Need help reading latest blood results

[PugMama78]

Hello,

Here are my latest blood test results after being on 25mcg Levothyroxine for 8 weeks:

TSH 1.93 mIU/L (0.30 - 4.2) 41.8%

Free T4 (fT4) 16.9 pmol/L (11.9 - 21.6) 51.5%

Free T3 (fT3) 4.3 pmol/L (3.1 - 6.8) 32.4%

T4:T3 Ratio 3.930 

I am still quite new to trying to read these, and wouldn’t mind someone else’s opinion on how these look?

My NHS endocrinologist has doubled my Levothyroxine dose to 50mcg due to me still having some lingering symptoms and has now referred me back to my GP for continued monitoring and care.

I say lingering symptoms, but I am feeling so much better from where I was at just a few months ago. My urticaria has now completely resolved and I am sleeping much better. I feel more focused at work with less brain fog. I have more energy to do things again. I still feel quite cold a lot of the time, and have some anxiety. Would my current levels suggest there is further room for improvement? I am struggling to understand this T4:T3 ratio and hope I am converting okay?

Here are my results from 6 weeks ago after just starting on Levothyroxine:

TSH 3.03 mIU/L (0.30 - 4.2) 70.0%

Free T4 (fT4) 18.1 pmol/L (11.9 - 21.6) 63.9%

Free T3 (fT3) 4.4 pmol/L (3.1 - 6.8) 35.1%

T4:T3 Ratio 4.114 

Thyroid Peroxidase Antibodies (TPO) 61 IU/mL (≤ 34)

 My TPO antibodies were 180 earlier this year, but I have yet to have a thyroglobulin antibodies test to confirm Hashimoto's.

Over the past few years my TSH has been around 4 or 5 and I haven’t been feeling great at all. It’s so good to finally feel like I have some energy for life again.

Joining this forum was a turning point for me in getting the help I needed, and I am eternally grateful for you all! ❤️

[DippyDame]

FT3 followed by FT4 are the important labs

Science proves TSH, following medication, is not a reliable marker

You absolutely need that increase....50mcg is the usual starter dose!!

Your FT3 is a tad low so expect further increases of levo.....that should help

If symptoms don't resolve and FT3 remains low then you may eventually need to add a little T3...but it's a bit early to conclude that. Might be considered if levo dose exceeds 75mcg/100mcg and FT3 is still low with remaining symptoms

High FT4 with low FT3 = poor conversion.

If Tg antibodies are high/ Hashi's then a gluten free diet should help.

You're on the right track....post new labs if you wish more help

Just ask!

Good luck.

[PugMama78 in reply to DippyDame]

DippyDame , thank you so much for your kind reply. Yes, I know I was on a very small dose, and had to fight to even get that! I’m now on 50mcg and hopeful to have even more positive effects from the increase, even though I am only now on a starter dose, I’m already experiencing so much improvement. That the itch is gone alone is huge cause for celebration. I was barely existing with it, getting no sleep, and beginning to wonder if there was a light at the end of the tunnel. I will continue to post my next blood test results in a few months time. Thank you again ❤️

[SlowDragon Administrator]

Retest vitamin D, folate, B12 and ferritin at next test too

Presumably you have increased iron rich foods in your diet to improve low ferritin

How much vitamin D are you taking

[PugMama78 in reply to SlowDragon]

Hello  SlowDragon ,

I’ve been trying to make necessary diet changes to increase iron. I’m taking vitamin d spray daily. 3000 IU.

I plan to run my own private bloods in 8 weeks time including all vitamins and then really focus on optimizing my vitamin levels. I’m using b complex + B12 BUT when I use at the dose it suggests I don’t feel good at all… really wired? So I’m only using half that suggested dose, sometimes less.

I’ll definitely post my next lab results in a few months time. Thank you for your continued support ❤️