Results from 6/3/2025

[Clementik]

I finally get all my result from endocrinology it was almost impossible to get them from them, doctors there are very good but nurses and secretary part provide very poor service ...

Please share your thoughts about my results

FT4 - 12,8 pmol/L 7.7-15.1

FT3 - 6,1 pmol/L 3.8-6.0 ❌

TSH - 4,59 mu/L 0.39-5.3

Albumin - 46 g/L 35-50

Free testosterone - 0,237 nmol/L >0.224

Testosterone - 10,5 nmol/L 10.0-27.6

SHBG - 24 nmol/L 13.3-89.5

FSH 2,9 iu/L 1.3-19.3

LH 2,7 iu/L 1.2-8.6

Prolactin 551 mu/L 56-278 ❌

Ferritin 101 ug/L 23.9-336

IGF-1 28,6 nmol/L 9.3-30.7

Cortisol 409 nmol/L no range

My testosterone improved from 7.0 to 10.5 also my SHBG improved from 13 to 24

Prolactin increase from 255 to 551 so is out of range now

FT3 slightly above range, any thought on this ? I increased my levothyroxine from 100mcg to 125mcg 10 days ago.

Ferritin should be higher ?

in 6 weeks I have to retest thyroid function, prolactin + liver function BUT no more testosterone checking ....

I lost 12,5kg and going to start second phase of my weight loss soon as new levo dose kick in so far feel good just hard to get out of the bed soon as i get out is all good

hopefully this is my last dose adjustment as want to be finally on final dose of levo

I started 100mcg accord plus 25mg mercury pharma but i start cutting accord and now only on 125mcg accord

my heart still skipping a beats, pulse in rest bellow 60, sometimes bit dizzy, rapid changes in blood pressure and heart rate with movement or when standing up, my have mild autonomic dysfunction and also got poor blood circulation in legs

high morning glucose level (no diabetic HbA1c 39) must have insuline resistance

muscle tension, tired/weak, limited to exercise, low libido, dry hands, brain fog/forgetfullnes, very bad tinusis - some symptoms gets better but still not ,,ok'' hopefully now when on final dose, if so hope it will get all better after 1 year knowing be hashimoto's and hypothyroid but feeling bad from 2017

chronic nasal turbinates swelling maybe due to chronic inflammation

 SlowDragon

[SlowDragon Administrator]

Your high TSH is very unusual considering how high your Ft3 and Ft4 are

your Dr said to increase dose Levo to 125mcg

When were B12 and folate last tested

Exactly what B vitamins are you taking

How much vitamin D are you taking as maintenance dose

[Clementik in reply to SlowDragon]

That's what I though, It's bit weird

not doctor, nurse said that - it was good move increase ?

i got my vitamin results 6 months ago and will do again in 5 weeks as i looking into that my ferritin decrease

I was taking B-complex and now taking only B12 this ones was cheap ones still from times i was not spending much on supplements but now I do

I'm taking 4000iu a day vitamin D already for 2 months

results from 6 months ago

magnesium 0,9 (0,7-1,0)

ferritin 245 (30-400)

folate 21,70 (8,83-60,8)

B12 70 (37,5-150)

Vitamin D 39 (50-200)

This was Blue horizont test in 9/2024

Later NHS test my vitamins D level 12/2024 and it was 33 so i start vitamin D therapy 40 000ui once a week and my Vitamin D was 78 end of 1/2025

2 weeks ago NHS checked ferritin was 101

I do not take any Iron now as i felt bad after taking the one i got at home so I need to buy better one

currently taking

folic acid i 800yg

B12 10yg

no iron

D3+K2 4000iu + 100yg

SlowDragon

[greygoose]

Your strange results - high TSH with high FT4 and FT3 - are probably due to your Hashi's - a bit of a Hashi's swing. And the TSH hasn't caught up with the Frees yet - it moves so much more slowly.

Nothing to worry about. But if you feel a bit hyper, just leave off, or lower your levo for a while. But, do it on you're own, don't get the doctor involved. Because once they've lowered a dose they really don't want to put it up again!

[Clementik in reply to greygoose]

This result been done after 12 weeks on 100mcg ... after 6 weeks my TSH was 3,35 with around same FT4 after, after 12 weeks it was this result you seen TSH 4,59

What should i check for when u mean hyper symptoms ? heart rate ? not able to sleep ?

