I don't understand my thyroid test results as my doctor seems reluctant to discuss them he looks at me like I should know what they mean

[storm1]

I have my thyroid readings but don't understand them if any one can help

my tsh is 0.26 mU/L (o.35 - 4.00) and my t4 level is 17.4 pmol/L but I still don't feel well ?

thanks claire

[nostoneunturned]

Please could you give more detail - what is the FT4 range? How much, and what meds do you take? When were you diagnosed hypo? Was your T3 checked? And in what way do you feel unwell?

[mummytina]

I have hypothyroidism and I've had it for 18 years and for the last year I've been feeling lethargicn very tired to the point that everything was an effort, vrain fog, forgetting peoples names and just feeling rubbish so I went back o the drs and he gave me a full "mot" and the blood tests came back that my tsh level was at 0.8 whereas my level is usually about 4.5 and also that I had pernicious anemia which means my body can't absorb B12 so had to have a course of 6 B12 injections over a period of two weeks then I should have felt better but I didn't so went bk and they did my thyroid and other tests again and my tsh level had gone up to 17.16 within 4 weeks so they had upped my levo from 125mcg to 150mcg and then 4 weeks later I had another blood test and it went down to 1.4 but according to the doctor he didn't expect it to go down so quickly so he has now put my levo down to 100mcg and I feel so tired again and also he has referred me to an endocrinologist to see what uis happening to me.

I would ask for a blood test to rule this out and also ask for a Vit D test because this can have an effect on ya body.

Sorry to waffle hope this helps

[storm1 in reply to mummytina]

thank you mummytina and ur not waffling lol but yeah will ask for bloods to be done

[mummytina in reply to storm1]

Post your results on here when u get them and if you don't understand any of it we could help you.

[storm1 in reply to mummytina]

tsh is 0.26 mU/L (o.35 - 4.00) and my t4 level is 17.4 pmol/L

I hope this helps

[PinkNinja in reply to storm1]

Do you have a reference range for the t4? This can vary widely from lab to lab. For instance, some labs have a range of 12-25, putting your result in the bottom half of the range which isn't ideal. The reference range at my local lab is 7.8 to 14.4 so going by that your result would be above the range. So you can see it is very difficult to tell whether your t4 is low or high without a reference range.

If you know the reference range please post so we can be of more help to you. If you don't know it, perhaps you can phone your GP's receptionist and ask her if it is printed on your results.

I definitely recommend the other tests mentioned as deficiencies can affect how well your cells can use the thyroxine and can give symptoms of their own.

Sorry I couldn't be more help regarding your thyroid results.

Carolyn x

[storm1 in reply to PinkNinja]

no Carolyn you have been very helpful, these are things that I didn't realise I could ask for, I have a print out of my medical form as I had to have them for a job I applied for and on it is a pack of lies, I asked for t3 test back in feb and they said on the file that they would test it, but when I go for blood tests they say its not been requested so on my next appointment now i'm going armed with my file and a list of the tests that you have all recommended for me, they say I don't suffer with depression even though they prescribe me citalopram I have high liver levels and lymph nodes on my groin which they say is not in any way related to my thyroid there are lots of answers I now need from them

Claire x

[PinkNinja in reply to storm1]

I'm sorry they are being so unhelpful I hope you get the answers you need so you can get well.

[nostoneunturned in reply to mummytina]

It is good that you have been referred to an endocrinologist as your doctor really has you on a yo-yo of treatment. Can't imagine why he was wary of a TSH of 0.8, sounds good to me. How did you feel when your TSH was running at 4.5?

There is lots of advice re B12 to be had on: pernicious-anaemia-society.org

[mummytina in reply to nostoneunturned]

I don't know how I felt, to me I seemed ok but I was always tired.

[nostoneunturned]

It is surprising that with such a low TSH and having been on meds for 3 years that you are still feeling like this. Pity there is no FT4 range available to see where you actually are in it, but do remember you have a right to ask for it, try the testing lab.

You are entitled to request a referral to an endocrinologist as after 3 years treatment you still have many symptoms and feel unwell, you could well have a conversion (T4 to T3 ) problem and the T4 is just building up - just a suggestion, I am no doctor.

Meantime as hypothyroidism can entail other problems. how about asking for a B12 etc check? Here are the tests and the optimal levels:

B12 500ng/L (minimum, any higher is fine, B12 never toxic)

Ferritin 90ng/L

Folate 10ug/L

Vit D 125 - 175nmol/L

[storm1 in reply to nostoneunturned]

hi the serum free t4 is 17.4 if that helps ?

[shaws Administrator]

This is an excerpt from Dr Toft ex President of the British Thyroid Association of a question/answer article in Pulse. If you would like to give your GP a copy of the whole article email [e-mail].

6 What is the correct dose of thyroxine and is there any rationale for adding in tri-iodothyronine?

The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range – 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This ‘exogenous subclinical hyperthyroidism’ is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).

Even while taking the slightly higher dose of levothyroxine a handful of patients continue to complain that a sense of wellbeing has not been restored. A trial of levothyroxine and tri-iodothyronine is not unreasonable. The dose of levothyroxine should be reduced by 50µg daily and tri iodothyronine in a dose of 10µg (half a tablet) daily added.