Latest blood results

[sobs1962]

I realise that I haven't posted anything for a long time, but would appreciate feedback and advice as will hopefully get another face to face appointment with the consultant endocrinologist fairly soon and having said he would be happy to prescribe Liothyronine for me dependant on blood test results, I have a feeling he will likely change his mind despite knowing how knowledgeable I am about my thyroid condition and the whole Liothyronine debacle. Results

03/02/2025

TSH 3.09 (0.27 - 4.20 )

FT4 17.6 ( 11.3- 21.6)

FT3. 3.1 (3.1- 6.8 )

TPO antibodies 66 (0 - 34)

Cortisol 204 (133 - 537) sample at 09.10am and no repeat done in afternoon.

I have spoken to the secretary for the C.E.(consultant endocrinologist) and apparently he's already signed off these results as normal despite the FT3 level being right at the very bottom of the reference range and now I think he'll go back on his word about prescribing me Liothyronine, as he said he didn't have a problem with it depending on the result of mainly my FT3 result and I feel that if my antibodies were high, chances are that I am currently experiencing a Hashimotos flare. Any advice or feedback very welcome.

[Buddy195 Administrator]

Welcome back sobs1962… I think it’s a couple of years since you posted here, so can you fill us in on what your current dose of thyroid medication is? Were key thyroid vitamins checked recently (folate, ferritin, B12 and vit D)?

[sobs1962 in reply to Buddy195]

I don't think any vitamin levels have been tested for a long while, it just doesn't occur to doctors to request them, proving that most of them don't really know what they're doing when it comes to thyroid health. I'm currently taking 75mcg and 100mcg on alternate days so overall dose is 87.5mcg as previously on 100 mcg and was told I was overreplaced. I believe that wasn't the case and my thyroxine levels were higher because there was a build up in my bloodstream as I'm not converting which seems pretty obvious, but trying to convince a doctor to see things the way I do is quite another story.

[Buddy195 Administrator in reply to sobs1962]

I would push for GP to test folate, ferritin, B12 and vit D in the first instance and if this cannot be actioned, I’d look to test these privately, like many members here do (myself included). Having these optimal supports thyroid health.

What time was your blood test? Did you take daily Levo after the blood draw?

I am hopeful that the endo will prescribe a trial of Liothyronine as your FT3 is so low.

[greygoose]

What do you mean by a Hashi's 'flare'? I ask because everyone seems to mean something different. The usual meaning of 'flare', when talking about Hashi's, is that levels of FT4 and/or FT3 suddenly rise to almost hyper levels. This is not your case. Your FT3 is very low, showing poor conversion:

FT4: 17.6 pmol/l (Range 13.3 - 21.6) 51.81%

FT3: 3.1 pmol/l (Range 3.1 - 6.8) 0.00%

And your TSH is much too high, due to the low FT3. I cannot see how any doctor can consider these results 'normal'. They are very far from it.

[sobs1962 in reply to greygoose]

I agree about the hashi's flare, my understanding is that during a flare, the immune system attacks the thyroid gland damaging it more than it is already and stopping the conversion process, I may be wrong about that but I just hope that the C.E.(consultant endocrinologist)doesn't change his mind about prescribing me Liothyronine, I have to have more bloods done in 2 months time and if he considers the results warrant it, we'll have a discussion about t4/t3 combination therapy. Thanks for your input , very much appreciated.

[greygoose in reply to sobs1962]

It's the attack by the immune system on the thyroid that causes the 'flare'. But I've never heard that it affects conversion. Don't think it does.

What does happen is that the dying cells leak their stock of ready-made hormone into the blood, causing levels of FT4 and/or FT3 to rise sharply - and therefore the TSH to fall. So, your blood levels look almost hyper. Your levels are in no way hyper-ish, so it isn't a Hashi's 'flare' - or Hashi's 'hyper' swing, which is a more descriptive name for what happens.

You are obviously a poor converter - a lot of Hashi's people are. But I'm pretty certain that has nothing to do with the attacks on the thyroid. I hope the consultant does prescribe T3, because you obviously need it. But he might want to increase the levo first to see if that helps - your FT4 isn't very high. Doubtful it will help but they don't seem capable of learning by experience.

Good luck!

[sobs1962 in reply to greygoose]

Thanks for that, yes, I need all the luck I can get at the moment.