But if i have this results in Blue Horizon ranges not NHS they will be all fine

[greygoose in reply to Clementik]

You can't chop and change ranges. To interpret a result you have to use the range that came with the result. That is why we convert them into percentages so that we can compare results even if they have different ranges.

Everyone's hyper - and hypo - symptoms are different. For me, the first sign that I'm over-medicated is a slight tremor in the hands. But for other people, it can be other things. That said, you might be fine with an FT3 that high - I know I would be - I like mine even higher. But yours is only just slightly over-range, so nothing serious.

Your TSH is weird but it could be an anomaly with the pituitary, or interference with the blood test - it happens. But what makes me think your FT3 result is more to do with the Hashi's than your dose of levo is the fact that it's higher in range than the FT4, which is only about 69% through its range. You cannot convert more T4 than you actually have, and only 30% of the T4 in your blood will ever be converted to T3. Therefore, with normal conversion, the FT3 will always be slightly lower in range than the FT4.

11 months ago, your results were:

FT4: 18.7 pmol/l (Range 12 - 22) 67.00%

FT3: 4.6 pmol/l (Range 3.1 - 6.8) 40.54%

which shows rather poor conversion - Hashi's people very often have poor conversion. So, that extra T3 must be coming from somewhere. Assuming that your thyroid would now be incapable of producing much in the way of hormone, due to the Hashi's. And you're not taking T3. The only other place it can possibly come from is a Hashii's 'hyper' swing, due to an immune system attack on your thyroid. In which case, the high FT3 level is only temporary, and will go down to hypo levels again at some point. Although impossible to say when.

[Clementik in reply to greygoose]

oh ok, get it ...

So increasment from 100mcg to 125mcg 10 days ago should be ok then ?

the result you mentioned was blue horizon this one was NHS so i checking % on that.

Thank you for your explanation, now i understand it clearly i'm still newbie even i tested positive for hashi year ago

so it's nothing to worry about ? I will come back with another results of thyroid function in 5 weeks as i got NHS blood test form

but i also wanna see my vitamins levels so will do blue horizon test i got home already for few months and is expire soon so i may do blue horizon test in 5 weeks (6weeks after increasment) and NHS one test will do weeks after as i find out after 6 weeks my tsh is lower and after 12 weeks go my TSH up by 1,1 it happen twice as i was on 75mcg and 100mcg for 12 weeks

I also read weight loss and lifestyle changes which i did a lot of them in past 3 months can put stress on the body and it can some weird hormone changes

[greygoose in reply to Clementik]

It can. But it doesn't always.

Forget the TSH - I know your doctor won't, but there's no need for both of you to sweat it. It's a very unreliable guide to thyroid status. It's a pituitary hormone. The pituitary is just another one or the body's numerous glands. They can all go wrong at some point. It's not the infallible oracle that doctors seem to think it is. And once you're on thyroid hormone replacement, it's not even that important.

As for the increase, this was possibly the wrong time to do it, but as you're a poor converter it probably won't make much difference.

[Clementik in reply to greygoose]

so you saying dose adjustment need be done based more on FT3, FT4 rather than based on TSH ? but TSH of 4,59 still quiet high. But i know what you mean if i understand it correctly

I may be a bit of headache now sorry for that but what you saying is - it was wrong time for increasment so i should wait ? if so, wait for what ? I'm poor convertor ? I though I'm converting more than good enough a my FT3 is high

So what should i expect from this 25mcg increment i already did ? TSH go down and FT4 up and slight increase in FT3 ? or Am I wrong ?

sorry for being headache just want to understand it

when i was on 100mcg for 12 weeks i felt fantastic between week 5-9 and then it was just worst and worst again

before next testing i will not exercise few days before test and put my calories back to ,,normal''

[greygoose in reply to Clementik]

Yes, I absolutely am saying that increases in dose should be based on FT4 and FT3, and definitely not on the TSH. The TSH should never be used for dosing as it's far too unreliable.

It possibly was the wrong time to increase levo given how high your FT3 is. And what you should wait for is your FT3 to drop, as I'm certain it will. After all, you don't really want it any higher, do you.

Based on your results from eleven months ago, you are a poor converter, yes. And your present high FT3 has little to do with conversion. It's the Hashi's... Do you know how Hashi's works?

What should you expect from the increase? Normally, your TSH should drop. But as your TSH is abnormal there's no guarantee that it will. But your FT4 should rise. But we really don't know what impact that will have on your FT3 - you'll just have to wait and see.

