Can some one help me make sense of blood results?

[nono]

Hi all

Iam new on this fantastic forum,have been diagnosed with Hashimoto for 11 months.

I take one and half grain Nature-Throid,the last time of taking this medicine was 15 hours before the blood test.

S-TSH mU/L 0.39 (0.40-4,0)

FT4 pmol/L 11 (12-23)

FT3 pmol/L 4,7 (3,5-6,5)

Thanks in advance.

[PinkNinja]

How are you feeling?

To me, going by your blood tests, it looks like you could do with a slightly higher dose. Of course, if you are feeling good then you don't need to increase but you may want to if you still have symptoms.

Your T4 is low and your T3 is in the bottom half of the range. Most people feel best with their T3 in the upper half of the range. Don't forget that NDT artificially lowers your TSH so that should be ignored. Your doctor needs to be adjusting your dose primarily by your symptoms and also looking at your T4 and T3 to make sure they are within range but with T3 in the upper half.

I hope that helps.

Oh, and there has been a study and paper published that shows that TSH/T4 relationship is not normal in hypothyroid patients. It only works properly for euthyroid patients and, to a degree, hyperthyroid patients. Just in case your doctor is worried about low TSH. TSH isn't something to worry about. If you were on too much NDT your T3 would be high. That would be something to be cautious about.

Carolyn x

[nono in reply to PinkNinja]

Thanks for response Carolyn,

I did the blood test after 27 days of the last increase from 1and 1/4 grain to 1and 1/2 grain ,is this time enough to give accurate results?

I am feeling better with little increased pulse 76 when I get up in the morning some times.

My family doctor is worried about low TsH and wants me to lower the dose of Thyroxine from 75 mcg to50 mcg and do a nother test after one month,I did not tell her that I began taking Nature-Throid I only need the family doctor to run the blood tests as they cant help me more .

[PinkNinja in reply to nono]

TSH is nothing to worry about. It is often low in people with hypothyroidism who are taking thyroxine. Mine is always low but my GP is fine with that because my T4 is within range.

Here is a very recent paper that demonstrates how the relationship between TSH and T4 is very different in hypothyroid patients compared with euthyroid patients. The original way of thinking on this is fine for euthyroid patients but doesn't work with hypothyroid patients, yet doctors still used it. This is why TSH should be ignored but T4 and T3 should of course be observed. T4 and T3 are best higher in the range.

ncbi.nlm.nih.gov/pubmed/234...

I hope that helps

Carolyn x

[shaws Administrator]

This is what Dr Lowe says about adjusting doses although I know you are on NDT now:-

Second is your use of such a very small dose of T4. The TSH usually descends into its reference range (formerly "range of normal") in response to 75 mcg of T4. When that’s accomplished, the patient is well!—or so conventional endocrinologists hallucinate, as do general practitioners who foolishly take their advice about treating hypothyroid patients. Seldom is low-dose T4 effective in keeping metabolism normal in most body tissues. In fact, the low dose of T4 may actually slow metabolism further. This can happen when the T4 dose lowers the pituitary gland’s secretion of TSH, which in turn reduces the thyroid gland’s secretion of T4 and T3. If the patient’s T4 dose is too low to compensate for the thyroid gland’s reduced release of T4 and T3, metabolism slows further. To the patient's surprise, she develops more symptoms of hypothyroidism after beginning the use of T4 alone.

Fats breaks down in the body at an abnormally slow rate in most hypothyroid patients taking only 75 mcg of T4. As a result, the patients gain and retain excess body fat. Many also develop high cholesterol. They do so despite exercising and lowering their calorie intake. Hence, the excess body fat and high cholesterol of many hypothyroid patients is "iatrogenic"—that is, doctor caused.

My suggestion is that you find another doctor who'll treat you properly with thyroid hormone. But I have a comment on the type of doctor you seek out. You complained that hypothyroid patients’ have trouble getting general practitioners to refer them to endocrinologists. This is a "problem" I don’t recommend that patients try to rectify. A referral to an endocrinologist isn’t likely to lead to safe and effective thyroid hormone therapy. Remember, scientifically false beliefs of the endocrinology specialty have caused the very iatrogenic health problem you’re now suffering from: weight gain after beginning low-dose T4. After falling into the river, the shivering soaked person doesn't get warm and dry by moving closer to the fountainhead.

[nono in reply to shaws]

Many thanks for the answer Carolyn and Shaws but Iam concerned if I increase the NDT I will have increased heart palpitation (Iam now on NDT only).

[PinkNinja in reply to nono]

In that case you may want to make sure you do not have low levels or iron, ferritin, B12, folate or vitamin D before considering an increase. These could also account for the low TSH while your T4 and T3 are still lower end. It could also account for your remaining symptoms and once these are sorted out, you may find you don't need an increase at all.

If you get these tested please post the results because the NHS ranges are very wide and are not necessarily optimal. Even with "normal" results you still might need supplements.

Carolyn x

[nono in reply to PinkNinja]

Thanks so much Carolyn for the valuable information.