Have been on 75mg Thyroxine for a good few years , but had a few symptoms of being freezing cold very fatigued, so have had FBC. All ok , but thyroid results are showing as Serum Free T4 levels 15.5 this was 19.1 six months ago . The serum TSH levels are 3.15 these were showing as 0.64 six months ago & 0.21 a year ago . Can anybody interpret my latest results, anything I need to speak to my GP about ?
Many Thanks
Sorry, but no-one can interpret your results without the ranges because ranges vary from lab to lab. But the mere fact that your TSH has gone up so much means that you need an increase in dose. A TSH should never be over 2 in anybody, even though that is still in-range. It's the ranges that are wrong. 
According to the results its say TSH is in the correct range as 4 is when medication should be changed . I just thought by looking as it it was a big change from 0.64 to 3.15 . I am going to speak to GP Tuesday but they have already marked the results as no action needed . Thanks for reply
It may be what it says but it's not correct.
A 'normal' (euthyroid - i.e. with not thyroid problems) TSH is around 1. Over 2 shows that the thyroid is struggling. And over 3 you are technically hypo - despite what doctors say about the TSH being over 10.
Once you are on thyroid hormone replacement (levo) the TSH should come down to 1 or under. Usually under because hypos usually need their Frees higher than euthyroid. With a TSH over 3 you are still hypo, no matter what they say.
Whoever marked your results as 'no action needed' either knows nothing about thyroid or is just fobbing you off. You still have symptoms so you are still hypo. So if you want to get well you're going to have to learn as much about your disease as you can and start fighting for yourself - and ignore all their ignorant comments because they know nothing about it, and they don't have to live with it.
Thanks so much I’ll be prepared for conversation on Tuesday
See GP to discuss increasing dose Levo to 100mcg
Guidelines of dose Levo by weight
approx how much do you weigh in kilo
Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or somewhere near full replacement dose (typically 1.6mcg levothyroxine per kilo of your weight per day)
cks.nice.org.uk/topics/hypo...
bnf.nice.org.uk/drugs/levot...
nhs.uk/medicines/levothyrox...
Adults usually start with a dose between 50 micrograms and 100 micrograms taken once a day. This may be increased gradually over a few weeks to between 100 micrograms and 200 micrograms taken once a day.
Some people need a bit less than guidelines, some a bit more
TSH should be below 2 when on levothyroxine
gponline.com/endocrinology-...
Graph showing median TSH in healthy population is 1-1.5
web.archive.org/web/2004060...
Comprehensive list of references for needing LOW TSH on levothyroxine
healthunlocked.com/thyroidu....
onlinelibrary.wiley.com/doi...
If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).
sciencedirect.com/science/a...
The optimal daily dose in overt hypothyroidism is 1·5–1·8 μg per kg of bodyweight, rounded to the nearest 25 μg.
Thank you
please add ranges on Ft4 result
Was test done early morning and last dose levothyroxine 24 hours before test
Exactly what vitamin supplements are you taking
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
VERY important to test TSH, Ft4 and Ft3 together
What is reason for your hypothyroidism
Autoimmune?
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)
NHS only tests TG antibodies if TPO are high
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)
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
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...
Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee
Only do private testing early Monday or Tuesday morning.
Tips on how to do DIY finger prick test
support.medichecks.com/hc/e...
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
Test results help
Blood Test Results - Advice please
Latest Test Results
test results
Test results. Hypo?