So, you felt good on 100 mcg levo between weeks 5 and 9. Then things got worse again. So, why didn't you increase at that point? This often happens. You feel good and then you feel bad again, and what that usually means is just that you're ready for the next increase.

What do you mean by 'putting your calories back to normal'? Have you been on a low-calorie diet?

[Clementik in reply to greygoose]

I already increased 10 days ago so I may just see what result will be in 5 weeks and see how i feel till that ...

I don't know how Hashi works ...

So far every time i increased Levo TSH drop, there is still room for FT4 to rise only what worry me is that FT3 is already high ...

I had booked endo testing so i could no increase that time ... is not easy with them i have to do exactly what they said, so i been waiting for testing and then what they say

I eating 300 calories less than i should eat so i'm on low calorie diet, but not extreme

[Tina_Maria in reply to Clementik]

The thing is, your weight has nothing to do with your calories - it is a result of your low T3. Your T3 is your active thyroid hormone and responsible for your metabolism. If our metabolism does not get enough T3, it is slowed down and we can experience fatigue, weight gain, tiredness but other things can happen such as an increase in cholesterol and glucose, as our liver cannot process these components. This has nothing to do with your diet, but is a result of your low T3.

As greygoose has explained, Hashimoto's is accompanied by so called 'hyper swings', which means that your thyroid is getting attacked by your immune system on occasions and as a result your thyroid kicks into action again and releases thyroid hormones. In your case, it decided to throw out some T3, hence your T3 levels are far higher than you would expect with your T4 levels and you taking 100 and 125mcg thyroxine. This is probably why you were experiencing some palpitations as you had much more T3 available than usually, which your body is not used to. However, this 'hyperswing' will burn itself out again and eventually, your T3 will fall again. If the palpitations and hyper-symptoms are bothering you, you could just drop down to 100mcg for a couple of weeks and see if that helps to improve your symptoms.

However, in the long run, you will still need to increase your medication, your FT4 is only 58% through the range at present, so you should definitely try to get this higher, which will maybe improve your T3 results from 11 months ago a bit, but you may end up have to take some extra T3 as well eventually, as you are not converting very well.

[Clementik in reply to Tina_Maria]

What you mean my weight have nothing to do with my calories ? I decrease my calories intake and did 10k steps daily and been doing light weight-lifting and lose 12,5kg in 2,5 months and was not even on my final dose of levo and i was able to do it only when started 100mcg levo, before I could not even dream about it ... my cholesterol has improved a lot since started levo and on my high glucose specially in the morning i working now, no sugars, no sweets, low carbs, no carbs before sleep and it's getting better and i have liver profile test in 5 weeks again so my fatty liver defo improved with weight loss of 12% of body weight, my T3 is not low now is 6.1 (3.8-6.0)

never hear about ,,hyper swings'' now i know what they are but i do not mentioned i have any palpitations now, no reason to drop back to 100mcg as I'm on 125mcg for 10days only and have no any hyper symptoms so far

you looking into my T3 level from 11 months ago but I'm on Levothyroxine only for 12 months so that not give you any better look into whole think

first you say i have to decrease my med because of symptoms i do not even have and then say i will need to increase dose to improve my results from 11 months ago also and saying I have to probably take T3 as I'm not converting very well but my FT3 is over limit at the moment it just do not make sense, if is high due to ,,hyper swing'' or not god know I wil just need to retest after few weeks and see where it is .... I always testing by Blue Horizont and NHS testing me often as their think i have pituitary problem but now my testosterone improved with weight lost so they hold the scan but my prolactin is high so they waiting if change after levo dose increasment but those test between Blue horizont and NHS are always different I see that on my HbA1C blood test for example in 5 days i had HbA1C tested in both one result was 38 another 41 with same range ...

they said i stressed my body a lot with weight loss and sudden life style changes that's way my prolactin maybe go up if still high MRI scan needed, endo wanted me to lose weight and see if my SHBG and testosterone will improve with weight loss, if would not i will had scan now but both go up, someone here say end of the last year how is possible endo want me to loss weight with low testosterone and with TSH of 6,4 that time, they wanted me to loss 7kg i did 12,5kg it was hard but no scan needed then they see prolactin is high now so scan just on hold for now

[Tina_Maria in reply to Clementik]

I think you may have misinterpreted what I was trying to say, sorry if it was not that clear.

