Following on from my last post about my friend and her blood test results. I now have the last set of results which 2 doctors have said are fine and that the levels balance each other out. These are the results:
TSH 5.54 (0.27-4.2)
Free T4 24.5 (11.9-21.6)
Free T3 3.4 (3.9-6.8)
I should add she has cancer and is receiving chemo. I am very interested to know what the knowledgeable people here think.
I'd be interested to know what the doctor means by levels balancing each other out... Her TSH is much too high - she's still hypo - here FT4 is too high and her FT3 is much, much too low. Where's the balance in that?
I must say I was astonished when I saw these results that two doctors could be happy with them! My friend is absolutely exhausted and sleeps most of the day away now. Of course she is having to contend with cancer and chemo but I'd imagine her below range T3 must be making things so much worse for her. She asked me what could she do. I said I'd check on the forum where there is so much informed opinion but I think she should ask for some T3. I simply don't understand the attitude of the doctors.
I think that attitude is called ignorance. I don't suppose they have a clue what T3 is, and from the comment abouut 'balance' think that having a high FT4 makes up for the low FT3, but that's really not how it works! Are these doctors endos? If not, she should insist on seeing an endo - but one that is carefully chosen. Because not all endos were created equal.
I imagine they're oncologists although I don't know for sure. I will speak to her tomorrow and tell her what you say. She has private health insurance so may be lucky and get a decent endo. Many thanks for your help - much appreciated.
Well, TUK does have a list of patient recommended, T3-friendly endos, but I can't remember the address to write to to obtain is. Hopefully someone will come along and post it. She might find one near to her or one who does telephone consultations, if she can't travel.
Thanks for the information. 
You're very welcom. Hope she finds a solution soon. Let us know how she gets on.
I certainly will.
My husband was in this same position - similar results and sleeping all day but this was blamed on the cancer and chemo. Was told there was evidence suggesting that in chronic illness you couldn't rely on the thyroid levels. He was left with t3 levels well below the normal levels - far from optimal. This was before I really had a good understanding of thyroid meds. You do have to work with the Oncologists but don't let them not treat the thyroid properly - TSH is far to high - most people feel better when it is about 1, definitely less than 2 and both t4 and t3 are high in the range. Can be difficult to get them to do the bld draws as suggested in this forum but your friend will need to be assertive. Knowing what I now know from this forum, I'm sure my husband would have benefitted majorly.
I think that you meant to say that FT3 is very low in range, not high.
No - optimal is t4 and t3 both need to be high in the range
Yes I agree you missed what I was trying to say. Happy Christmas.
It is a very difficult situation. Many cancer treatments interact with thyroid - actual levels and possibly interference with tests.
It needs a "pharmaceutical forensic" analysis to check through everything. As well as whether the cancer itself is causing issues.
The "balance each other out" is utter nonsense which, I suggest, is due to lack of real understanding. If they had found specific effects from medicines, I don't think they would have come out with such utter rubbish.
My friends husband ended up hypothyroid after having radiation on his jaw for cancer. He had to start taking levothyroxine. Unfortunately he only lasted a year after being diagnosed as it was melanoma which spread throughout his body. This happened during Covid and we were unable to even attend his funeral he was only 51 years old.
That maybe true( that many cancer treatments interact with thyroid but surely if there are symptoms of hypothyroidism some if which could also be attributed to the chemo, surely it would be wise to have treated the hypothyroidism? At one point in my husband's case TSH was 65 and t3 was less than 3 - they did increase his thyroxine but his t3 never recovered. T3 is not readily available in NZ nor is it endorsed by NZ Endos so this was not possible at this time. All I am saying is don't let them ignore the test results or put all the symptoms down to the chemo because unless if the thyroid is left under medicated, this will make for an extremely uncomfortable time and a very poor outcome.
I agree not to ignore the test results - absolutely. The balance of probability definitely would appear to be in the direction of there being an issue.
All I was trying to do was point out that some of the medicines used just might do things like affect the actual tests, such that what looks like a low T3 might not actually be as low as it looks. We now know that, for example, biotin can affect many laboratory test results by interfering with the test. And this has only recently come to the fore despite biotin being very extensively taken. How many more substances might affect tests but, due to being less used, could take much longer yet to be widely recognised?
I find it all very frustrating. I see my friend being very brave and uncomplaining dealing with the pain of the spreading cancer and being absolutely exhausted. Of course I don't know if it's the chemo, cancer or morphine causing her exhaustion but for two doctors to say that her over range T4 and under range T3 balance each other out and are happy to ignore them inexplicable. I suppose I am grasping at straws to make whatever time she has left easier but knowing how I felt before treatment for hypothyroidism, I hate to think that her tiredness is being needlessly exacerbated.
Very bizarre results 
Help with my friend lab results...
My results....
New! Help with my test results.
My latest Thyroid results 
