low Neutrophil high Free T4

[Graves1234]

in 2017 I was administered i131 radioactive iodine) for Graves’ disease .. this ultimately put me into Hypothyroidism so was put on Levothyroxine. For the last several years my T4 reading on TFT TEST was around 0.1 (all good) this last test was 24.2 high abnormal .. my fbc test was good apart from low neutrophil reading of 2 .. Have I gone back into having Graves again I wonder .. I thought that wouldn’t happen .. anyone else had this or know what is happening .. many thanks for reading

[greygoose]

Can you give us a range for that T4, please? Because ranges vary from lab to lab.

[Graves1234 in reply to greygoose]

hi Thank you the range is 11 - 22 I was 24.2

[greygoose in reply to Graves1234]

So, if your T4 was 0.1, how can that be good?

[Graves1234 in reply to greygoose]

sorry got confused that was the 0.1 was the previous TSH READING not T4 .. I just noticed the TSH reading isn’t on these results ..

[greygoose in reply to Graves1234]

Well with an FT4 of 24, it's going to be low, that's for sure.

When you did that test, how long was the gap between your last dose of levo and the blood draw?

[Graves1234 in reply to greygoose]

Thanks about 23 hours .. I took the daily dose after the blood test.

[greygoose in reply to Graves1234]

OK. Well, I don't know then. Was your thyroid completely destroyed by the RAI? Or do you still have some working tissue left?

[Graves1234 in reply to greygoose]

I have no idea , I thought it was destroyed as I went to hypothyroid .. my thyroid was only scanned before I took the i131 and not scanned after. A good question to put to my Gp .. I’m phoning them today.

[greygoose in reply to Graves1234]

You can become hypo without the thyroid being completely destroyed. I think the original idea of RAI was just to destroy enough of it to reduce hormone output to reasonable levels. But they never seem to have been able to work out just how RAI it takes to do that and always give too much. At least, that was my understanding, I could be wrong.

[Kerry124]

Graves’ is a lifetime condition and just because your thyroid has been destroyed doesn’t mean you are completely cured. Have a look a Elaine Moores site in the USA she also had RAI and there is a lot of useful information on there that might help you

[Graves1234 in reply to Kerry124]

Thanks you .. I was wondering if it was graves again but wasn’t sure if it could be. It’s been a long time since i131.

[Kerry124 in reply to Graves1234]

I know a Graves’ sufferer and stress can set off her symptoms even though she has been in remission for many years. It is a complicated autoimmune disease with many facets to it.

[pennyannie]

Hey there again :

Looking back it seems I wrote to you some 5 years ago - and I can't really add much more than I've already shared with you.

I really do think you owe it to yourself to arrange a full thyroid blood panel to include the key core co-factors of ferritin, folate, B12 and vitamin D and then post the full results and ranges as then, at least, we have the full base information on which to offer considered opinion on.

If you doctor can't run these blood tests for you there are Private companies who can -

if you go into Thyroid UK - thyroidukorg - there is a whole page dedicated to Private Blood test companies and the necessary test is generally marketed as a full advanced thyroid function blood test and around 10/11 bio markers and this is where we all start off -

I use Medichecks as they offer a nurse home visit to draw my blood which is the least stressful way for me and now I just run the advanced thyroid blood test yearly to monitor my own vitamins and minerals accordingly as my thyroid seems pretty constant on the dose I found for myself some 7 years ago.

Just take one step at a time - and get back your own health and well being.

The only new research we have since 5 years ago is detailed below -

which I'm afraid does not make for good reading -

pubmed.ncbi.nlm.nih.gov/338...

ncbi.nlm.nih.gov/pubmed/306...

but there is much we can do for ourselves - as I too am with Graves Disease and post RAI thyroid ablation in 2005 - and also at the time with a low white blood count -

Did you ever dip into Elaine Moore and start reading up - I know it's challenging - but so worthwhile - there is quite a lot of stuff to get your head around and I'm afraid mainstream medical do not seem to know much about Graves Disease and it is a poorly understood and badly treated Auto Immune disease.

web.archive.org/web/2024122...

RAI is a toxic substance that eventually will have burnt through your thyroid rendering you Primary Hypothyroid and it is essential that you are dosed and monitored on your Free T3 and Free T4 readings though fully appreciate this is not routine in primary care with doctors guessing what and where your TSH should be and what it means -

and basically the TSH means diddly squat - after definitive treatment and with no thyroid :

I became so much more unwell trying to get my TSH into the range - that once I had some understanding of what was going on with me, and after being refused any other treatment option - T3 or NDT - in 2018 - I started self medicating and now look after myself and am much improved staying away and DI for Myself.

[Graves1234 in reply to pennyannie]

Thank you .. yes I’m going to look at the blood profiles today and get some definitive answers though I have no idea what my doctor willl do with the results or even accept them.. I’m am totally surprised by my latest reading as it’s been in the right levels for years and I haven’t changed the doses they give me .. thanks again for your advice ..

[pennyannie in reply to Graves1234]

Once with the results and ranges you start a new post on here - and we then explain what thy all mean and offer considered opinion on how you can move forward and the questions you can then ask your doctor -

Always arrange an early morning by around 9.00 am for the blood test -

It must be a fasting blood test - so just take in water over night - and take your T4 for that day - after the blood draw - so having left around a 24 hour window from your last dose of T4 - Levothyroxine,

Stop all supplements 1 week before the blood test so we measure what your body is holding - and not that just ingested for your ferritin, folate, B12 and vitamin D and if taking anything containing biotin this also needs to be be stopped a good week before the blood test as it tends to ' mess ' with some Lab assays and can give false blood test readings -

Best is using any postal kit to arrange the appointment for either a Monday or Tuesday so the sample can be posted same day, and received and actioned with the results back before the weekend - so with no delays stuck in a post box somewhere - and then just start a new post and this the 1st step we all make in order to get back to a better health and well being.

[Poniesrfun in reply to Graves1234]

“I’m am totally surprised by my latest reading as it’s been in the right levels for years and I haven’t changed the doses they give me …”

But we change. And our changes might be temporary (illness, major life change, vacation) or permanent (menopause, weight loss, etc.). Before jumping into making major changes to meds based on one blood draw, I would consider my body’s response to the level increase, look for possible other factors (change in brand or new batch of meds on a refill, etc.), and re-test thyroid levels. As pointed out already, without a thyroid, TSH is a useless indicator; we need to resolve symptoms — not chase numbers.

Patti in AZ

[Graves1234 in reply to Poniesrfun]

You make some good points and I don’t want to knee jerk my response .. thank you

[Auntyp62]

hi, my tsh never rises above 0.5 and I like my t4 to be high in range to function, luckily my gp allows me to follow my own instincts on when I feel well. Curious my neutrophils are 1.9 low ……maybe a connection. I go by if I feel well

[Graves1234 in reply to Auntyp62]

That’s interesting as I don’t feel particularly ill .. get tired but put that down to age 64 ..

[Auntyp62 in reply to Graves1234]

Lol I think we all start putting things down to age, I am 73 but like to think I am 30. I get tired easily too and I’ve still get that one to conquer. I do know it’s a struggle for me to keep my vitamin d up no matter what I take or how much sun I get and it certainly makes a difference.

[Graves1234 in reply to Auntyp62]

Indeed xx take good care xx

[Hectorsmum2 in reply to Graves1234]

are you able to take your pulse and temperature? see if they are also a bit high.

[Graves1234 in reply to Hectorsmum2]

My pulse has been erratic more so at night but it’s currently steady and I don’t think I have a temp