I truly commend you that you have managed to lose that much weight, this was a great achievement. All I was pointing out was that your low T3 was very likely the reason for your weight gain in the first place (and other factors such as your high cholesterol and glucose), as low T3 slows down your metabolism. And you have mentioned yourself that you were only able to start losing weight when you were on 100mcg of levothyroxine, which indicates that your T3 was a probably a bit higher than before, so it could assist your metabolism. And when your metabolism is more active and has more T3, your body can also process cholesterol and glucose better. Yes, activity and restricting calories can help to improve this as well, but the main factor in this is the T3, and when this is consistently low, no amount of dieting or calorie restrictions can help that much, as it is the T3 that is the causing factor.

You also mentioned in your original post:

my heart still skipping a beats, pulse in rest bellow 60, sometimes bit dizzy, rapid changes in blood pressure and heart rate with movement or when standing up

These symptoms could be a result of your T3 being on top of the range at the moment, hence your heart feels like skipping a beat together with the blood pressure and heart beat changes. And as I pointed out, it is unlikely that the high T3 comes from your conversion of T4 to T3 alone, as you cannot make more T3 than you are taking in, especially when you are not converting well. Hence the reason for the high T3 must be that your thyroid is currently producing some T3 itself, as a result of an immune attack. Therefore I suggested to perhaps go down to 100mcg for a while to see if the above symptoms will improve. If these symptoms are not bothering you (and they could also be simply through your body getting used to your higher dose), you could continue on your current dose and test again in 6-8 weeks.

Your current TSH of 4.59 suggests that you are still under-replaced and therefore your health care professionals have suggested to increase your dose, as they go by the TSH and not by your free thyroid hormones usually. And as your T4 is also still low and your high T3 probably temporary, this is why I have mentioned that you would need the increase in dose as well. So you could temporarily drop down to 100mcg again if you are concerned that your T3 is on top of the range, or if you feel okay you could stay on your current dose and test again after 6-8 weeks - it is up to you.

And please remember that we do not know exactly what is going on with your thyroid at the moment, all we can do is take clues from your results and what you tell us and we interpret it as best as we can. There is no judgement, only advise based on other results and symptoms we came across before, in the hope this will help you to get better.

[Clementik in reply to Tina_Maria]

I lost 12,5kg because of daily weight-lifting, daily fast-pace walking, eating healthier, more balanced, changes in lifestyle completely, I use to have very bad liefestyle and I changed it by 360• improving my liver, sugar, no eating sweets etc can write book about what everything I changed from sleeping routine to small things but i felt weird dizzy etc as i felt I was going against something in my body

I was able to do that on 100mcg because before I had no energy to do that, on 100mcg I had finally some energy to move

First of all I gain weight due to my lifestyle but defo also due to my health condition

That was you mention was linked to mild autonomic dysfunction

My heart skipping beats since 2019, not new symptom

I will stay on this dose as i feel slight better than last 2 weeks on 100mcg, just worry how i gonna feel later

Thank you for you clues and explanation of what is autoimmune attack on my thyroid and what is cause

[greygoose in reply to Clementik]

Yes, I know you already increased your dose. And we will see what happens in 5 weeks. But, you increased it on the basis of your high TSH without taking your thyroid hormone levels into consideration. So, that may not have been the right thing to do.. Time will tell.

So, let me try and explain how Hashi's works....

As you probably know, it's what we call and autoimmune disease. Autoimmune means that the body is trying to destroy itself, for some unknown reason. With Hashimoto's Thyroiditis, the body is trying to destroy its own thyroid.

So, from time to time, your immune system launches an attack on your thyroid and kills off a few cells. The dying cells release their store of thyroid hormone into the blood (no, your thyroid does not 'kick into action', it's no-longer capable of doing that, it's like puncturing a paper bag, the contents of the bag spill out and so when the cell is destroyed its content of thyroid hormone - T4 and/or T3 spill out into the blood).

This causes the FT4 and/or FT3 to rise sharply. In your particular case, on this occasion, it's the T3 that has been spilt into the blood, so your FT3 has risen. This has nothing to do with your conversion. Your conversion, according too that test 11 months ago, is poor. It's not suddenly going to improve to the point of being able to convert T4 you don't even have, that just cannot happen. The high FT3 is due to the slow destruction of your thyroid and is therefore only temporary. Eventually, the excess hormone is going to be used up or excreted and your level is going to drop again, and you will be hypo once more, and still a poor converter.

And that is a Hashi's 'hyper' swing, a temporary excess of thyroid hormone in the blood.

