blood test: Is T4 level 14.3 TSH 3.27 and serum... - Thyroid UK

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crps profile image
crps
12 Replies

Is T4 level 14.3 TSH 3.27 and serum free T3 level normal? T4 range 12-22, TSH range 0.3-4.2

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crps
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shaws profile image
shawsAdministrator

I assume you are on levothyroxine? If so, your TSH level is too high and you should aim for 1 or below the only thing is, I don't think the GP's know this.

When you post your blood test results, you have to put the ranges too (as labs differ throughout the country). It makes it easier for members to comment.

crps profile image
crps in reply to shaws

T4 range 12-22, TSH range 0.3-4.2. How do u get ur TSH lowered from 3.27 to 1 or less?

shaws profile image
shawsAdministrator in reply to crps

I apologise, on re-reading your question above I realise you did give the ranges.

Your GP has to increase your levo, probably by about 25mcg till your TSH is 1 or below, or until you feel much better. Your doctor may think that because you are 'within range' that you are taking enough. If you have symptoms you are not.

crps profile image
crps in reply to shaws

Have appointment in few wks will ask her then. Thanxs

crps profile image
crps in reply to shaws

yes on thyroxin

crps profile image
crps in reply to shaws

my doctor sees nothing wrong with the TSH level and will not increase thyroxin she said she does not see need to inrease the signals from the brain unless nessassery. Not sure what she means by that.

shaws profile image
shawsAdministrator in reply to crps

If you email louise.warvill@thyroiduk.org and ask for a copy of the article by Dr Toft ex of the British Thyroid Association and question 6 highlight for your GP.

This is an extract

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.

helvella profile image
helvellaAdministratorThyroid UK

Did you take thyroxine before having blood drawn for the test?

Rod

crps profile image
crps in reply to helvella

I did, i never thought of that. ill withhold it the next time. That will be a while since last test only done in feb

Clarebear profile image
Clarebear

Your exults definitely show room for an increase. Most people fell well when their FT4 is at the top of the range I.e 22, yours is only 14.3. Increasing your dose of thyroxine will bring your TSH down. What dose are you on at the moment? Xx

crps profile image
crps in reply to Clarebear

25 mg i was on 50 mg and was reduced and that didnt help

Butterfly_79 profile image
Butterfly_79

Does increasing the thyroxine increase the ft4 , mines dropped again from 15 to 9 but tsh is 1?

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