine. We need to take the same T3 every day to help us find the right dose.

When I test I take my second grain of NDT around 12-13 hours before my test. It's pretty much what I do anyway, I take 1 grain at 8am and 1 grain at 5pm normally. I take my Levo top up with my morning grain.

Doing it the way you seem to have done it means your FT3 is showing much lower than it would at 5-10 hours post dose.

I hope that's somewhat helpful.

[Starseed56 in reply to FancyPants54]

Thanks Fancypants. I thought previous advice is no thyroid meds 24 hours before a test? I didn’t go two days without meds, I just dropped Wednesday and Sunday evening doses so two grains a week. Sorry if I didn’t explain that clearly. But I think I’ll take them again now! Taking doses at bedtime and on waking works well for me as it doesn’t clash with eating. You’re advising take the Sunday night dose, at least 12 hours before eating? I no T3 has a short life but T4 doesn’t and that dropped too. It’s all so complicated! 💜

[FancyPants54 in reply to Starseed56]

You need to leave 24hrs between last dose of levothyroxine and a test. But with NDT, which contains T3, it's recommended to leave 10-15 hours (depending on which group you are with) between the last dose and the test. So if you take 1 grain in the morning and 1 in the afternoon, you would take the morning dose the day before your test and adjust your afternoon dose so that it is between 10-15 hours before the blood draw. Don't eat or drink apart from water before the blood draw in the morning after you get up.

I try to always leave the same amount of time between my last dose and blood drawer with each test I do so that I can compare like for like. It's usually 12-13hrs gap for me.

Is that more clear?

[Starseed56 in reply to FancyPants54]

Yes thanks for explaining that’s helpful. I don’t think my T4 would have dropped so much (5 points) with the dose interval, tho I can see it’s different for T3. I’m going to take two grains a day now with no dropped doses and test again in a while. I’m not too bothered about another test prior to speaking to endo because my main intention is to follow a trail to getting T3 prescribed!! 💜