Low calorie diets can make things worse. Because you need calories to convert. If you don't get enough calories - and 300 calories may not be drastic but can make a hell of a difference! - your body will not be able to convert T4 to T3, so you will become more hypo and put on even more weight. And yet, minus 300 calories would not be enough to make you lose all that weight if that weight were fat. But the fact is that it is unlikely to be fat. It's more likely to be water-retention, because that's what hypos do: they retain water. And the only way to lose that is to optimise your FT3 (the active thyroid hormone). So, I'm sorry to tell you that your weight loss is far more likely to be due to your 'hyper' swing than your diet. So, yes, you do need to 'put your calories back to normal'.

What you have to be careful of is not increasing your FT4 too far. Because if your FT4 goes too high, it can have a negative effect on your conversion, so your FT3 will drop even further. And be careful not to cut out too many carbs, because that too will negatively affect your conversion: you need carbs to convert.

NHS are always different I see that on my HbA1C blood test for example in 5 days i had HbA1C tested in both one result was 38 another 41 with same range ...

The difference between the two is so slight as to be irrelevant. It would be unreasonable to expect two results with different testing methods to be exactly the same. Blood testing is not an exact science. Results will only give you a rough estimate of levels at best.

if is high due to ,,hyper swing'' or not god know I wil just need to retest after few weeks and see where it is

I explained to you why I'm sure it is a 'hyper' swing - because you cannot convert T4 you do not have and the FT3 would always be lower in range than the FT4 if it comes from conversion alone. Yours is much, much higher, therefore it can't all come from conversion, and the only other place it can come from is the ruptured cells of your damaged thyroid.

But, be aware, the level can stay high for a long long time, it may not have come down in a few weeks, it may still be high. But it still won't have anything to do with conversion.

Your cholesterol has come down a lot since starting levo because high cholesterol is usually cause by low T3. And even though you're a poor converter - I'm afraid you really are - enough of that levo (T4) will have been converted to T3 to have had an effect on your cholesterol level. That doesn't have much to do with your diet, either.

[Clementik in reply to greygoose]

Thanx for explanation now i understand it clearly

But talking about my T3 level from 11 months ago and saying I'm bad convertor when I'm 12 month only on levo may be not right

Saying i lost 12,5kg of my weight to to ,,hyper swing'' make me laugh after i know how much i did for it , daily weight-lifting, daily fast-pace walking, eating healthier, more balanced, changes lifestyle completely, I use to have very bad liefestyle and I changed it by 360• improving my liver, sugar, no eating sweets etc can write book about what everything I changed from sleeping routine to small things

[greygoose in reply to Clementik]

It's not about how long you've been on levo. It's about your blood test results. To know how well you convert you compare your FT4 result with your FT3 result. The FT3 should be just slightly lower than your FT4. The larger the gap between them, the worse your conversion.

These were your results:

FT4: 18.7 pmol/l (Range 12 - 22) 67.00%

FT3: 4.6 pmol/l (Range 3.1 - 6.8) 40.54%

There is a gap of about 27% between the FT4 and the FT3, when it should be about 5%. That is poor conversion. Doesn't matter if you've been on levo for 12 months or 12 years, that is still poor conversion. You can argue all you like but that doesn't change the numbers.

As for your weight loss, I understand that you worked very hard for it. And whilst that may have helped you loss whatever excess fat you had, it is highly unlikely that the whole of your weight gain was fat. It was far more likely to be water-weight. And no diet and no amount of exercise is going to make you lose that. To lose the water-weight you need high levels of T3.

And I'm talking from experience here, not just something I read in a book. I'm 80 years old and I've been hypo since about the age of 8, and I've had a good few 'hyper' swings when I suddenly lost a lot of weight without doing anything about it, and my thin hair grew thick and long, and I had masses of energy when normally I'm a bit of a slug. And all that was due to the extra T3.

Well, you don't have to believe me but you asked and I'm just telling you the way it is. Sorry if it doesn't fit your theories.

[Clementik in reply to greygoose]

What i was saying that time i was on levo for just few weeks, I think not even six as I was doing that test to see if i got positive antibodies

Nah, don't take it wrong I asked for thought and you deliverd, without you commenting i would never know about ,,hyper swings'' etc ... thank you so much for your comments they help a lot I need to focus on this as i need my hormones in good ranges there is more imbalances not just thyroid I'm 32 years old and in best age of life I want to enjoy life as i know older i get harder it will be with this condition I will try to get fit much as possible