Advice on abnormal blood results

[Castle82]

Hi I have had hypothyroidism for 25years now treated with levothyroxine I take 225mcg daily recently my bloods showed its went hyper tsh 0.01 and t4 24and gp wants to reduce my dose thing is all my symptoms extreme fatigue, low mood, hair loss,weight gain, dry skin, sore joints etc all come under hypothyroidism so both myself and gp are confused as to why my bloods are showing these levels and i look hyper and over medicated . Anybody else been in this position? I do have a pressure feeling where my thyroid is on my neck so gp wants to examine my neck next week. Any help would be appreciated. Thanks

[greygoose]

Hi Castle82, welcome to the forum.

Do you have a range for that FT4? We can't interpret blood test results without ranges,, and ranges vary from lab to lab.

You cannot become hyper if you are hypo. The thyroid cannot suddenly regenerate and start over producing hormone. You can be over-medicated but impossible to tell without an FT3 result. But my guess is that your FT4 is high because you are not converting that T4 to T3. And that's why you still have hypo symptoms, because it's low T3 that causes symptoms, not TSH, and not a lot of symptoms are caused by T4.

So, to know what's going on, you need full thyroid testing:

TSH

FT4

FT3

TPO antibodies

Tg antibodies

vit D

vit B12

folate

ferritin

We need to test nutrients because being hypo often results in low stomach acid, causing deficiencies in nutrients. And nutritional deficiencies cause a lot of symptoms of their own.

If your GP can't, or won't, do all these tests, you could do them privately. But it's very important to get the full picture.

[Castle82 in reply to greygoose]

Hi thanks so much for replying so quickly yes TSH 0.01 and T4 is high at 25 that's all that was tested so I have booked in privately to get an advanced thyroid blood test this week to cover the T3 and antibodies as Gp says Nhs won't check them I will ask my Go to test the others you mentioned.

[SlowDragon Administrator in reply to Castle82]

Do you always get same brand of levothyroxine at each prescription

How old are you approx

Male or female?

Essential to also test vitamin levels

Test vitamin D, folate, B12 and ferritin at least annually

Exactly what vitamin supplements are you taking

hairloss suggests low iron/ferritin all very

Request GP do full iron panel test including ferritin

Joint pain - suggests low vitamin D

Again get tested

Is your hypothyroidism autoimmune

ALWAYS test early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Post all about what time of day to test

healthunlocked.com/thyroidu...

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

Only do private testing early Monday or Tuesday morning.

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)

NHS only tests TG antibodies if TPO are high so it’s important to test both

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

[Castle82 in reply to SlowDragon]

Hi I'm 43 years female and the chemist has changed my brand within the last 2 months. I have started taking vitamin d3 + k2 this week along with a magnesium supplement to try help with fatigue and support my immune system.

[SlowDragon Administrator in reply to Castle82]

Which brand were you taking

Which brand are you now taking

ALWAYS get full thyroid test 2-3 months after any brand change in Levo

Test vitamin D, folate, B12 and ferritin at least once a year

Recommend you get tested now

[greygoose in reply to Castle82]

OK, sounds like a plan. But when you post them on here, don't forget to give the ranges. We cannot interpret blood test results without the ranges because they vary from lab to lab.

[BusyBee2210]

Hi there, this happened to me about 20 years ago. I had had two doses of radioactive iodine by then to control my overactive thyroid and I had been ok for a number of years when I suddenly started getting hyperactive symptoms again. My GP was baffled so I paid privately to see a thyroid specialist. Turns out I have Addison’s disease. The adrenals and the thyroid are closely linked and if cortisol is low it makes thyroid symptoms a lot worse. Doctors don’t think about Addison’s because it is quite rare, but it is definitely worth mentioning it

[pennyannie in reply to BusyBee2210]

Sorry to read this - RAI is known to be taken up, to a lesser extent, by other glands and organs in the body - including the adrenals -

full details available in Elaine Moore's first book - Graves Disease A Practical Guide - and on her website now found archived below :-

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